Permit 1
ELECTRICAL PERMIT
OF TIGIPARD
PERMIT #: ELC96-0615
DATE ISSUED: 09/26/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd Tigard, Oregon w�ou#°m�m� (503)1339-4171
' ' PARCEL: 2S113AD-01800
SITE ADDRESS...: 16640 SW 72ND AVE #B-10
SUBDIVISION • ROSEWOOD ACRE TRACTS ZONING:I—L •
BLOCK ^ LOT ^11
Project Description: Installing three branch circuits.
_
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS-----
1000 SF OR LESS....: 0 0 — 200 amp - 0 PUMP/IRRIGATION ^ 0
EACH ADD'L 5008F...: 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-16900 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/O SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 2 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 ---
PERCISION INTERCONNECT type amount by date recpt
16640 SW 72ND AVE PRMT $ 45.00 CJS 09/26/96 96-284429
5PCT $ 2.25 CJS 09/26/96 96-284429
TI8ARD OR 97223
Phone #:
Contractor: •
STONER ELECTRIC $ 47.25 TOTAL
2701 SE 14TH
REQUIRED INSPECTIONS -------
PORTLAND OR 97224 Wall Cover Elect'l Service
Phone #: 503-233-3631 Elect'l Service
Reg #..: 44823
This permit is issued subject to the regulations contained in the �~~' .� e(5COZ --
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitteg%Signature
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 CZdrw
than \8N days. Issued By
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 INSTALLATION ONLY---- —
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO
Call for inspection — 639-4175
•
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # , LC ct G
%0� �,� Date Issued q- az- (-46- ��� �l Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: c\ 4. Complete Fee Schedule Below:
Name of Development c..c - 7c-Al s- Number of Inspections per permit allowed
Address _ [ L k Q h: `I N ` 3t,il3 - `D Service included: Items Cost(ea) Sum
City /State /Zip ' T c -c . 0 � :: k - 1 . . c 4a. Residential - per unit
(� L 1000 sq. ft. or less $110.00 4
Name (or name of business) ` c cc_`.- ,o rS74. s (Wit t Each additional 500 sq. ft. or
portion thereof $25.00
Commercial tz Residential ❑ 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
Installation, alteration, or relocation
Electrical Contractor s tJt .\ r c i� 200 amps or less $60.00 2
Address Q1 01 �k \yam' 201 amps to 400 amps $80.00 2
City �'ork1,,,N C State t Zip Zi C ( '),C) 401 amps to 600 amps $120.00 2
y x 601 amps to 1000 amps $180.00 2
Phone No. 03- a -3 - 3 e "3 1 Over 1000 amps or volts $340.00 2
Job NO. 1 r8 q C S Reconnect only $50.00 2
contractor's license NO. n1 G- IO2a7 4c. Temporary Services or Feeders
Contractor's Board Reg. No. L
• j Installation, alteration, or relocation 2
Signature of Supr. Elec'n i/� is �� 200 amps or less
201 amps to 400 amps $50.00 2
License No. /leas Pone No. _ _ 401 amps to 600 amps $ 75.00 2
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 2
City State Zip purchase of service or feeder fee.
Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
purchase of service or feeder fee. tt 2
The installation is being made on property I own which is First branch circuit $35.00 7-,S . ` 2
not intended for sale, lease or rent. Each additional branch circuit p $5.00 t, n
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 con special occupancy the allowable in any of the above
Per inspection $35.00
as described in N.E.C. Chapter 5 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
NOTICE Surcharge (.05 X total fees) $ „Z at5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ► 1, ;LS
5b. Enter 25% of line A for •
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 1 l5
COMMENCED. wordkomdeWeler. ❑ Trust Account # .-
prm.app
Balance Due $ 1-1 2 5
CITY OF TIGARD BUILDING INSPECTION NOTICE v3. !e
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: kc, Dat e: / a L l /0 A.M. P.M. /
1 ' Entry: ••
Address: / ( co G v 7 nZ ✓yri
Tenant: 't Ste: MST:
Con /Own: 4.__. BUP: MEC:
PLM
ELC: :
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
•6 (>0 i./
Inspector: // C Date: l/ —��
APPROVED DISAPPROVED/CALL FOR REINSP. 410 CO