11635 SW HALL BLVD 1
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llb35 SW HALL BOULEVARD
CITY OF TIGARDELE, :C:T'RIC:AI_ FIERIhIT
PERMIT #: ELC98-O4O5
DEVELOPMENT SERVICES DATE ISSUED: 07/20/96
13125 SW Nall Blvd., Tigard,OR 9,143 (503)639.4171
FIARCEL: 15135DD-O20O1
51 TE ADDRESS, . . : 11635 SW HALL_ PLVD #c
SUBDIVISION. . . . :MEI'Z.GER ACRE TRACTS ZONING:R-1 :
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :028 JURISDICTION: TIG
FIro j ect Descri pt i on: Alteration to residence.
-- RESIDENTIAL
UNIT-......... SRVC/FEEDERS---- --------•MISCEL.LANEOUS--.---
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMPI/I RR I GAT I ON. . . . : 0
EACH ADD' L_ 501DSF . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE 1_11'G. . : 0
LIMITED ENERGY. . . . . : 0 401. - 600 amp. . . . . . . : 0. SIGNAL/PANF-L. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 1 EO1+amps-•1000 volts. : 0 MINOR LAPEL ( 10? . . , 0
-----BRANCH CIRCUITS--•----- ---ADD' L INSPECTIONS--- -
0
NSP:CTIONS---
0 - 200 imp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER I14SPECTION. . . . . : 0
`01 - 400 amp. . . . . . : 0 lst W/O SRVC OR FDR. : 0 P,FR HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRIACH CIRC: 0 IN P,L.ANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 ------------ --- --PL_AN REVIEW SECTION-----------------
1.000+ amp/volt. . . . . : 0 >=4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMP'S. . : CLASS AREA/SPEC OCC. :
Owner: --•_______.__.___._________________________.-___._-.______-- FEES ----- -- -------
CL.ARE.NCE P'OTTS type amoLint by date recpt
11635 SW HALL BLVD #2 PRMT $ 68. 00 DL_H 07/0/98 98-3037466
TIGARD OR 97223 5PCT $ 3. 40 DLH 4+7/20/98 98-307466
Phone #:
rontractors _________________________-_---
FIARKIN ELECTRIC INC $ 71. 40 -rami_
20250 S MOLLALA AVE
------- REQUIRED INSP'ECTICINS -----
OREGON CITY OR 97045 F_lect' 1 Service
(~'hone #: 246-1301 Elect' 1 Final
Reg #. . : 000351
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes ani' all other
applicable laws. All wore will be done in accordance with approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for sore than 18N days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Jregun Utility Notification Center. Those rules -et forth in OAR 9`i? €'01-eF►IB throuqh OAR 0,5c"-N1-i987. you may obtain a copy
of these rules or direct gorstions to O11NC by calling i246-1987.
Permittee aignit.1.n e : I Issr-ied By •
------------------------------OWNER INSTALLPTION ONLY-_.-----------------.-_-
'The installation is being made on property I own which is not intended for
sale, lease, or re,,*. �/
IIWNER' S SIGNATURE i =A ^__l�L DATE:
-------------------------CONTRACTOR INSTALLATION /ONLY---------------------
SIGNATURE
--------------------SIGNATURE: OF SUPR. ELEC' N s eTi' 'q�/n�� C��/CIN � DATE:
LICENSE NOs
+++++++++++•F++++++++++++++++++++++++++++++++4•+++++++4-i•++•h .++++++++++++++++++++i
Call 6?9-4175 by 7:00 p. m. for an inspection needed the next hLlsine.ss day
+++++++++++4.++++++++++++++++++++++++++++++++++++ $-++++++++++++-t.+++++++++++++++4-+
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # __—_-
,�^ Permit # EI-r^ Z0 _—
Phone (503) 639-4171 Date Issued 772. PV _
FAX (503) 684-7297 Issued b
CITY OF TIGARD TDD No. (503) 684-2772 Y --''�
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Reluw:
Name of Development �1^1 ./�( � ^ r Number of Inspections per permit allowed —
Address L �.�J _y11�_LLlLL1 L�(J.— _ Services Inclutl±d Items Cosgoa) Sinn
City/State/Zip' 4a. P.esidential-per unit 4
�� 10008q n or lees $11000
Namu (or name o usiness) ti�l'l�/�((' / [Jr � F po add theiei 500 eq 11 or —
mon theieot E?�00 '
Commercial❑ Residential�
Limited En fd l �s 0n
7777____ Each 11 ng S Home or Modular / /!)well ng Servu:e or Feeder L f6H 00 J/rrL'1X1._
Parkin Electric, Inc. 20250 S Molalla Ave 4b.Services or Feeders
Oregon City,OR 97045 503-657-4958 fax:557-059 installation niteration,o,rplocalion
SIMI
Contractors License#: 34-4C exp 10-01-98 200 amps or less $190 00
Supervisor: 4241•S exp. 10-01-98 t/ 20, amps to 400 amps =_ 00
101 00 amps $12120 amps l0 00 00
Contractors Board Reg# 35151 exp. 10-12-98 601 amps to 1000 amps $160 00
Metro# 2416 Cap. I I-tI I ')tt Ovsr 1000 Rmps or IONS $334000
Reconnect only $5000
Owncr ��jj(U?C
4c.Temporary Services or Feeders
Installation,alleraton,or relocation r
J 200 amps or lose $50 00
Signature of Supr. Elec'n� �+ --- -
201 amps to 400 amps $75 OC
License No. _ Phnne No. 401 amps to(400 Rrnpe $10000
Over 600 amps to 1000 volts
2b. For owner ins talh,tian►: sop V above
4d. Branch Circuits
Print Owner's Name_ Nmv alteration or extension per panel
Address _—.____ a) The lee(or branch arnme with
purchase of ear rice or boder Ars.
City State Zip________ Each branch orcud $500
Phone N0. b)The lee for branch orcuds Without
The installation is being made on property I own which is purchase of service or bsdar be. 2
Flet branch circuit $3500
not intended for sale, lease or rent. Each aadetonat branch arcual $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irripallon circle L40 00 2
Each sign or outhrte lighting $4000
Signal cirouit(s)or a limned energy 2
Please check appropriate item and enter tee in section 58. panel alteration or extension $4000
4 ar more iesidential units to one structure Minor Labeia(10) $10000
_Service and feeder 225 amps or more
System over 600 volts nominal 4f Each,additional inspection over
_ the allowable in any of the shave
Classified area or structure containing special occupancy
as described in N E C Chapter 5 Per Per Hour hourInspcti°" $35 00
$5500
In PIRni $5500
3ubrnit 2 Sete of plana with application where any of the above
-ppiy. Nat required for temporery consiruction services. y. Fees:
l 5a. Enter total of above fees $
NOTICE, 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
41)
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONFD FOR Plan Review It required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account N $
Balance Due s �L�SL
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