Permit FROM : OMNI ELECTRIC PHONE NO. : 503 635 1391 Sep. 12 1995 09:23AM Pi
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # qs --c7,70 4/c ?
Permit # `Lt cis D•.190
` �� ' � °,l i: A l i Phone (503) 639 -4171 Date Issued 9- - / a - 9s
FAx (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 - 2772 Issued by �tiA� /ef S��„�,�/f
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
•
Name of Development FLIGHT DYNAMICS Number of Inspections par permit allowed
Address 16600 SW 72nd service included
ncluded: Items Cost(ea) Sum
City /State/Zip T i g a rd.. OR ' 4a • •Residential - per unit 4
t 000 sq. ft or lees S11o.00
Name (or name of business) same Each add r d 500 sq. TM• or
portion thereat 125 00 1
Commercial 611 Residential ❑ Lirrrited Direr 128.00
•Each Manufd Flame or Modular 2
Dwelling Service or Feeder 189.00
2a. Contractor installation only: 4b. service or Feeders
Electrical Contractor Omni Electric Contractors lrratellm(en.elie .erreioeation 2
2�' amps a leas aso 00 2
• Address PO Box 178 8 201 amps to 400 amps 00.00 2
City a ke Oswego State OR Zip 97035. m1 • amps +of0oarnoa $120.00 2
ty P sot amps to 1000 amps $180.00 2
Phone No. 635 -4306 Orer toaoampamvelts 1640,00 "."� 2
Contractors License No. 3 -182C Reconnect °'iy 06000 •
Contractor's Board R- • • -. • 17 ' 9 4c. Temporary Services or Feeders
I,ntaflation, alteration, or relocation 2
Signature of Supr. Elec'n 4 - °7/L.. � 200 slops et leas 550.00 2
License NO. 2345S Phone o635 -4306 Tp1 amps to 8p0 amps x,00 2
401 amps to 800 arose 1100.00
Over 800 amps to 1000 volts
2b. For owner Installations: two 'V above.
dd. Branch Circuits
Print Owner's Name New, alteration or extension per pane{
Address a) The fee for branch circuits with
City State Zip E t d " " °r feeder fee. 1;5.00 2
Phone No. b) The tee for branch circuits without
The installation is being made on property I own which is purchase al sonic* ar 1badw Am. 3S 2
not intended for sale, lease or rent. Each adddiorral branch circuit MAO Tr=
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (I! required): Each pump or irrigation circle 540.00 2
Each egn or outline lighting 1440.00
Signal circuit(s) or a limited energy 2
Please check appropriate Item and emer fee in section 5B. panel. alteration or extension 140.00
A or mom residential units in one structure Minor Labels (10) 5100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4r. 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 Impaction Sss.00 - Per hour 168.00
In Plan( 166.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction semiotics. 5. Fees:
NOTICE 5a. Enter total of above fees $ �
5% Surcharge (.05 X total fees) $ _2.25
PERMITS BECOME VOID IF WORK OR CONSTRUCTION g+btotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF 51a: Enter 25% of line A for
•
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review it required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal 5
COMMENCED. la Trust Account # $ yi889
Balance Due $ 47.25
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection: I. ice. , ,. iii. iii..
Footing 'isp. Cei�g Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. ect.
Date Requested: % g/95
Time: AM PM
Address: `4606 [, 7 ? 4 -1.e &
Builder: ,mv • (, C ya0,:7 Permit #: ,6.„5.5"" o
ZZ
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J o
/� C" < i / -37 , -1 -77� 7 4a ?
w reo iy eci .
Ins ector•� i
/ 4 e-- Date: ��1�'1�
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp. �.�
�Q 7 t, CIS