Permit CITY OFTIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES ~�m�� n�o���n nmn°�.� . ~��~" xm .~��~~� PERMIT #: ELC96-0817
13125 SN/ Hall Bhvd., Tigard, OR97223 (503)639-4171 DATE ISSUED: 12/30/96
/] `- - ���
' "~-� '� -� // *` '^ PARCEL: 2S103BD-HG006
SITE ADDRESS...: '. - m . **111L, � .� ' ,
SUBDIVISION � ^ HUNTER'S GLEN� Z8NING:R-4. 5 PD .
Bb'8CK^.........: LOT :006
Project Description: Electrical app for•temporary sales trailer. On the site
temporarily until a model home is constructed (FACING ERROL ST).
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS
1000 SF OR LESS....: 1 0 - 200 amp.......: 0 PUMP/IRRIGATION ^ 0
EACH ADD'L 500SF...: 0 201 - 400 amp.......: 0 SIGN/OUT LINE LTG..: 0
LIMITED. ENERGY, 0./ � '4 6��� 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......: 0 W/SERVICE OR FEEDER: 0 PER INSPECTION.....: 0
201 - 400 amp,. . ., . : 0 1st, W/O SRVC QR 01 !
401 - 600 amp ^ 0 EA ADD'L BRNCH CIRC: 0 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 --- ----
LEGEND HOMES • type amount by date recpt
6900 SW HAINES ST PRMT $ 110.00 JDA 12/30/96 96-288281
• . . . . - 5PCT $i '.• 5.50 J.D. A 12/30/96 96-288281
TIGARD OR 97223
Phone #:
Contractor:
GARNER ELECTRIC $ 115.50 TOTAL
21785 SW TV HWY
#L REQUIRED INSPECTIONS
ALOHA OR 97006
Phone #:
Reg #..: 116721
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This permit, is issued subject„ the _regulations contained in. the „47/
.Tioard`Muoicipal Code, State , Om Specialty Codes. and .4l�othpr e r • ^y"nat� `e
applicable laws. All work will be done in accordance with '
approved plans.- This permit mill expire,if work, is not. started ,1 , \ •
within 180 days of issuance , or if work i» suspended for more ^ _`_��
than 180 days. ' 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: .DATE: ,_ `
LICENSE NO:
Call for -639-4175..
.
CITY OF TIGARD Electrical Permit Application Plan Chec
13125 SW HALL BLVD. Rec'd B
TIGARD OR 97223 Date Rec'd /21 -' -1
Date to P.E. - Phone (503) 639-4171, x304 Date to DST -
Print or Type
Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit # ELC�� -f7Rr 7
Fax (503) 684 -7297 Called
1. Job Address: /J/ 4. Complete Fee Schedule Below:
Name of Development .'/� �� .5 (`l/ t.Q> Number of Inspections per permit allowed
Name (or name of business) f 5 Service included: Items Cost Sum
Address // f!) ,2O r r (97/9 / • ✓ 4a. Residential - per unit pd
City/State/Zip 1000 sq. ft. or less I $110.00 // 4
tY p 74°/'/7 Each additional 500 sq. ft. or
Commercial ❑ 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 a J„current licenses) 4b. Services or Feeders
rat c/
Installation, alteration, or relocation
Electrical Contract / 200 amps or less $60.00 2
Address � / S Z 4 / 201 amps to 400 amps $80.00 2
City li-Id 1.1 G( State e Zi G_ __ 401 amps to 600 amps $120.00 2
Phone No � iJJ -/ 3d e 601 amps to 1000 amps $180.00 2
/
Job No. o c D Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 2' i`( Ex I U/ c2/41 9 `f _ Reconnect only $50.00 2
- / � Z
OR State CCB Reg. No. / , � / Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. / Exp.Da o Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec 'n 201 amps to 400 amps $75.00 2
- 7 401 amps to 600 amps $100.00 2
(7 2 V �/ 141cr y Over 600 amps to 1000 volts,
License No.4 ' Ex . ate // see "b" above.
Phone No. 'J" /- .
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installation • a) The fee for branch circuits with
e 4 , i; �� purchase of service or
Print Owner's Nam - ser /Ls!� %�%i feeder fee.
Address
/""' Each branch circuit $5.00 2
City State Zip b) The fee or u • s
ty p 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 circui $5.00 2
intended for sale, lease or rent. . 4e. Miscellaneous
service or feeder not included)
Owner's Signature / „eh „! iII� ■__.4/ Each pump or irrigation circle $40.00 2
AP Each sign or outline lighting $40.00 2
3. Plan Rev - sect �f r- . w i red): * Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units iri 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: I 00
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ 5
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 #
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /' FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. .
San. Sewer iGas Line Appr /Sdwlk Reins.
Other:
C
Date: ( � . M. P.M. Entry:
Address: �y�
Tenant: / ��� f / ? "Step- MST:
BUP:
Con /Own: b 9 - 3 3 7 MEC:
PLC:
ELC:
THE FOLLOWING CORRECTIONS ARE REQU ED: ELR:
s c 77 -E. •::1) rr
•
Inspector: / Dat-• °' — '
A /. APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO