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Permit CITYOFTIGARD DEVELOPMENT ELECTRICAL PERMIT , m�m��u�n���w owon�o�o SERVICES PERMIT #::- ELC96-0705 13125 S0y Hall �hui Y��r������� /�3)������ - Tigard, ` - DATE ISSUED:.`11104/96. . • PARCEL:i 2S1 SITE ADDRESS.. 12323.SW66TH•AVE`. ' � � • ` . SUBDIVISIQN.; . WEST PQRTLANDrHE IBHTS� ��.^,� '.-�- ZONING :C-G' • BLOCK ~ LOT :24 Pro ject l}escription:^adding 1 branch circuit - .. ---RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS---- MISCELLANEOUS 1000 SF OR LESS ^ 0 0 - 200 am ^ 0 PUMP/IRRIGATION ^ 0 EACH ADD'L 500SF...: 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).-/` 0 • MINOR. LABEL (10)...: 0 ----SERVICE/FEEDER_--- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS--- ' `0,`, 200- amp, 0/'•: W PER INSPECTION.' 0.. - 400 amp ^ 0 1st W/O SRVC OR FDR.: 1 PER HOUR ^ 0 401 - 600 amp... •0 EA'ADD'L BRNCH.CI 0: 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 ---- PHONE ASER4f€(1 ueVn��2/t1-1r---432---) type amount by date recpt 12323 SW 66TH AVE - - PRMT $ 35.00 TAT 11/04/96 96-286062 5PCT $ 1.75 TAT 11/04/96 96-286062 TIGARD OR 97225 ,Phone#: . - Contractor:- - ' , JPC ELECTRICAL SERVICES INC $ 36.75 TOTAL 4040 SE INTERNATIONAL WAY REQUIRED INSPECTIONS MILWAUKIE OR 97222 Ceiling Cover Elect'l Service Phone #: 503-654-3325 • Wall Cover • Elect'l Final Reg #..: 93774 This permit is issued subject to'the regulations' contained in thr; Tigard Municipal-Code, State ofOre. Specialty. Codes-and al}other. Perm i S i gnat ur 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 or�if work is suspended for more ' ' than 180 days. Issr��d By J' - ---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 for inspectionL 639-4175. , . Community Development ELECTRICAL PERMIT APPLICATION , A 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # L.-('.cib -6105 ;II Phone (503) 639 -4171 Date Issued I I It-{ FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Issued by I jUU Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development T hona nert c Number of Inspections per permit allowed Address 1 2 3 A 3 - Lt.I Co AJ'e Service included: Items Cost(ea) Sum City /State/Zip "rt Lr d ©r^ C t "7 AD- 5 4a. Residential - per unit 4 1000 sq. ft. or less $110.00 - Name (or name of business) Each additional 500 sq. fl or portion thereof $25.00 1 Commercial ® Residential ❑ Limited Energy $25.00 - Each Maned Home or Modular 2 Dwelling Service or Feeder $68.00 2a. Contractor installation only: 4t,. Services or Feeders r Installation, alteration, or relocation 2 Electrical Contractor) I C C i eC.�r; cn 1 se N t c es 200 amps or less $60.00 2 Address 41D-0 nivnic7t oela 1 kk X410 1 2 01 amps to 400 amps $80.00 2 $80. `-`� 401 amps to 600 amps $120.00 2 City M;'t4 Ink; L Statecjt� zip Gt7 y 601 amps to 1000 amps $180.00 2 Phone No. 6s4 -3 32.S Over 1000 amps or volts $340.00 2 - Contractor's License No. - ILI -31- C Reconnect only $50.00 Contractor's Board Reg. No. 093774 4c. Temporary Services or Feeders Installation, alteration, or relocation 2 2 00 amps or less Signature of Supr. EIeC'n 201 amps to 400 amps $75.00 $50.00 2 2 License No. '-f ($I 5 0. Co S 4 -3 3 25 401 amps to soo amps $100.00 Over 600 amps to 1000 volts _ 2b: • For owner installations: . - - - - ` - - - see - b - above. - . 4d. Branch Circuits Print Owner's Name New, alteration or extension per panel Address a) The fee for branch circuits with City State Zip purchase of service or feeder fee. 2 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. 2 First branch circuit I $35.00 35 -00 2 not intended for sale, lease or rent. Each additional 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 $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: NOTICE 5a. Enter total of above fees $ 36-0 c) 5% Surcharge (.05 X total fees) $ 1 7 rT 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 T ANY TIME AFTER WORK IS Subtotal $ A COMMENCED. • •❑ Trust Account # $ Balance Due $ 3 (, • � 7,5 wad`conMah.Nc -prm ago CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceiling - Plumb. Post/Beam Mech. Shear /Sheath Framing -Mech. PIbg.Und /FIr /Slab Plbg. Top Out Insulation _.1211 Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: / / Date: it /11/31 % U 10 A.M. P.M. Entry: Address: Tenant: Ste: MST: BUP: Con /Own: MEC: PLM: ELC: •I/MMIQ THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: + q=P " Inspector: /. s { _ ,_1 ► Date: X APPROVED DISAPPROVED /CALL FOR REINSP. , CO