9675 SW MCDONALD STREET-1 I
IS PIHUOG3W MS SL96
ry '1
0
a
3
I
tn
cr
h I
o
a
O�
A `
U
t
r
i
b
R1
C
O
a
it r
�n
r
�o
�7
W
9675 SW MCDONALD ST
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: EI._C97-0:'49
13125 SW Hall Blvd, Tigard,OR 97223 (503)639.4171 DATE ISSUED: 04/24/97
PARCEL: 2S I(t2CD-02613
�31TE. ADDRESS. . . :09673 SW MC DONALD ST
SUBDIVISION. . . . :TWAL_ITY HILL ZONING:R-4. 5
FLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 13 JURISDICTION: TIG
Pr^o.ject Description: instl2branch circuits/job46883
----RESIDENTIAL UNIT----- ---TEMP' SRVC/FEEDERS----- -----M I SCELLANEDIJS-----
1000 SF OR LESS. . . . : 0 0 - 2010 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : A 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ 5Vr /FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
----SFRVICF/FEEDER------ -----BRANCH CIRCUTTS----- ---ADD' L INSPECTIONS-----
0 - 200 amp. . . . . . . 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
2:01 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADDSL BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 -- 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION----------------
1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . . > 600 VOLT NOMINAL.. . :
Reconnect only. . . . . : 0 SVC/FDR 1= 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner-: ------------------------------------------------------- FEES
VICKI NICHOLSON NICHOLSON type amount by date recpt
9675 SW MC DONALD ST PRMT $ 40. 00 TAT 02/24/97 97-293692
TIGARD OR 972224 5PCT $ 2. 00 TAT 02/24/97 97-293692
Phone #:
Contractor,: ---------------------------------------------------
JPC ELECTRICAL. SERVICES INC $ 42. 00 TOTAL
4040 SE INTERNATTONAL. WAY
------- REDU I RED INSPECTIONS ---------
MTL-WAUKIE OR 972222 Ceiling Cover Undergros.rnd Cove
Phone #: 503-654-3325 Wall Cover Elect' l 7,er,vi �-e
Reg #. . : 000937
This permit is issued subject to the regulations rontained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permite Signati e
applicable lasts. All work will be done in accordance with {�
4. approved plans. This permit will er,pire if work is not started /
p� within 180 days of issuance, or if work is suspended for more
N than 180 days. Issaed By
--_.---------_---____------------.-_.--OWNER INSTAL-LATION ONLY---- --. -.---------------------
rThe installation is being made on property I own which is not intended for
-J sale, lease, or rent.
m OWNF.R' S SIGNATURE- DATE:
LU
INSTALLATION ONL_Y---------------------------
S T GNATURE OF SUPR. FLEC' N: _. C _ DATE: �
I
L._I CENSE NO:
Call for inspection - 639-4175
rJ Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # �71--e
Phone (503) 639-4171 Date Issued _y�.�
CITY OF TIOARD FAX (503) 684-7297 Issued by _
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development VI A'i i c.h o I c,)n Number of Inspections per pormil allowed
Address Sf--'re included Items Cost(oa) Sum
City/State/Zip- !c,M A or 1_ — 4s. Residential-per unit 4
+o0c eq ft or less $11000
Name (or name of business)_ Each portion thereof rddt ere f eq n or
porol $2600 1
Commercial❑ Residential V1 l.imaad Energy (2500 _
Each ManiA'd Fbme or A/oduler ?
ravelling Saw*or Feeder -- $88 00
?.a. Contractor Installation only: 4b.Services or Feeders
�—. Inelallahon,alteration.or relocation ?
Electrical Contractor,���� �G Pc �r r cct Ja N iU s 200 amps or lase 1100 00 2
Address It t w ,�v 1 Ill/ i p ?01 amps to 400 amps 100 00 2
�--� ('fVn t�Ona 401 amps to 800 singe f1?0 00 ?
City YY), kyJA4k.f State_j( Zip eo, s,,pe,o l000amps 11+0000 ?
Phone No. (o E,U - 3 3:2.5 Over 1000 amps or Volta $,'140 00 2 i
Contractor's license No. *3neconnect only -- $5000
Contractor's Board Reg. No. )9 337, 4c. Temporary Services or Feeders
Irstallallmn alteraton,or relcr_atirn 2
Signature of Supr. Elec'n 4;� - 200 amps to leas 7500 2
Lcense No. >•1 f�l 5,; one No. to S 4-3 3��� 201 amps to 400 amps $1175 00
401 amps l0 800 singe $100 00
Over 800 amps to 1000 volts
2b. For owner Installations: see W above
4d. Branch Circuits
Print Owner's Name New,alteration or extension per panel
Addressa)The lee for bench arcurle wlfh
Zip city a State — pumhe"of WVk*or&a* riga.
7 Each branch circuit $500 _
Phone No. b)The fee for branch arcurte without
The installation is being made on property I own which is purc►N»of"wke or brads/fa. 2
First branch circuit $3500i
()U 2
:,
not intended for sale, lease or rent. Each additional brarxcircult 1 $500 _��
Owner's Signature _ 4e. Miscellaneous �—
(Service or feeder not included) 2
3. Plan Review sectlo:i (If required): Each pimp or angalwn cirde $4000 2
Each ergo or marline lighting $4000 _M
Signal circuif(s)or a Ixnaed energy
Please check appropriate item and inter fee In section SB. panel mheraton or extension SAO 00
4 or more residential units in one structure ; ..or Labels(lo) $10000
4. Service and feeder 225 amps or more
System over 600 volts nominal 41.Each additional inspection over
~ Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E C. Chapter 5 Per inspection $3500Per hen _ $5500
In Plant $5500
_I Submit 2 sets of plans with application where any of the above — —
m apply. Not required for temporary construction services. 5. Fees:
WNOTICE So. Enter total of above fees $ Yo •0 U
5%Surcharge(.05 X total fees) $ 2.0 Cl
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Sb. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. El Trust Account If $
Balance Due $ 4�,� .06
ead�oom■rWwr vim ro