Permit �
~--' ELECTRICAL PERMIT / �
��
PERMIT #: ELC96-0448
DATE ISSUED: 07/26/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 9722308199 (503) 639-4171 PARCEL: 28113AD-01700
SITE ADDRESS...: 16920 SW 72ND AVE
SUBDIVISION ^ ROSEWOOD ACRE TRACTS ' ZONING:C—G
BLOCK ^ LOT ^30 '
Project Description: Permit for partial electrical w/ one 800 amp service and 2
circuits
for AC — Mike to do plan review, plans not complete.
------------ --• — -----
---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......: 2 W/SERVICE OR FEEDER: 10 PER INSPECTION : 0
201 — 400 amp ^ 0 1st W/O 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..:
O'' Reconnect only ^ 0 SVC/FDR >= 225 AMPS..:X CLASS AREA/SPEC OCC.:
Owner: ---- — — FEES -----
BORDERS BOOKS type amount by date recpt
16920 SW 72ND STREET PRMT $ 350.00 JSD 07/26/96 96-282184
PLCK $ 87.50 JMH 07/11/96 96281477
TIGARD OR 97224 5PCT $. 17.50 JSD 07/26/96 96-282184
Phone #: 224-2676
Contractor: — — --- --- --
VIKING ELECTRIC INC $ 455.00 TOTAL
4326 SE WOODSTOCK STE 518
------- REQUIRED INSPECTIONS -------
PORTLAND OR 97206 Ceiling Cover Elect'l Ser'ice
Phone #: 775-3479 Wall Cover Elect'l Fi l
Reg #..: 056527
� � I r ��\ \�/
This permit is issued subject to the regulations contained in the � -" \-
Tigard Municipal Code, State of Oro. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with '
approved plans. This permit will expire if work is not started ^
���
within 188 days of issuance, or if work is suspended for more �N�N���� ` '~-
than 180 days. I -. sued 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
" , Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. '/� ' r/8
Tigard, OR 97223 Permit .# / 4
p Date Issued
�
�� 1i Phone (503) 639 -4171 �J
FAX (503) 684 -7297 S'h e lf ,p .1.‘,f___ G 4 -77, -3/'71
CITY OF TIGARD TDD No. (503) 684 -2772 " "7/
Inspection (503) 639 -4175 yuitLkta q Amity (. - 07-13 -' gio--1-
1. Job Address: 4. Co plete gee Schedule Below:
�■ _
Name of Development_ / 1 re C e- d Number of Inspections per permit allowed
Address J[�,' ( / 5 ) , 7 .Z Service included: Items Cost(ea) Sum
City /State /Zfp t -. I F- 4a. Residential - per unit
1 1000 sq. ft. or less $110.00 4
Name (or name of business) j) , c t, iti f ( `c ..13r )-S Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial Residential El Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
-
2a. Contractor installation only:
4b. Services or Feeders
c ` Installation, alteration, or relocation
Electrical C e ntractor ' a i _ G 200 amps or less 2. $60.00 / ,:,Zd - 2
Address _ - 1 . "_. 201 amps to 400 amps $80.00 2
� 401 amps to 600 amps $120.00 2
City
• .` State er Zip 7 7., 601 amps to 1000amps ] i $180.00 _ =- 2
-'� �j
Phone No. 7 3 (i . $340.00 7 Over 1000 amps or volts $50.00 2 '
Job NO. Reconnect only
contractor's license NO. ).4s '', C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Installation, alteration, or relocation 2
Signature of Supr. Elec'n . f A TN . 200 amps or less 2
License No. Phone No. - 3 79 201 amps to 400 amps $50.00
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
purchase of service or feeder fee. 2
City State Zip Each branch circuit /G) $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35.00 2
not intended for safe, lease or rent. Each additional branch circuit $5.00
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
X 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
Chapter 5 Per inspection $35.00
as described in N.E.C. Cha
P 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 $ JJ 0. CO
NOTICE 5% Surcharge (.05 X total fees) $ -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 67 .
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) $ ?7-5D
Subtotal
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS $ 9-55, on
COMMENCED. wordicomdev,eJeo l u AL'eeem � 2g i $ -66.37
prm.aPP L 3 / l 3
Balance Due $