Permit CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT —
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 ttlf :RESTRICTED ENERGY
",P PERMIT #: ELR98 -0191
j� DATE ISSUED: 07/24/98
RCEL: 2S114A0 -01100
SITE ADDRESS...:16285 SW 85TH
SUBDIVISION . ZONING:I —P
BLOCK • LOT • JURISDICTN: TIG
Project Description: Installation of protective signaling, job no. 24135.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM BOILER • LANDSCAPE /IRRIGAT..:
GARAGE OPENER CLOCK ° MEDICAL
HVAC • DATA /TELE COMM..: NURSE CALLS
VACUUM SYSTEM FIRE ALARM ° OUTDOOR LANDSC LITE:
OTHER: .. HVAC PROTECTIVE SIGNAL..:X
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
DURHAM HALL type amount by date recpt
16285 SW 85TH AVE PRMT $ . 40.00 DEB 07/24/98 98- 3076341
TIGARD OR 97224 5PCT $ 2.00 DEB 07/24/98 98- 3076341
Phone #:
Contractor:
HONEYWELL INC • $ • 42.00 TOTAL
15495 SW SEQUOIA
STE 100 REQUIRED INSPECTIONS
PORTLAND OR 97224 Ceiling Cover Low Voltage Insp
Phone #: 968 -3333 Wall Cover Elect'1 Final
Reg #.. 000578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the
Oregon Mil' • 'cation Center. Those rules are set forth in OAR 952181-8010 through OAR 952 -001 -0080. You may obtain copies of
these rul or direct estion to at (503)246 -1987.
Issue by . • Permittee Signature,A:2Q_ app 49
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 INST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: , Au 6..14 9/ - DATE:
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
RECEIVED
_ CITYiOF TIGARD Electrical Permit App lication Plan Chec
13125 SW HALL BLVD. J�L 2 � 1 998 Rec'd B
T Date Rec'd • 7 - af - 4t
TIGARD OR 97223
COMMUNITY D,:vl_LOPI� ;LNI Date to P.E. -------
Phone (503) 639 -4171, x 304 D ate to DST
Print or Type , o/� /
Inspection (503) 639 =4175 Incomplete or illegible will not be accepted Permit # £ t/€ 9f�
Fax (503) 684 -7297 Called
1. Job Address: // / l 4. Complete Fee Schedule Below:
Name of Development D Pharin yal r. �U s SS /
inenri - 3,CAn y 0o Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
Address 1 /4 , 2g5 S'( 85Yb Ave. Bld 0 ` ° 4a. Residential -per unit
J 1000 sq. ft. or less $110.00 4
City /State /Zip Ty and � (V' 97:22V Each additional 500 sq. ft. or
Commercial l Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all c rrent licenses 4b. Services or Feeders
Electrical Contractor onPr (vr' Installation, alteration, or relocation
S 200 amps or less $60.00 2
Addre 15 y75 S&) Se rnm u kw 0 /00 201 amps to 400 amps $80.00 2
City rnri StatE OR zio 9 72 7 / 401 amps to 600 amps $120.00 2
Phone No. .5 03 - 94 g 3300 601 amps to 1000 amps $180.00 . 2
Job No. �, 4/1.35 Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 2(0 e L EExp.Date /0/V97 Reconnect only $50.00 2
OR State CCB Reg. No.05 7 7.7. Exp.Date t .2 4c. Temporary Services or Feeders
COT Business Tax or Metro No Ex t@ / t Installation, alteration, or relocation
200 amps or less $50.00 2
Si nature of Su r. Elec'n 201 amps to 400 amps $75.00 2
.,./C- 9 P 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 9 77 F Exp.Date 10/ //97 see "b" above.
Phone No. 503 -91, A : ' 0a
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name, feeder fee.
Address Each branch circuit $5.00 2
b) The fee 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 $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required) :* Signal circuit(s) or a limited energy i $ 40 .00 Yn . (7
panel, alteration or extension 2
Minor Labels (10) $ 100 . 00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the above
`System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ q 0 . 0a
5% Surcharge (.05 X total fees) $ 2_ O a
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (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
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # ya. Oa
$
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
6/16/00 Activities for Case #: ELR98 -00191
1 :33:17 PM •
4 4 •
Assigned Hold Updated A ®
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ..
• ELRC001 Application Received 7/21/98 DEB MAIL DRA 7/24/98 e
ELRC003 Permit Created 7/24/98 DEB MEMO DRA 7/24/98 Needed to have addressing`'
corrected for site. Done by Kit •
on 7- 24 -98.
ELRC700 Ceiling Cover DRA . 7/24/98
ELRC720 Wall Cover DRA 7/24/98
ELRC725 Low Voltage Inspection 9/25/98 BRP FAIL J *H 10/7/98 EJ out for the weekend, left
message for EJ to reschedule.
ELRC799 Elect'l Final DRA 7/24/98
ELRC500 (F) Issue permit 7/24/98 DEB _ DONE DRA 7/24/98
ELRA920 Miscellaneous action 2/15/00 JMT DONE No Hold JMT 2/15/00 research inspection request
ELRC580 Expired by limitation • 6/7/00 HAP DONE No Hold AKJ 6/7/00
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