Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00339
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DEVELOPMENT H P Tigard. ) 639 - 4171 DATE ISSUED: 6/9/99
m: PARCEL: 2S111AC -05201
SITE ADDRESS: 14820 SW 92ND AVE
SUBDIVISION: LAUNALYNDA PARK • 41 ,AN ZONING: R -4.5
BLOCK: LOT : 020 J(.1RISDICTION: TIG
Project Description: First branch circuit and one add'I branch circuit .
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
KAREN WALKER CAPITOL ELECTRIC CO INC
14820 SW 92ND 12810 NE AIRPORT WAY
TIGARD, OR 97223 UNIT 1
PORTLAND, OR 97230
Phone: Phone: 255 - 9488
Reg #: LIC 048748
SUP 3132S
ELE 26 -496C
FEES Required Inspections
Type By Date Amount Receipt Elect) Service
PRMT BON 6/9/99 $42.85 99- 316008 Elect'I Final
5PCT BON 6/9/99 $2.14 99- 316008 r ` ^� n
Total $44.99 ORIGINAL
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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 started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Permit Signature: �1� ( /( — � ���� � Issued 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: £ 1A I m,Ltcy, DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
FROM: AIRFLOW ENGINEERING TO: 2577121 JUN 4, 1999 9:32AM P.02
VIi UF:IIGAHU Electrical Permit Application Plan Chock
13125 SW HALL BLVD. RECEIVED Recd By
TIGARD OR 97223 Date Recd - -
U N 0 7 1999 Data to P.E.
Phone (503) 639 -4171, x3041 Date to DST
Inspection (503) 639 -4175 Print or Type Permit N _C14 oc c7 31
Fax (503) 684 -7297 COMMUNITY DEVEplete or Illegible will not be accepted Patted
1. Job Address: 4. Complete Fee Schedule Below:
Name Of Development__ ___ _._ - __ _ Number of Inspections per permit allowed
Name (or name off businoss) 1<itefti ki A L kit? Service Included: Items Cost Sum
Address 14 Y 70 SW 9 7 Yk -- - f 4a. Residential - per unit
1000 se- it. or lets $110.00 4
City/Stale/Zip Ti btk!il_ ... 'T1- 7 2 2 Each additional 500 sq ft or
p °ron thereof $25.00 1
Commercial ❑ Residential CII ^ w
Limited Energy $25.00
Each Manul'd Home or Modular
Dwelling Service or Feeder . $68.00 2
2a. Contractor installation only:
(Attach copy of all Current licenses) 4b. Services or Feeders
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Electrical Contractor_ OA/ T t1C . Installation, alteration. or relocation
_ ra CF_c i 2r r_ �U �
Address /Z2)O dUe lu
it 2r 4-).4 ' 20 amps less - 160.00 2
� 201 1 amps t to o 41X1 amps __ $50.00 2
City �Ac _ State ,. -.0 ..._..._.Zip__. 401 amps 10600 amps 112000 2
Phone No._ 2SC -- 9` e8 601 amps to 1000 amps $180.00 2
Job N0. c / 9 - 554 ()vCr 1000 amps or volts $340.90 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 2G-196 C Exp.Date
OR State CCB Reg. No. 4t: 746 Exp.Date 4c. Temporary Services or Feeders •
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COT Business Tax or Metro No. Exp.Date Installation, alteration. or relocation •
I 200 amps or lass $50.00 7. 201 amps lo 400 amps 5>5.00 2 .
Sign2lute of Supr. t'tpr n�._ - ✓yiC_ 401 amps to 600 amps $100.00 2 •
Over 600 amps to 1000 volts,
license No. Zf 65- 5 _ . ___Exp - Date f P v.i see 'b" above.
Phone No. 2 j 9Y8&' 4d. Branch Circuits •
New, alteration or extension per panel .
2b. For owner Installations: a) 1 ho leo 10 branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address
Each branch circuit 15,00 2
(,it ,State Zi b) The lee for branch circuits
y p _..._ .._.- - - _ _. . wilhoutpurche /J
Phone No._ _ _ ___ -- service or feeder fee. r ' 5
First branch circuit / $35.00 2 i
Tho 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 louder not Included)
Owner's Signature Each pump or Irrigation circie $40 -00 2
Each sign or outline lighting __ $40 -00 2
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3. Plan Review section (if required):' Signal circuits) or a limited energy
panel. alteration or extension $40.00 2
Minor Labels (10) 5100.00
Please check appropriate Item and enter fee in section 58.
4 or more residential units in one structure 41. Each additional Inspection over i
Service and feeder 225 ernes 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
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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: */
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Not required for temporary construction services. - Se. Enter total of above foes $ .1 5% Surcharge (.05 x total lees) $ Z , l
NOTICE Subtotal $
5b. Enter 25% of lino 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it reatrirerj (Sec.3) $ •
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NO1 COMMENCED WITI ON 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ •
IS SUSPENDED OA ABANDONED FOR A PERIOD OF 1 A0 DAYS Al ANY : �
TiME AFTER WORK IS COMMENCED- ❑ 1,„, Amount a ?
Total balance Due l t Q p,
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6/16/00 - Activities for Case #: ELC1999 -00339 0+
1:55:31 PM 4
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 6/7/99 BON RECD No Hold BON 6/9/99 Incorrect fees sent. Delay in
issuing permit until correct fees
arrive by mail.
ELCA003 Permit created 6/9/99 BON DONE No Hold BON 6/9/99
ELCA730 Elect'I Service 6/9/99 6/9/99 No Hold BON 6/9/99
ELCA799 Elect'I Final 6/9/99 6/9/99 No Hold BON 6/9/99
ELCA500 (F) Issue permit 6/9/99 BON DONE No Hold BON 6/9/99
ELCA920 Miscellaneous action 2/18/00 JMT DONE No Hold JMT 2/18/00 research inspection request
ELCA580 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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