9009 SW HALL BLVD-6 • _ bMNr.iIiPM`t:.9tdrtA;4ss ,a ', �..:,,.::, ,,
FSI
W
Y
W
r
d
r
i
"09 9W MALL BLVD
�iVi,
CITY CSF TIGARD ELECTRICAL PERMIT'
PERMIT #: ELC96-0186
COMMUNITY DEVELOPMENT DEPARTMENT I SSU17 - h9/17/96
DATE _D. L
13125 SW Hall Blvd Tigard,Oregon 97223.9199 (5031639-4171
PARCEL: IS12600-01100
0 )00,,- bW iii-ii_L bLVu
SUBDIVISION. . . . : ZONING:C-G
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . ."
Project Description : Installing one signal circ,jit.
------RESIDENTIAL UNIT,.-.-.--- -----TEMP' SRVC/FELDERS----- -----MISCELLANEOUS--------
1000 SF OR LESS. . . . : 0 IZI 200 AMP. . . . . . . : 0 PUMP/IRRIGATION. . . . i
EACH ADDIL 500SF : 0 2'01 400 ramp. . . . . . . : 0 SIGN/OUT LINE LTG. . .-
LIMITED ENERGY. . . . . . 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . :
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL (10) . . . : 0
RV ICE/FEEDER----- ---ADDIL INSPECTIONS—-
0 - 20CA amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . 1 0
,_o I - 400 amp. . . . . . . 0 list- W/O SRVG OR FDR. : 0 PER HOUR. . . . . . . . . . . ! 0
401 600 amp. . . . . . : 0 EA ADDIL BRNCH C'lr(C: 0 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . : 0 RIF-VIEW
1.000+ amp/volt. . . . . : 0 >=4 RES UN!7S. . . . . . . . ) 600 VOLT NOMINAL... . :
12qronnect only. . . . . : 0 SVC/FDR > 225 AMPS. CLASS AREA/SPEC I)L(.-'. :
Owner.- FEES
1APGE1 type a m I)1.t nt by date vecpt
9009 SW HALL BLVD PRMT 40. 00 CJS 09/17/96 96--J'84171813
5PCT $ 0111
(.,JS
OR 97,2213
�Ivne #:
(Intractor:
c 11J'
YWELL 4J_'. 00 TOTAL,
,5495 SW SEUUOIA SUITE 100
REQUIRED INSVIECTIONS
0112ll-AND OR 97224 Wall Cover Elect' l Final
'i-tone #*. 51Z&S-968-3333 Elect' l Service
q #. . s 5';'824
This permit is issued subject to the regulations contained in the
Tigard Municipal Lode. State of Ore. Specialty Codes and all other Permittee Sirs- i !(re
applicable laws. All work will be done in accordanre with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suslotided for more Ia-I z:;;
than 100 days, Issi.ted By
--OWNER INSTALLATION ONLY-------
lie installation is being mode -*n. property I own which is riot intended for
;,,k I e I lease, or rent
1,01F R I S 5 1 GNA T U RE ....... DATES ..............
------- INSTALLATION ONLY----
I.GNATURE OF' SUPR. ELECI N., DATE,-
10EN1,3E NO:
Gall for inspection b.5,j—,+175
Community Development ELECTRICAL PERMIT APPLICATION
/ 1 125 SW Bali Blvd.
Tigard, OR 97223 Permit # ,ELf11Cj'I q E
Date Issued q - 1 T- Pt�-
Phone (503) 639-41/1
FAX (503) 684-7297
CITY OF TIGARD TDD No (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete 'ee Schedule Below:
Name of Development Cl 1 ' '" L= Number of Inspections per permit allowed
Address__ ��z LLL, IService included Items Cost(ea) Sum
City/StateiZlp___J- rI 2.2� _ 4a. Residential -per unit
J Tel
— �- 1000 sq. ft. or less _ $11000 _ 4
Name (or name of business) Tel Each additional 500 sq h or
portion thereof $2500
Commercial Ind Ryidential ❑ Limited Energy $2500 ^
Each Manurd Home or Modular
Dwelling Service or Feeder $6800
2a. Contractor installation only:
4b. Services or Feeders
Installation,alteration,w relocation
Electrical Contractor c- zoo amp,or to+s $60 00 _
Addre 5 5' Ste_ �n 201 amps to 400 amps -- $80 00 _�
City C _ St Zlp 2 401 amps to 600 amps $120 00 z
601 amps to 1000 amps $18000 2
G —
Phone No._ 33� _- _ Over 1000 amps or volts $34000
Job NO. Reconnect only $5000
contractor's license NO._, .jjG L[= 4c. Temporary Services or Feeders
Contractor's Board Reg. N - 1 �� .—_ Installation,alterabon,or relocation I
Signature of Supr Elec'n �—r----- 200 amps or lett
— zu1 amps',a 400 amps $50 00 2
License No.-?j�(J-L_� Phone Nd '`f[`g {� I 401 amps to 80N amps $75,00
-- 2
Over ago amps to 1000 volts $10000
2h. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Name _ New aaeration or extension per pane
Address 'T a)The fee for branch circults with
City_ StateZip. I purchase or service or reader fee.
Each branch circuit $500
Phone NO. _ b)The fee for branch circults without
The Installation is being made on property I own which is + purchase of service or feeder foe
not intended for sale, lease or rent. I First branch circuit $3500 _
Fach additional branch circuit $5.00
Owner's Sig.ature __ 4e Miscellaneous
(Service or feeder not Included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4000 2
Each sign or outline lighting $4000
Signal circult(s)or a limited energy 2
Please check appropriate Item and enter fee in 9e0on 5B. panel alteration or extension $4000
4 or more residential unfts in one structure Minor Labels(10) $10000 _
Service and feeder 22.5 amps or more
System over 600 volts nominal 4f. Each additional Inspection over
Classified area or strurture containing special occupancy the allowable in any of the above
as described in N E C Chapter 5 Per nspecunn $3500
Per hour $5500
In Plont $5500 i
Submit 2 sets of plans with application where any of the above
apply. Nnt required for temporary construction services. 5. Fees:
5a. Enter total of above feed $ �,O e D
NO"1"ICE 5%Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal q _`
AU rI ORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR it 5b Enter 25%of ..ie A for
CONSTRUCTION OR WORK IS SUSPENDED OR ^RANDnNED FOR Plan Review if required (Ser 3) $
A PER100 OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ T_
COMMENCED. Trust Account #
mm err
)'glance Due
�
m m m m m m m
a
j \ -4 \ \ \\ k w
R 8 / @ 2 ° & ~ Q
2 ± m m / f o � /
\ $ R % / } \ f k
\ \ / { \ 2 { \ 2
. } ( I / q
\
q ) ) E
�
n
�
m �
$
} \
( \ }
2 �
/ � g
Oto m
\ k
RR E C
X m G ]
2 0
�
$ $ m 6
q g f / o
�
�
cr)
r �
$ [
c
J co pR 2 / CD
G U a y = cn m � &
cl
\
{ 9 k \
2B �
& f fg(/ E
� .#Bk
§ � kƒ)
\%% }f
7E ®
)
\ } � $
). 7