Permit CITY OF TIGARD ELECTRICAL PERMIT
',I..; ,� DEVELOPMENT SERVICES PERMIT #: ELC97 -0609
I' � DATE ISSUED: 09/10/97
11 ) :. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 2S115BA -00101
SITE ADDRESS.•.:162O0 SW PACIFIC HWY #X
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTION: TIG
Pro j ect De scr i pt i on : ADD SEVENTY -SEVEN (77) BRANCH CIRCUITS TO EXISTING
COMMERCIAL BLDG.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR •
401 — 600 amp 0 EA ADD'L BRNCH CIRC: 76 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 >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
MARSHALL'S type amount by date recpt
16200 SW PACIFIC HWY PRMT $ 415.00 GEO 09/10/97 97- 299111
SUITE #X SPCT $ 20.75 GEO 09/10/97 97- 299111
TIGARD OR 97224
Phone #:
Contractor:
ROSE CITY ELECTRIC CO INC $ 435.75 TOTAL
4012 NE CULLY BLVD
REQUIRED INSPECTIONS
PORTLAND OR 97213 Ceiling Cover Underground Cove
Phone #: 287 -6164 Wall Cover Elect'1 Service
Reg #..: 000035
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work 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 more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -8010 through OAR 952- 001 -1987. You lay obtain a copy
of these rules or direct questions to OUNC by calling ( )246 -1987. /oet,
Permittee Signature: Issued By* 4 41-7
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : Lam/ DATE: v7 9 �r"
LICENSE NO : 4 7
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # t.G. f l 7 - 0 &e �� ��
Date Issued
,�
,.l II Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: � c 4. Complete Fee Schedule Below:
Name of Development ► V /� lCU j "SJ Number of Inspections per permit allowed
ii Q� '1 D
Address 1L O s -Lk) Qu, (7ktA J
, i.e Service included: Items Cost(ea) Sum
City /State /Zip l l( ` q 1 !' - 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or n e of slness) Each additional 500 sq. ft. or
portion thereof $25.00
Commercia Residential 111 Limited Energy $25.00 1
Each Manutd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contracto Al l�J� 200 amps or less $ 60 . 00 2
- u u ` � ,_
Addre • / ∎ 201 amps to 400 amps $80.00 2
City AS� /�T& State lob" _ 2 401 amps to 600 amps $ .
$120.00 2
Phone No.g - 7 Ca I 601 amps to 1000 amps
n2 Over 1000 amps or volts $340.00 2
Job NO. I JI, Reconnect only $50.00 2
contractor's license NO. f.--t.D < < 3C_...-- 4c. Temporary Services or Feeders
Contractor's Board Reg. No. ii / Installation, alteration, or relocation
Signature of Supr. Elec' f x±'41: "V- -L /..-/ 200 amps or less 2
License No. 2_L L' 7 , Phone No. 7 (, / (a Y 201 amps to 400 amp $50.00 2
/ 401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. / �y /
not intended for sale, lease or rent. � 2
First additional branch $$5.00 �v
Each additional branch circuit 7/ $5.00 � )
Owner's Signature 4e. Miscellaneous T� J tl �`
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. 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 $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: /[ S(X)
5a. Enter total of above fees $ �T I� i
NOTICE 5% Surcharge (.05 X total fees) ' $ ___,:;__13
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. 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. wmTCOmdevwNec- ❑ Trust Account #
$
prm.epp
Balance Due $ 43 •7
•
6/30/99 Activities for Case #: ELC97 -00609
4:42:19 PM .
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 9/10/97 GEO RECD GEO 9/10/97
ELCC003 Permit created 9/10/97. GEO PASS GEO 9/10/97
ELCC700 Ceiling Cover 9/10/97 10/22/97 MJR PART J'H 10/23/97 Electrical ceiling cover
, • approved except for west end of
space. Low voltage permits and
installation needed.
ELCC720 Wall Cover 9/10/97 1016/97 MJR PART J *H 10/9/97 Wall cover approved for north
and rear area. Columns need
inspection after repair.
Underfloor cover approved.
ELCC799 Elect'I Final 9/10/97 11/12/97 MJR PASS MJR 11/12/97
ELCC500 (F)Issue permit 9/10/97 GEO PASS GEO 9/10/97
ELCC720 Wall Cover 10/8/97 MJR PASS J'H 10/13/97 Column cover approved.
ELCC700 Ceiling Cover 10/28/97 MJR PASS J *H 11/6/97 ELECTRICAL CEILING
COVER APPROVED.
ELCC800 Case Finaled 11/12/97 MJT PASS MJR 11/12/97
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