Permit A. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00325
o DEVE O ) 639 -4171 DATE ISSUED: 06/14/2000
PARCEL: 2S115BA -00102
SITE ADDRESS: 16200 SW PACIFIC HWY P
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Branch Circuit
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SYSTEM CAPITAL REAL J + J ELECTRIC INC
PROPERTY CORPORATION PO BOX 813
PO BOX 66207 ALBANY, OR 97321
CHICAGO, IL 60666
Phone: Phone: 541 - 928 -7695
Reg #: SUP 3252S
LIC 00000322
ELE 22 -3C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT JMT 06/14/200C $37.50 0002936 Elect'l Final
5PCT JMT 06/14/200C $3.00 0002936
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY:
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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
01/19/00 WED 17:37 FAX 503 598 1960 CITY OF TIGARD Ij0U2
t • ^
CITY OP TIGARD • Electrical Permit AppliitiVED Plan Check d
13125 SW HALL. BLVD. Rec'd By 1/1"1.4 1
TIGARD OR 97223 • MAY 2 4 2000 • Date Rec'd
. Phone (503) 639.4171, x304 - j� Date to P.E.
Inspection (603) 639 -4176 Print of Typ� OMMUNITY D Permit D __ �j _ � � �3 as
Fax (503) 59 & EVELOPMENT - Q
1960 Incomplete or illegible will not be accepted Called s � - t'-G
• 1. Job Address: 4. Complete Fee Schedule Below: •
• Name of Development Number of Inspections per permit allowed
Name (or name of business) /i7en0.1/4405 Service included: Items Cost Sum 4.
Address /4: 541 PAciF /c i 4/ it - 1' 4a. Residential - per unit
• /State/Zi ! 972 1000 sq. ft. or less $ 117.75 4
ry p /G i / Each additional 600 sq. ft. or
• portion thereof $ 26.75 1
Commercial ® Residential ❑ Limited Energy $ 80.00
0106 a '!y Each Manufd Home or Modular
• 2a. Contractor Installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
Information for COT data base . , , Installation, alteration, or relocation
Electrical Co . f LEC re/c 200 amps or less $ 64.25 2
Address f O. ,Oy.. 13 /3 201 amps 10 400 amps _ $ 85.50 2
• City LA State Zip 97,32/ 401 amps to 800 amps $ 126.50 2
• Phone No. '// - 7� . Over 1000 ampps s or voila $ 3 383.75 2
Job No. 'jta0 _ Reconnect only $ 53.50 2
Elec. Cont. Lice. No. „12 - 3C Exp.Date /D - 0/- Do 4c. Temporary Services or Feeders
OR State CCB Reg. No. 5.2.2 Exp.Date O`/ -o.2 Installation, alteration, or relocation
COT Business Tax or Metro N .Date 200 amps or less $ 63.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. EIeC'n A 401 amps to so0 amps $ 107.00 2
Over 800 amps to 1000 volts,
License No. .3 2 . 5 Exp.Dat /O -o /- AZ see "b" above.
4d. Branch Circuits
Phone No. .52,1/- 4219- 74,95' New, alteration or extension per panel
a) The foe for branch circuits
2b. For owner Installations: with purchase of service or
feeder fee.
Print Owner's Name . Each branch circuit $ 5.35 2
• Address b The fee for branch circuits
without purchase of aervlce
• City State Zip • or feeder fee.
Phone No. First branch circuil )( $ 37.60 , 7 7
Each additional branch circuit $ 5.35
The installation Is being made on property I own which Is not 4e. Miscellaneous
Intended for sale, lease or rent (Service or feeder not included)
Each pump or InigatJon circle $ 42.75
Owner's %nature Each sign or outline lighting $ 42.75
Signal (*cuigs) or a limited energy
(if required):* •*
' panel, a e lsre 0) or extension S 60.00
3. Plan Review section
(. Q �• Minor Labels (10) $ 16::99
Please check appropriate item and enter fee In section 8B. 41. Each additional Inspection over / �' , z •
4 or more residential units i i one stnrcture the allowable In any of the above
Service and feeder 225 amps or more Per inspection $ 6o.00
Per hour $ 50.00
System over 600 volts nominal In Plant • $ 59.00 _
Classified area or structure containing special occupancy as
described In N.E.C. Chapter 6 5. Fees: •
Enter total of above fees $ 37
* Submit 2 sets of plans with appilcation'where any of the above apply. ariu Ito Surcharge (05.X total fees) $ . =' .00
Not required for temporary construction services. Subtotal ' Or $
6b. Enter 25% of line 6a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ -
• IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR I
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account a
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ yQ SQ
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JAN -19 -2000 17:42 503 598 1960 P.002