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Permit ,...„ CITY OF T ELECTRICAL PERMIT /4n 0 " DEVELOPMENT SERVICES PERMIT #: ELC98 -0387 �`) - ' � .. ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07/14/98 1 PARCEL: 2S1O1DA -00104 SITE ADDRESS...:13333 SW 68TH PKWY SUBDIVISION •GTE ZONING:MUE BLOCK LOT • JURISDICTION: TIG Project Description: Farmers Insurance Group TI - -- 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 • 1 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/O 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 FARMERS INSURANCE type amount by date recpt 4600 WILSHIRE BOULEVARD PRMT $ 40.00 JSD 07/14/98 98- 307320 LOS ANGELES CA 90010 5PCT $ 2.00 JSD 07/14/98 98- 307320 Phone #: Contractor: ELECTRICAL CONTRUCTION CO $ 42.00 TOTAL PO BOX 10286 REQUIRED INSPECTIONS PORTLAND OR 97296 Ceiling Cover Elect'l Service Phone #: 224 -3511 Wall Cover Elect'l Final Reg #..: 049737 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 188 days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the ru s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-881-0818 through OAR 952 -801 -1987. Y. may obtain a copy of these rules or direct questions to by cal ng ( )246 -1987. Permittee Signature: 1 Issued By: ■ �i` 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 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + ++ 07.05; 96 11:53 V503 684 7297 (ITY OF TIGARD 0002. 1102 J ©b# 78284 ( Community Development ELECTRICAL PERMIT APPLICATION C 13125 SW Hall Blvd. ! �� � $ Tigard, OR 97223 Permit # r 4 Date Issued / r h y7 . 4 � , �. , J Phone (503) 639 -417 / ai r- • FAX (503) 684 -7297 CRY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Fa rmers Grow Insurance Number of Inspections per permit allowed Address 13333 SW 68th Parkway Service included: Items Cost(ea) Sum City/State/Zip Tigard, OR 97223 4a. Residential • per u11t 1000 sq. ft er less 3110.00 4 Name (or name of business) Farmers Group Each additional 500 eq. It or portion thereat nergy 325.00 unwed E 325.00 1 Commercial ® Residential Each Maned Noma or Modular Netting 388.00 . 2a. Contractor installation only: Service 2 4b. Ser'iceS or Feeders Electrical ContractorELECTRICAL CONSTRUCTION'. CO. ‚° Installation. Marathon. or relocation ten Address P.O. BOX 10286 2 201 a or 400 340.013 0 2 amps to 400 amps 360.00 2 City PORTLAND State OR Zip 97296 4 01 amps 10 600 drops 3120.00 2 Phone No. (503) 224 -3511 501 amps to 1000 amps 3150.05 - over 1000 amps or voles - 5760.00 2 Job N0. 7828.1_ Rsaorareel only 130.00 2 contractor's license NO. 26 -45C 4c. Te Contractor's Board Reg. No.49737 _ I f Service Feeders Signature of Supr. Elec'n 200 amps or idea 2 License No. Wilk 3378S Phone No(503)22_4-3511 �� a to 2 Over 600 amps to 1000 "ma 5100.00 2b. For owner installations: am 'V above. 4d. Branch Circuits Print Owner's Name Now, Morahan or extension per tune Address a) The fie for breach coarha with City • State Zip Dive/sass of ~Wes e' reader foe. 2 Each branch circuit 55.00 Phone No. • b) The fee for bronco eaeuna without The installation is being made on property I own which is purchase or service or feeder fay. . 2 First branch circuit 335.00 2 not intended for sale, lease or rent. Each a0elaenal branch circuit 35.00 Owner's Signature 4e. Miscellaneous (Sen or feeder not included) 2 dca Each pump or Irrigation circle 340.00 2 3. Plan Review section (if required): Each elfin or outline Iynung sao.00 - Signal eircunt(s)or 0 !jetted energy 2 , Please check appropriate item and enter fee in section 5B. panel, alteration or "mansion 1 340.00 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 es described in N.E.C. Chapter 5 Per Inspection '� Pernour 355.00 In Paint 355.00 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 $ 40.00 5% Surcharge (.05 X total fees) $ 1. UU Subtotal $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION 6b. Enter 25% of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sea3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS $ COMMENCED. e.,....e..r..e ❑ Trust Account # . S hm.ror OA ( 9 _ g Balance Due $ 42.00