Permit CITY OF TIGARD
ELECTRICAL PERMIT
A DEVELOPMENT SERVICES DATE ISSUED: C 09/�9�98
PARCEL: 2S101DA -00104
SITE ADDRESS...:13333 SW 68TH PKWY
SUBDIVISION •GTE ZONING:MUE
BLOCK • LOT • JURISDICTION: TIG
Project Description : Alteration of electrical service.
- -- 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: 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
OREGON ELECTRIC GROUP type amount by date recpt
1010 SE 11TH PRMT $ 35.00 DLH 09/29/98 98- 309575
PORTLAND OR 97214 5PCT $ 1.75 DLH 09/29/98 98- 309575
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 36.75 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'l Service
Phone #: 234 -9900 Wall Cover Elect' 1 Final
Reg #..: 203
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. 1111 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 lib! . •y ..11i . (503)246- ' :7.
sito
Permittee Signature: /' _fAf.kJ/ ' slued By: Alha ,„,pj,.
1 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
/ ��74" /
SIGNATURE OF SUPR. ELEC' N : 0`I✓ ,9 �/L / C9"T77'( DATE: ,,
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
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. CL e_ 9d - D6 U v
Tigard, OR 97223 Permit #
, ,,� ;, �,;� Date Issued rrZ9 /7 P
1i Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 V Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Farmer' s Ins . Number of Inspections per permit allowed
Address 1 3333 SW 68th Parkway Service included: Items Cost(ea) Sum
City /State /Zip Tigard, Oregon 4a. Residential -per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) ( Gaurd Shack) Each additional 500 sq. 11. or
portion thereof $25.00 •
Commercial Residential El 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 Oregon Electric Group Installation, alteration, or relocation 2
200 amps or less
Address 1010 .S P 1 11-h 201 amps to 400 amps seo.00 2
City Portland State or_ Zip 97714 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. 234-9900 Over 1000 amps or volts $340.00 2
Job NO. 77641
Reconnect only $50.00 2
contractor's license NO. 2 6- 9 4c. Temporary Services or Feeders
Contractor's Board Reg. No. ,, Installation, alteration, or relocation
Signature of Supr. Elec'n dA_. /1 .%, : /..' 4 200 amps or less 2
201 amps to 400 amps $50.00 2
License No.2 8 41 S hone No. 714_4900 401 amps to 600 amps $ 75.00 2
Li_ Over 600 amps to 1000 volts $100.00
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
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
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. First branch circuit _y x35.00 35.00
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:
5a. Enter total of above fees $ 35 00
NOTICE 5% Surcharge (.05 X total fees) $ 1 _ 7 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ h _ 7 S
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. .«dWorncleoteleo> ❑ Trust Account #
pm.app
Balance Due $ 36.75