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Permit • � ELECTRICAL PERMIT ' PERMIT #: ELC96-0115 OF � /96 ' � DATE ISSUED: 0 / ' . COMMUNITY DEVELOPMENT DEPARTMENT � � • PARCEL: 1S136DD-00801: 13125 SW Hall Blvd. 71 . SITE ADDRESS...: 11565 SW 6/|!1 AVE • SUBDIVISION....:' WEST PORTLAND HEIGHTS • ` ZONING:C—P BLOCK..........� ' ` LOT.............�3 Project Description: Mercer office, bldg — temp svc ---RESIDENT1AL • ---TEMP SRVC/FEEDERS---- ----_MISCELLANEOUS----- 1000 S. OR LESS....: 0 0 — 1 PUMP/IRRIGATION.....: 0 EArH'ADD'L 500SF... 0 201 — 4N0amp.......: 0 SIGN/OUT LDNE LTG..: 0 LIMITED ENERGY � . . . : 0 401 — 600 amp. . . ... . : 0 8IGNAL/PANEL. . . . . . . : 0 MANE. HM/ SVC/FDR...; 0 601+amps-1000 volts.: 0 MINOR LABEL ( 10}. . . : 0 ----SERVICE/FEEDER---- • ----BRANCH CIRCUITS- --_ADD INSPECTIONS--- 0 — 200 amp. , . . . . : 0 'W/SERVICE OR FEEDER: 0 PER INSPECTION,, . . .,i 0 , 201 — 400 amp......: 0 1st W/0 SRVC OR FDR. : 0 PER HOUR...........: 0 401 — 600 amp. . . . . : 0 EA .ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601 1000 m 0 PLAN REVIEW SECTION —7-------------- _ a p.�...� —_--------------_ —�-------- ----- 1000+ amp/*Olt. .`. . . : 0 >=4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL..: Reconnect only..,..: 0 SVC/FDR )= 225 AMPS..: CLASS AREA/SPEC OC[.: Owner: FEES ---�-- ----- �MERCER, ROSS & VICKI type � amoln�t by date recpt . 11535 SW 67TH ` PRMT $ • 50.00 JSD 02/23/96 96-276235 • 5PCT $ 2.50 JSD 02/23/96 96-2�6235 ' TIGARDOR 97223 Phone #: 620-6 . -- Contractor: _------- ------�-------�--- -------_ --_------------ GENIE ELECTRIC CONSTRUCTION . 52.50 TOTAL 20395 SW AVERY _ PO BOX 575 ------ REQUIRED INSPECTIONS. •HERWOOD OR 97140 Elect'l Service Phone #: • Elect'1 Final Reg # ..: / This �mit is issued subject tv the regulations contained in the ' ��� _ Tigard Municipal Code, State of Ore. Specialty Codes and all other { Permittee Signature applicable }am. Ali work will be done in accordance with approved plans. This pernit will expire if work is not started �� within 180 days of issuance or if work is suspended for uore wm�°� r than 1 days. ` 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: • -------_----------------CO�TRACTOR INSTALLATION ONLY -------------�-------- SIGNATUNE �OF SUPR. ELEC'N: _ �_ DATE: • • •LICENSE NO: ' ' Call for inspection — 639-4175 • • • ' � � • if z ... • • . Community Development ELECTRICAL PERMIT APPLICATION 1�7 �' (7 / rO � / S� Tigard, OR 97223 Permit # c-- / CP I 13125 SW Hall Blvd. I Date Issued oce el I P hone (503) 639 -4171 - CITY OF TIGARD FAX (503) 684 -7297 TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: ! 4. Complete Fee Schedule Below: Name of Develo nyent In I-G e b- °heI cc, i f Number of Inspections per permit allowed Address //, S5' S a -7 J/ 4 d' e, Service included: Items Cost(ea) Sum City /State /Zip �� at (9 - Ng 7� •.� 4a. Residential - per unit J 1000 sq. ft. or less $110.00 4 Name (or name of business) Ill cp-c ei^ Each additional 500 sq. ft. or portion thereof $25.00 Commercial XI Residential ❑ Limited Energy $25.00 Each Manufd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders F` ' Installation, alteration, or relocation Electrical Contractor tic./ t a e{ec��r.C% C© t,s • lir e 200 amps or less 560.00 2 Address PO, ,Bcx 5-7J 201 amps to 400 amps $80.00 2 401 amps to 600 amps $120.00 2 City Sfiei w oc� rl State Cv- Zip s' 7140 601 amps to 1000 amps $180.00 2 Phone No..3 /- 810 Over 1000 amps or volts 5340.00 2 Job NO. 2 6,92.. Reconnect only $50.00 2 Contractor's license NO. " 4c. Temporary Services or Feeders �y Contractor's Board Reg. No 3 Installation, alteration, or relocation 7r �`^/� g� 2 Signature of Supr. Elec'n L'n 200 amps or less 1 U C 1_ 2 - P 201 amps to 400 amps $50.00 License No. /34 !F S Phone No. 6� '/ �390J 401 amps to 600 amps (($75.1)0'' 2 Over 600 amps to 1000 volts $100.00 il . 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 City State Zip purchase of service or feeder fee. 2 Each branch circuit 55.00 Phone No. b) The fee for branch circuits withou The installation is being made on property I own which is purchase of service or feeder fee. 2 Ea a additional not intended for sale, lease or rent. Eat ddch n a l b $35.00 branch circuit $5.00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or irrigation circle 540.00 , 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: 5a. Enter total of above fees $ C NOTICE 5% Surcharge (.05 X total fees) $ O PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reevivi ew if required (Sec.3) $ • A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. wordkomdeNeIeo- ❑ Trust Account # prmapp Balance Due $ . 4 , S� ; • CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: ..641fi. 1 I I ' ' 11 ;A i Footing Susp. Cei ing Sprink. Rough Appr /Sdwlk Foundation Plbg. Underslab Mech. Rough -in Fireplace Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL: Post /Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing - Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. - Elect. Date Requested: -2 --j 2. (e (9c Time: AM PM Address: / / SCE S b 7 Builder:. Permit #: - O( /S THE FOLLOWING CORRECTIONS ARE REQUIRED: � 6 q 6 • I Spector: iro-A Date: a----D APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE _ Call For Reinsp. C.---• F- CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Servi -' FINAL: Foundation Water Line Ceiling - Plumb. Post/Beam Mech. Shear /Sheath Framing -Mech. PIbg.Und /FIr /Slab Plbg. Top Out Insulation . - Elect. Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk .Reins. Other: J Date: 51/ 1 9 A.M. _ P.M. Entry: Address: - 0 &Nag Tenant: Ste: MST: G9 /- 4'/'-L3 . ' �•. Con /Own: r YI.,C� : �VIEC: PL ELC: M: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: / , » c m fr & r c/' ( e , . -e r ' r 0" 1 �-F' c7( Nill c..-i 6 it. cc---, ? � ' rte. ��✓ - AI - ' - . z 1 .,a _ .eL ► �� • — J cL �' !' ` ; !✓l `P . Inspector: ��G'� ,t C `cr . e( / Le cif),,,( Da te: `� �, APPROVED DISAPPROVED /CALL FOR REINSP. CF CO