Permit CITY OF TIGARD
DEVELOPMENT ELECTRICAL PERMIT
~�°���~u~~�" "�"�~"�" SERVICES PERMIT #: ELC96-0725
-�� 18125 SW Hall Blvd,�a�C�9������/�
Tigard, ' ' DATE ISSUED: 11/15/96
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- -��RCEL: 1S134CA-00512
SITE -ADDRESS.:. 11180 SW 119TH AVE
SUBDIVISION,,..:.PANORAMA-NO.2 ZONING:R-4.5
BLOCK..........: LOT...... ^23
Project DescriptionFOR 1 BRANCH-CIRCUIT & 1 LIMITED ENERGY PANEL
_
---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 ^ 1
MANF. HM/ SVC/FDR�.:'0 —601+amps-1000 volts.,: 0 MINOR LABEL (10)...: 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS---
0 — 200 amp • ~ .1D W/SERVICE OR FEEDER:.. 0 • PER INSPECTION ^ 0
201 — 400 amp......: 0 1st W/O SRVC OR FDR.: 1 PER HOUR...........: 0
401 — 600 amp...a..: 0^ • '` EA ADD''L BRNCH CIRC .0, IN PLANT ^ 0
601 — 1000 amp.....: 0 ----PLAN REVIEW SECTION —
1000+ amp/volt > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Qwner:' _ , FEES-
ROBERT BUTZ type amount by date recpt
11180 SW 119TH • ' • • • - `' ' � $•' ^ 75.00LTAT 11/15/96 96-286598
5PCT $ 3.75 TAT 11/15/96 96-286598
TIGARD OR 97223
Phone #:
Contractor: —
ATLAS ELECTRICAL CONTRACTORS $ 78.75 TOTAL
4403 SE ROETHE RD
-- REQUIRED INSPECTIONS --
MILWAUKIE OR 97267 Ceiling Cover Underground Cove
'Phone #1. 503-659-2212 • • • ' .� � Wall Cover Elect'l Service
Reg #..: 000015
/
This permit is issued subject to the regulations contaioed'intho '` �N�� ^�~ '' /' f
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permit ignaturz
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started... J/
within 18N days of issuance, o �i
rf work is suspended for more ^m 1� ^ �� ^ . r ^��'v'
than I8tdavu ' Issued By . A(
�
---- 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:
' ' • ' Ca,ll,. for` inspect io/z' _ ]539-4175
08/21/96 13:24 $$503 684 7297 CITY OF TIGARD 0002/002
. , Community Development ELECTRICAL PERMIT APPLICATION
-- 13125 SW Hall Blvd.
Tigard, OR 97223 Permit # - L•.e - 67 5
. „ Date Issued i 1 i
�,j Phone (503) 639-4171
FAX (503) 684-7297
CITY 01 TIGARD TDD No. (503) 664 -2772. , , --- ... .. • .
• Inspection (503) 639 -4175 • • • - •
! -
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Bob Butz Residenc _ Number of inspections per permit alloeaed
Address 11180 SW 119th Avenu Service included: Ilene Coates) Start
City /Statel2ip Tigard, Oregon 97062 4a. Residential _ per unit
1 000 sq. R a was Si t0.02 - - 4
Name (or name of business) Each "' 0allowl Mk R or
portion Owed
Commercial 0 Residential Q tame E x.00
Each Wooed lien. er Itedul r Z
Maim SOWS Or Feanor max - 2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor Atlas Electrical tmtatirber.dtanreon.arelocation Moto 2
. 200 11,14M Or kiln Address 4403 SE Roethe Road zol moo to 402 aripe - 2
mom ��
city Milwaukie State OR,. ZipZip 97267 am imps m® "o` i;�00 a
501 arms � b 1000 amps 2
Phone No. 659 -2212 _ r 1 elmorvo 11340.00 2
Job NO. X r a.>avactodr sso -m
contractor's license N0. 3 -2C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 15 2 benolbttotL enerenon. or renoomon
Signature of Super. Eler: n r.. 200 AM of k ' 2
License No. 2581S phone Na_ 65 - 2I2 2 '°n �"° 40 amps - - 140.00 2
401 wee to bob mei $76.02 00
Ora1500 wow to 1000 veto .... Stamm
2b. For owner installations: we If Wow
4d. Branch MUMS
Print Owners Name - - -- nee. 4rlenente ar amar.l.r Par We
Address a) The tee ter Protect areultr "r°' 2
protest arnicaoremrr
City State - Zip Each broom mart $500 �-
Phone No. _ _ _ b) Te nee tar lab at ra arur wtlhare 2
The installation is being made on property I own which is pendese arae1'tea mow fee.
not intended for sale, lease or rent. Ew a ddball -1-... 1 0 35.00
Ewa oddball branch draw 99.00
•
Owner's Signature 4e. for 2
(Service or feeder not included) 2
3. Plan Review section (if required): Each a 6. s �
2
Sprat olor l(a)or 1anted enemy
Please check appropriate item and enter fee in section 58. pate+. Worm Cr E121Mitint 1 $40.00 40.00
4 or more residential ratite in one btnjcw,e Lbw Lobar (10) roam
Service and feeder 225 amps or more 4: Each additional InspeWon over
- System over 604 volts nontlnal the allowable In any of the above
Classified area ar SIMONS containing special occupancy Per berm:rim $35.00
as destxibed In N.E.C. C 5 Pot now i113.00
In Ptarrt x.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary consbruetion Services. 5. Fees:
NOTICE 5a. Enter total of above tees $ 75.00
5% Surcharge (.05 X total fees) $
if r u btekrt $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION sr ter 25 1 S _78,4i •
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF sb- E Plan Revue► mri o fire A er
CONSTRUCTION OR WORK 1S SUSPENDED OR ABANDONED FOR Subtotal (Sec.3)
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS S '�
COMMENCED. .um 0 That Account s s
Balance Dire $ 7878 775
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