Permit CITY OF T' GA R®
4.000,1 DEVELOPMENT SERVICES 9 - PE RMIT #: CAL PE 0 0 T
DATE ISSUED: 2/15/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639- 1 ELECTRICAL PERMIT
/� PARCEL: 1S135DB-04800
SITE ADDRESS: 11465 SW 92ND AVE 4144
SUBDIVISION: DOGWOOD RIDGE ZONING: R -4.5
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Replacement of service panel. Job No. 3030 -45.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
•
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
STRONG, THOMAS L AND ROXANN S PHOENIX ELECTRIC CO
11465 SW 92ND AVE 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 2/15/00 $64.25 00- 321725 Elect'I Final
•
5PCT DEB 2/15/00 $5.14 00- 321725
Total $69.39
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 . . 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow r - adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obt copies of these rules or direct questions to OUNC at (503)
246 -1987.
•
PERMITTEE'S SIGNATURE f Ar . I • UED 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. LEC'N:r? ,--6 DATE:
LICENSE NO: 4 / 7 / '
Call 639 -4175 by 7:00pm for an inspection the next business day
FEB -15 -00 TUE 02:39 PM PHOENIX ELECTRIC CO FAX NO, 15036843611 P, 02/02
C!i'Y OF TIGARD Electrical Permit Application R��d t'
13125 SW HAL BLVD.
Date Rec'd o2 _/J
TIGARD OR 97223 Date to P.E,
Phone (503) 639 -4171, x304 Data to DST --------
Inspection (503) 639 -4175 Print of Type Permit # e-/,CMiD
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below: •
Name of DevetopmentY �� 6Wh \1 ).0 -\� S iy C i - Number of Inspections per permit allowed
Name (or name of business) � 1I Service included: Items Cost Sum J•
Address \\ - t 0,.5 ¶i t ') Cr „ 1 t^, -" c - 43. Residential - per unit
City /State /Zip \ , 4 C .r Cdr' .. I 1 -)-_ 7000 sq, fl, or less ,� $ 117.75 4
Each ad 500 sq. ft. or
portion Thereof 5 26.25 1
Commercial Reside al Li mited Energy $ 60,00
Each Manufd Home or Modular
cn*10 ' Q, '° - ` - Dwelling Service or Feeder _ $ 72.75 2
2a. t ont ~ r a a C tor instal only:
(Prior to permit Issuance, applicants must provide contractor license 4b, Services or Feeders
information for COT data ase), • Installation. alteration, or relocation
Electrical Contractor - -- \ _l F 4 Y e) 200 amps or less 1 $ 64.25 (4..;..)- 2
201 amps to 400 amps $ 85.50 2
Address 0 1 c:4- c E' -r a� `
j t - - -C (� -
401 amps to 600 amps S 128,50 2
City u .' State Olvt. _ Zip ' ,) . , 601 amps to 1000 amps $ 192 50 2
Phone No. • ' - ` Ove 1000 amps or volts 5 363,75 -. 2
Job No F-1)?-,0 `q-S- Reconnect only $ 53.50 ^ 2
Elec. Cont. Lice, No. -- C Exp.Date bc. Temporary Services or Feeders
OR State CCB Reg. No. `'a' ' Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. , ^I Exp.Date 200 amps or less $ 53.50 - 2
201 amps to 400 amps $ 80.25 • 2
�
t '' A� 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n J Over 600 amps to 1000 volts,
C � soo "b" above.
License No._ `/ �J Exp.Date
Phone No Le?.6 1' A C -Ct) 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service br
feeder fee.
Print Owner's Name Each.branch circuit $ 5.35 2
Address b) The fee for branch circuits
. • without purchase of service
City _ _ State Zip _ or feeder feo.
Phone No. First branch circuit $ 37.50
Each additional branch circuit 5 5.35
-y-
The installation is being made on property I own which is not ao. Miscellaneous
intended for sale, lease or rent, (Service or feeder not included)
Each pump or irrigation circle $ 42,75 _ ^
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section ( parL e ls (10 or extension 5 07.00
if required):* t Minor Labels (t7) 5 107.00 -_
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure . the allowable in any of the above
Per inspection 5 50.00
Service and feeder 225 amps or more
Per hour . $ 50,00
_System over 600 volts nominal In Plant $ 59.00 _-
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above foes $ (0 ( 1
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ e-. ,
Not required for temporary construction services_ Subtotal $ ,. ■ • .> •
5b. Enter 25% of line 5a for
NOTICE Plan Review if re quired (Sec. 3) $ -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal S
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS 1;SC Account# ' �- ��
AT ANY TIME AFTER WORK IS COMMENCED. oral balance Due $ .D < T J
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