Permit CITY OF TIGARD ELECTRICAL PERMIT
�.A, . DEVELOPMENT SERVICES PERMIT #: ELC97 -0766
M;1fj DATE ISSUED: 11/19/97
!�+� - - � .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 D
PARCEL: 2S101DA -00101
SITE ADDRESS...:13190 SW 68TH PKWY ` T
1�
SUBDIVISION :TRIANGLE CORPORATE PARK ZONING:C —P
BLOCK LOT •003 JURISDICTION: TIG
Project Description : Installing a permanent 22 sq. ft. wall sign
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 1
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.: 0 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 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
GERDING /EDLEN DEVELOPMENT type amount by date recpt
4650 SW MACADAM AVE PRMT $ 40.00 GEO 11/17/97 97- 301002
STE 200 5PCT $ 2.00 GEO 11/17/97 97- 301002
PORTLAND OR 97201
Phone #:
Contractor:
HEATH SIGNS * *DUPE ** $ 42.00 TOTAL
HEATH NORTHWEST, YAKIMA
PO BOX 9608 REQUIRED INSPECTIONS
YAKIMA WA 98909 Ceiling Cover Elect'1 Service
Phone #: 232 -2620 Wall Cover Elect'l Final
Reg #..: 000642
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 952-881 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OIJNC by calling (503)246 -1987.
Permittee Signature: I1ar` Issued By: 1",
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 : 4/A A %o it / 0 — L - DATE: ! 1- 11 " q/
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Cd
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. q �{
Tigard, OR 97223 ermit # 1 1 '� l (_ J
,�� ate Issued M - 0/(,6
t"v�t Phone (503) 639 -4171
'` L " '' FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Triangle Corp Prk Number of Inspections per permit allowed
Address 1319 0 SW 6 8th Parkway Service included: Items Cost(ea) Sum
City /State /Zip Tigard OR 9 7 2 2 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business)U. of Phoenix Each additional 500 sq. ft. or $25.00
portion thereof
Commercial ® Residential 111 Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor Heath Signs
Installation, or es 0 alteration, $60.0
200 amps or less 2
Address 4 6 4 4 SE 17th Ave 201 amps to 400 amps $80.00 2
City Portland State OR Zip 97 20 2 401 amps to 600 amps $120.00 2
City 601 amps to 1000 amps $180.00 2
Phone No. 2 3 2-2 6 2 0 Over 1000 amps or volts $340.00 2
Job NO. 5 6 8 8-1-1 Reconnect only $50.00 2
contractor's license NO. 37 -45 cls 4c. Temporary Services or Feeders
Contractor's Board Reg. No. • 4 2 6 3 / Installation, alteration, or relocation
Signature of Supr. Elec'n / _.Piff��� 200 amps or less 2
License No. 3 6 6 s ig Phone No. 2 3 2- a 201 amps to 400 amps 550.00 2
401 amps to 600 amps 575.00 2
Over 600 amps to 1000 volts 5100.00
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 2
purchase of service or feeder fee.
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits Willow
-
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35.00
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 _4_14 $40.00 4 0 _ f) 0)
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) 5100.00
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 555.00
In Plant 555.00
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
NOTICE Surcharge (.05 X total fees) $ ^
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter ev i 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. wcrd\comdev,eleo- ❑ Trust Account #
prm.app
Balance Due $ 4 2.0 0