Permit CITY OF TIGARD ELECTRICAL PERMIT
„,., \ DEVELOPMENT SERVICES PERMIT #: ELC97 -0695
_41.41
L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639°4171 DATE ISSUED: 10 / 22 / 97
PARCEL: 2S112DC -00300
SITE ADDRESS.° °:15705 SW 72ND AVE
SUBDIVISION° °..:SOUTHERN PACIFIC TIGARD INDUST ZONING:I —L
BLOCK ° LOT °001 JURISDICTION: TIG
Project De scr i pt ion: Add service or feeder 601 AMPS to l 'Ai% AMPS and ten (10)
branch circuits to an existing commercial building.
- -- 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: 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 • 1 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 PLASTIC type amount by date recpt
15705 SW 72ND PRMT $ 230 °00 GEO 10/17/97 97- 300166
TIGARD OR 97224 SPCT $ 11.50 GEO 10/17/97 97- 300166
PLCK $ 57.50 GEO 10/17/97 97- 300166
Phone #:
Contract or:
CAPITOL ELECTRIC CO INC $ 299.00 TOTAL
12810 NE AIRPORT WAY
UNIT 1 REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Underground Cove
Phone #: 255 -9488 Wall Cover Elect' 1 Service
Reg #.. : 000487
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-m1-1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5 )246-1987.
Permittee Signature: /VA / 1 . C�� Issued By: / / /iiL•
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 INSTALLA ION ONLY �
( � / i
7
SIGNATURE OF SUPR. ELEC' N: /71A- P! y/1.J
DATE: -� !
1
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + F + + + + + + + + + + + + + - F + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
10/15/97 WEI) 11: Lit FAA 5U) 5)16 latfu !,111 VI 11VruU/ »i v•.�
'CITY OF TIGARD Electrical Permit Application Plan Check n
13125 SW HALL BLVD. Reed By •
TIGARD OR 97223 Date Recd 0
Date to P.E. vik7 -
Phone (503) 6394171. x304
Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit n J Li? c ?. 9J
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) � ; PhIshL. Service Included: items Cost Sum
1
Address ACT 45 w 7 2-.0d 4a. Residential - per unit
Ci /Slate/Zi 0 2.. et 7 1000 sq. f . or less - $110.00 4
tY P Each additional 500 sq. ft. or
Commercial Residential ❑ portion thereof U5.00 1
Limited Energy - $25.00
Eacn MamBd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $!38.00 2
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Cw► / �Jts /.e,c _ Installation. alteration. or relocation
Address / 2 9 /D £ 14 t d f W w 200 amps or Ina - S60.00
pet y 201 amps to 400 amps $80.00 2
ri1
City fog f /s4^ State -t" R Zi p 4 a 401 amps to 600 amps $120.00 49e
Phone No. ZS3 4 Y £S" 601 amps to 1000 amps $160.00 / 8 O. 2
Job No. 97 • 70 o - 9' 7 7/ 7 Over 1000 amps or volts ^ $340.00 2
Elec. Cont. Lice. No. 2.4 y 9 4 C Exp.Date • Reconnect only - 550.00 2
OR State CCB Reg. No. Y g 7$1 Exp.Date Jl ]]G ' 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation. alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n lit /I�� 201 amps to 400 amps 575.00 2
401 amps to 600 amps _ S100.00 2
above.
'.rtse No.� / 3 2 5 over 600 amps to 1000 volts.
ice
Exp.Date 4 e°
?hone No. 2 5 ' ygs see ^ 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The tas far branch cir:ij War
purcbaso of service or
Print Owner's Name loader fire. 0 0
Each branch circuit /-.0- 55 ..--
Address b) The lee 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 = 55.00 2
intended for sale, lease or rent -
4a Miscellaneous
(Sanrice or feeder not included)
Owner's Signature Each pump or Irrigation circle 540.00 2
Each sign or outline lighting 540.00 _ 2
3. Plan Review section (if required) :' Signal circuit(s) or a limited energy
panel, alteration or extension $10 2
Minor labels (10) 0 .
Please check appropriate Item and enter tee In section 59. '
4 or more residerdial units In one structure 4f. Each additional Inspection over
Service end feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00
Classified area or stmetUre containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant 555.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 23 G o 0
Not required for temporary construction services. 5a. Enter total of above fees $ -r 5% Surcharge (.05 X total fees) $ /
NOTICE • Subtotal $ -6
5b. Enter 25% of rin0 5a for $ S 7 $ 6
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reauired (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 ❑ Trust 41 e e
TIME AFTER WORK 15 COMMENCED. S
Total balance Due
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