Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00532
164i
DEVELOPMENT r SERVICES J ) 639 - 4171 DATE ISSUED: 9/1/99
13125 PARCEL: 2 S 103AB -W G OO B
SITE ADDRESS: SWEENEY PL TRACT B
SUBDIVISION: WALNUT GLEN ZONING: R - 4.5
BLOCK: LOT : OOB JURISDICTION: TIG
Project Description: Installation of two (2) 200 AMP service /feeders and two (2) branch circuits.
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: 2 W /SERVICE OR FEEDER: 2 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:
RIVERSIDE HOMES R J ROUSE ELECTRIC INC •
15455 NW GREENBRIER PKWY #140 19450 SW CIPOLE ROAD
BEAVERTON, OR 97006 SUITE 107
TUALATIN, OR 97221
Phone: 645 -0986 Phone: 503 -612 -0840
Reg #: LIC 000904
SUP 661S
ELE 34 -359C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT GEO 9/1/99 $139.20 99- 318046 Elect'I Final
5PCT GEO 9/1/99 • $9.74 99- 318046
Total $148.94 ORIGINAL
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.
PERMITTEE'S SIGNATURE ISSUED BY: "
r
OWNER INSTALLATION ONL
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: G"� _ DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
s /0 3 Re- 6, .,
Community Development ELECTRICAL PERMIT APPUCATION
13125 SW Hall Blvd.
Tigard, OR 97223 RECEIVED Permit # Fed 3,
Date Issued
•11 1'` Phone (503) 639 -4171 AUG 2 5 1999
1 FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 - UNITY DEVELOPMENT
Inspection (503) 639 -4175
1. Job Address: I�� ,) p 4. Complete Fee Schedule Below:
Name of Development V�o rte)-- L n I lia) Number of Inspections per permit allowed
Address U CO t 11'Q.ut t St t 566 ti -I ( T xv ZP Service met Items Cost(ea) Sum
City /State/Zip i (0 aArd 4a. Residential - per unit 4
1000 sq. R or less 3111100
Name (or name of business) S t� LIG ( q-5 503 sq. n. or
portion thereof $4
Commercial ❑ `�" ti al L d Energy $25.0 7 esid
/a , )/ , C1^ Each Manure Home or 61odWar 2 Feeder ' 309.00
2a. Contractor installation only : / a A
1 • 4b. Services or Feeders ,n (/ .`f /, a- `A 6 J°
Electrical Contractor P.7, i Q LL J t. i C, ( .14,C. a` °A. or 0A Q �. 2
A • "�(,SQ ;S , ( fo±_s_ 201 amps to 400 amp slaw 2
City State Zip Z 401 amps to 600 amp` $121100 2
- 601 amps to 1000 amps *160.00 2
Phone No. 6 ( - CAN Q over 1000 asps or vats 3340.03 2
Job NO. , 5 S (v (o only mace 2
Contractor's license NO. c1- 33 e- 4c. Temporary Services or Feeders
Contractor's Board Rag. No. I Menem or ra+ocaaion •
Signature of & r. Ei& n ).. 200 saw ar less 2
License No. LS Phone No. (� 1 11 - ()$'{ Q 40 ernes amps o a �m 2
Over 600 laps** 1030 vacs 3100.00
2b. For owner installations: sea I' above.
4d. Branch Circuits
Print Owner's Name preen ,aeration or mansion per pi11e
Address a) The fee for !starch circuits adN 2 - `D. 7Z e
City State Zip > branch orserNn or feeder fbo.� `✓i�/ 2
Each bran circuit 15:00"
Phone No. b) The fee (or branch darts isertiout 2
The installation is being made on property I own which is pardiass of torrioo or hoofer foe. 335.00 2
not intended for sale, lease or rent ter, aaalrbon.l bands circuit 35.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation tide 540.00 2
Each sign or outline ipbtIng 340.00
-
Signal cira s) or a hired energy 2
i5
Please check appropriate item and enter fee in section 5B. panet, alteration or a tension $40.00
4 or more residential units in one structure Melor I.abeis (10) 3100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4t Each additional Inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as descnbed in N.E.C. Chapter 5 Per inspection 333.00
Pa hour $55.00
-
In Piers 355.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees s 'r' r `
I
4 9 0 % S (.p5 X total fees) . _ -- •21k7%
PERMITS BECOME VOID IF YVORK OR CONSTRUCTION / _
5b. Enter 25% of fine A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review d required (3) S
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR
Subtotal
A PERIOD OF 180 W
DAYS AT ANY TIME AFTER ORK IS S
COMMENCED. meraum.,e..i..• ❑ Trust Account # /x ry
.mat. _ /
V
Ba lance Due $