Permit CITY OF T PERMIT I #: ELC98
r� � ,�� : .: DEVELOPMENT SERVICES DATE ISSUED: 09/03/98
-- 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 PARCEL: 2S101DA - 00104
SITE ADDRESS...:13333 SW 68TH PKWY #1ST
SUBDIVISION :GTE ZONING:MUE
BLOCK LOT JURISDICTION: TIG
Project Description : Electrical TI
- -- 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 ist W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 7 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 $ 70.00 B 09/03/98 98- 308839
LOS ANGELES CA 90010 5PCT $ 3.50 B 09/03/98 98- 308839
Phone #:
Contractor:
ELECTRICAL CONTRUCTION CO $ 73.50 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 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 952-001 -0010 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling
,,. �(503)246 -1887
Permittee Signature: iVeill -_ Issued By:
OWNER INSTALLATION ONLY
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : Dvu hCw DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
07.05.96 11:53 $`503 681 7297 CITY OF TIGARD Z002:002
002
Community Developrne ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. /
Tigard, OR 97223 Permit # .1- C-rI 2-/ -
r ., , llit',. RUG 31 1998 Date Issued 9 _ 13
1 : � I Phone ( 503) 6394171 rll
! . FAX (503) 684 -R9 !lfafTY 0c'cLOPMENT
CITY OF TIGARD TDD No. (503) 684-2772 5
'.1 Inspection (503) 639 -4175 I rlo Job# 08 -71 (TN) 8 -25 -98
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Farmers Insurance Number of Inspections per permit allowed
Address 13333 SW 68th Parkway Service included: Items Cosgea) Sum
City /State/Zip Tigard, OR 4a. Residential_ - per unit
1000 sq. ft. es less 3110.00 4
Name (or name of business) Each eddIIlonel 500 aa. n. or
r` portion thereof 325.00
Commercial MC Residential Li unwed energy 525.00 1
E VA M0nuf d Home or Modular
Duelling Service er Reeder 388.00. 2
-
2a. Contractor installation only: •
4b. Services or Feeders
Electrical ContractorELECTRICAL CONSTRUCTION CO. Installefion, alleretlen. °f'e10ma1en
200 amps
er
Address P.O. BOX 10286 neo.00 2
amps to cope 380.00 2
City State OR Zip 97296 401 amps to coo amps 3120.00 2
Phone No. (503) 224 -3511 801 amps 1e 1000 amps 3!80.00 2
over loon emRs or volts 3340.00 2
Job NO. O8 -71 r Reconnect only Ss0.00 2
contractor's license NO. 26 Mg r INN 40. Temporary Services or Feeders
Contractor's Board Reg. No. M7 l7M�
Si Signature of Supr. Eiec'n Installation aheraaon, or relocation
g up Ai�� I /. ICYZAW � zoo amps er teas 2
7 201 amps to 400 mops 360.00 2
License No. : _ -___ : O • Phone NO 401 ao1 antes to coo emus 375.00
• Over 600 ranee to 1000 mica 1100.00
2b. For owner installations: (MOW Gnaw.
4d. Branch Circuits
Print Owner's Name ... alteratron er extension per Pane
Address a) The tee for branch camas with
City State Zip pureness er sarvles a lb00Sr res. 2
Phone No. Ea`h branch ctru'it 35.00
e) The tee ter branch ornate without
The installation is being made on property I own which is purchase of service or feeder fee. 2
Fbe1 watch tdreuib 1 335.0o 35.00 2
not intended for sale, lease or rent. Each eeemenal erenert owe 77 35.00 7 - flQ
Owner's Signature 4e. Miscellaneous
(Service or feeder not Inducted) 2
• 340.00 2
Each pump or trngatlon circle
3. Plan Review section (if required): Each elan or ein e+e wining 140.00
Stenal c f t(s) er a limited energy
2
Please check appropriate item and enter fee in section 513. panel. alteration or.nNnsion 340.00
4 or more residential units in one structure Minor Labels (10) 3100.00
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 PertruReawn 355.00
Per hour 355.00
In Plant 355.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE sa Enter total of ebove fees $ 70.00
5% Surcharge (.05 X total fges) $ 3.50
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
6b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec 3)
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR subtotal $
$
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. - .i..a......n.o ❑ Trust Account # S
r .ror
Balance Due $ 73.50