Permit CITY OF 1'IGARD ELECTRICAL PERMIT
n , DEVELOPMENT SERVICES PERMIT #: ELC98 -0485
. i,,,a �1( DATE ISSUED: 08 / i 2 / 98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S101DA -00104
SITE ADDRESS...: 13333 SW 68TH PKWY
SUBDIVISION •GTE ZONING:MUE
BLOCK • LOT • JURISDICTION: TIG
Project Description: Addition of branch circuits. Job No. 77855.
- -- 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..: 0
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.: 1 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 2 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 $ 45.00 DLH 08/12/98 98- 308207
LOS ANGELES CA 90010 5PCT $ 2.25 DLH 08/12/98 98- 308207
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 47.25 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'l Service
Phone #: 234 -9900 Wall Cover Elect'l Final
Reg #..: 203
This peruit 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 peruit will expire if work is not started within 1:%
days of issuance, or if work is suspended for more than 1: 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- 081-018 through OAR 952 -0®1 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (583)246 -1987.
Permittee Signature: /M/LE Issued By: /[( 4
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent. /
OWNER'S SIGNATURE: //"//9- DATE:
CONTRACTOR INSTALLATION ONLY �/
SIGNATURE OF SUPR. ELEC'N: D/1l /9'/�/ 740 / DATE: a/42/�"
LICENSE NO: jjj
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
"" Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 RECEIVED Permit # ��c . yes
A ir ,; i
Date Issu ��' ,' „�
I Phone •
(503) 639 -4 il7
FAX (503) 684..7 1 2 1998
CITY OF TIOARD TDD No. (503) U'T75 j
Inspection (503) DEVELOPMENT
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Farmers Insurance Number of Inspections per permit allowed
Address 1 3333 SW 68th Parkway Service included: Items Cost(ea) Sum
City /State /Zip T i gard, Or . 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) Farmers Ins. Each additional 500 sq. ft. or
��,, " portion thereof 825.00
,
Commercial `L`J Residential ❑ Limited Energy 825.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor Oregon Electric Group 1 01 0 S E 1 1 t h Installat ,or relocation
20 amp to 400 amps $60.00 00 2
Address 660.00 2
City Portland Or. State Zip 97714 401 amps to 600 amps 81 2 2 0.0 00 2
6 01 amps to 1000 amps
Phone No.? 3 4 - 9 9 0 0 Over 1000 amps or volts $340.00 2
Job NO. 77Q55
Reconnect only mom 00 2
contractor's license NO.2 6- 95C i / - 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 2 0weir, Installation, alteration, or relocation
Signature of Supr. Elec'n / 4,,,,A 200 amps or less 2
License No. 2 8 41 S - one No. 2 3 4 - 9 9 0 0 201 amps to 400 amps 650.00
401 amps to 600 amps 875.00 2
Over 600 amps to 1000 volts 8100.00
2b. For owner installations: gee "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip 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
not intended for sale, lease or rent. Firs bit 1 5$5.00 3 5.0 0
Eaacc h a additionnal al branch circuit �- 85.00
Owners 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 circuits) 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 655.00
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 $ 4 5.0 0
NOTICE 5% Surcharge (.05 X total fees) $ 2. 2 b
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 47 . 2 5
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
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. F El Trust Account # $
p...0"
Balance Due $ 4 7. 2 5
/2 a, 9P 0309- -