Permit ■
�� CITYOFTIGARD
,s, h,., ,, DEVELOPMENT SERVICES ELECTRICAL PERMIT
� � 11 PERMIT # : ELC96 -0727
1 3125 SW HaII Blvd., Tigard, 0R 97223 (503)639.4.171 DATE ISSUED: 11 / 15 / 96
PARCEL: 2S112DC -00300
SITE ADDRESS...: 15705 SW 72ND AVE
SUBDIVISION • SP TIGARD INDUSTRIAL PART. ZONING:I —L
BLOCK • LOT •1
Project Description: ADD SERVICE FEEDER & 10 BRANCH CIRCUITS
- 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: 10 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
TETRA WEST NIKE ATE type amount by date recpt
15705 SW 72ND PRMT $ 110.00 TAT 11/15/96 96- 286560
5PCT $ 5.50 TAT 11/15/96 96- 286560
TIGARD OR 97224
Phone #:
Contractor:
ELECTRICAL CONTRUCTION CO $ 115.50 TOTAL
PO BOX 10286
REQUIRED INSPECTIONS
PORTLAND OR 97296 Ceiling Cover Underground Cove
Phone #: 503 - 244 -3511 Wall Cover Elect'l Service
Reg #..: 49737
This permit is issued subject to the regulations contained in the A
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e i gnat ure
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 4 L A _IL,. . �./1 ,-
t 180 days. Issued By /
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 for inspection 639 -4175
V/05./96 11:53 72513 684 7297 (IT1 OF TIGARD 0902.'112
- ' Community Development ELECTRICAL PERMIT APPLICATION
13125
T
Tigard, OR a 97223 Permit # _ �L -91)--1-12-7------
r ...,r r, ; 1 i , ; , Date Issued
1 Phone (503) 639 -4171 .
.4 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 Tetra West Nike ATE Number of Inspections per permit allowed
Address 15705 SW 72nd Service included: Items Cost(ea) Sum
City /State /Zip Tigard, OR 48. Residential - per unit
1000 sq. R. or Jess 5110.00 4
Name (or name of business) Nike Each eddhlonal 500 sq. n. or
portion thereof 525.00
Commercial ® Residential ❑ Lifted E+ergr 323 1 - Each Manufd Home or Modular
Dwelling Serviaa nr Feeder 588.00. 2
2a. Contractor installation only: 4b. Services or Feeders -
Electrical Contractor Electrical Construction Co. Installation. afereUcn. or relocation 2
Address P.O. Box 10286 _ gm amps o 400 amps 1 $ .00 60 _ nQ 2
City Portland. State OR Zip 97296
401 amps 10 600 amps 5120.00 2
801 amps to 1000 amps 8180.00 -
Phone No. 224 -3511 °vet woo entpsorvolts 8340 2
Job NO. 77144 Reconnect only $50.00 2
contractor's license NO. 26 -45 _ /AM
Contractor's Board Reg. No. 4973 7.%x- 4c. Temporary Services or Feeders
Installation, ahannton, or retocatton
Signature of Supr. Elec'n lr` __ 200 amps ar rasa 2
2 01 amps to app amps 550,00 2
License No. 2986S Pho ; No.224 - 3511 2
401 amps to 600 amps 575.00
Over 600 amps to 1000 volts 5100.00
2b. For owner installations: see 'V above.
4d. Branch Circuits
Print Owner's Name stew, alteration Or extension per pane
Address _ a) The fee for branch circuits with
City State Zip purchase of vies er feeder nee. 2
aef
Each branch OW 10 moo 50.00
Phone No. b) The fee for branch eearfla without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit 535.00 2
not intended for sale, lease or rent. Each additional Meth acct u l 35.00
Owner's Signature 4e. Miscellaneous
( Service or feeder not Included) 2
3, Plan Review section (if required): Each pump or Irrigation circle 340.00 2
Eden sign or MAIMS singing 540.00
Slgnat cifevrt(s) ore limited energy 2
Please check appropriate item and enter fee in section Se. panel, efleratIon or extension 340.00
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
as described in N.E.C. Chapter 5 pe t,on $6.00
Per hour 555.00
In Plant 555.00
-
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 above fees g 110.00
5% Surcharge (.05 X total fees) $ 5.50
Subtotal $
PERMITS BECOME V010 IF WORK OR CONSTRUCTION 6b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal g 115.50
COMMENCED. - askeme„M.w ❑ Trust Account 0 S
pn,.wr
115.50
Balance Due $
RECEIVED
NOV 1 2 1996
COMMUNITY DEVELOPMENT