Permit CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PER MIT 4" ELC98 -0128
!{- '��`')� DATE ISSUED: 03/20/98
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
/�j 0 53T PARCEL: ES 112AC -01801
SITE ADDRESS... :4#496 SW 72ND AVE
SUBDIVISION •FANNO CREEK ACRE TRACTS ZONING:I —L
BLOCK LOT •047 JURISDICTION: TIG
Project Description: Install a new 200 AMP service /feeder.
- -- 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 • 1 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
MOCHA DELIGHT type amount by date recpt
14965 SW 72ND AVE PRMT $ 60.00 GEO 03/20/98 98- 304296
TIGARD OR 97224 5PCT $ 3.00 GEO 03/20/98 98- 304296
Phone #:
Contractor:
BRIDGETOWN ELECTRIC $ 63.00 TOTAL
STEENSLID & CO
2230 NE THOMPSON REQUIRED INSPECTIONS
PORTLAND OR 97212 Underground Cove Elect'l Final
Phone #: Elect'l Service
Reg #..: 103824
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 - 901 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OAS by calling (503)246 -1987. / /
�
Permittee Signature: Issued By- � J . /lii6r,
-- - �[ - -- 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 Q
SIGNATURE OF SUPR. ELEC' N : e Z7' - DATE: 7 ✓ — m e ' - 9
LICENSE NO: Ali 7-7 s
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the net business day
++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # V- -4/07K
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development e r ` tle / ; - �. Number of Inspections per permit allowed
Name (or name of business) Jl 1 G- ,��[ / • Service included: Items Cost Sum
1
Address /¢9/ J
S • id 7Z ri • 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City/St a /Zip / t�/1 f!3 4/Nt- . Each additional 500 sq. ft. or
Commercial Residential El portion thereof $25.00 1
. Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of al� ,��rren icense tOt;.504-%. sJ 4b. Services or Feeders /.
/
Electrical Contractor I d �fee d'/ t Installation, alteration, or relocatiect 7
Address 72 3 a IL. -l� ► 20201 1 amps less � $80.00 2
��� amps t to o 400 amps $80.00 2
City� -1fa 4 d _ State Zip q72,, 401 amps to 600 amps $120.00 2
Phone No. Zf3/ - 4''3°i 7 601 amps to 1000 amps $180.00 2 .
Job No. 71q R Over 1000 amps or volts $340.00 2
D '/ ' Reconnect only $50.00 2
Elec. Cont. Lice. No.lo 'k8 L Exp.Date /
OR State CCB Reg. No. /3 Exp.Date • - 4c. Temporary Services or Feeders
COT Business Tax or Metro No 4 Exp.Date Installation, alteration, or relocation
200 amps or less
Signature of Su Elec _ _ �L 2
�! _ _ _ 201 amps to 400 amps $10.0 $50.00 2
g P 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Ne � � 7 7.S Exp.Date /071/41 Over "b" above.
Phone Nr 2)3/ - 9397 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting - $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
-
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: i/ e% Cid
Not required for temporary construction services. 5a. Enter total of above fees $ lD
5% Surcharge (.05 X total fees) $ 3
,_--
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY /
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
$
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
13
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I CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 67,14
Date Requested: 3 3 J'J A.M. P.M. MST:
055 Location: ,� �� , ,D— , L / _ A/ BUP:
Tenant: E`��I,j: , /, .//! "A /Aii„;,_4. .,, Suite: Bldg: MEC:
Contractor. ; _ / Phone: 6 78-.23 / 3 PLM:
Owner: / //,, Phone: ELC: CP -0/ �--
. IiaJt) A ./+1(_/rit,• i r 0-4 'i 4-p d d ELR:
/ i I g i ' ' /, I 4 / / •. 1 J Ce ! 1. SIT:
BUILDING BLDG (con't) PLUMBING rl' CHANICAL 4 414745 11 , SITE
Site Post/Beam Post/Beam Post/Beam Sewer /Stone
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -hi UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt � / jeA f CL
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL 4 r INAL FINAL
■ 1 THIS CA— ( 00
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O can for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector. 76 Date: 3 - Q 47t 9 re ( Page of
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3'-8'
6 �h' 1' -0' 7' 1' -0' , 8 1/2' (4) - 4/i' Dia. Lift Inserts P
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3, -0' No. 2436P
Galvanized Diamond Plate Door
w/ Locking Latch
PLAN VIEW TOP PLAN
Top Not Shown, See Top Plan
OPTIONAL 18' x 18• Knockout
2' -0' Long Galvanized "C" Channel (1 Each End)
(1 Each Side)
1 th • Dia. Lift Hole 12' x 12' Knockout OPTIONAL
(1 Each Side) \ (2 Each Side) 1 -6 Long Galvanized 'C Channel
(1 Each End)
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L 1'-0 /OONAL ' I 1• -0'
Galvanized Pull / Lift Iron
6' Dia. Sump (1 Each Corner).
SECTION AA END VIEW
-- _ - - - -- --- _ -
Brian Moore '_
ffC I ANT
SCALE: 1 / 2 t n =1'-0" SERVICE DESIGN CONSULT
UTILITY VAULT' Portland General Be(
PO Box 323 Phone (503) 682-2844 For PGE Inspection 9480 SW Boeckman
Wilsonville, Oregon 97070-0323 Fax (503) 682 -265 -Call: 503/590 -1210 Wilsonville, Oregon 9
Internet: 503/570 -4406
Division of O a P IK 9.1 Brian_Moore @pgn.com Fax: 503 /570 -4420