Permit _ _-_� _____ __ __-_ . -_- �- -- _ ___ �.
ELECTRICAL PERMIT
PERMIT #: ELC96-0488
� �� OF � �m�w�� � � DATE ISSUED: 07/26/96
1 COMMUNITY DEVELOPMENT DEPARTMENT
1 1u1uoSw Hill Blvd. Tigard, Oregon n7223°*1*e (503) 639-4171 PARCEL: 18133AD-02200
SITE ADDRESS...: "' 2. .2:. -
SUBDIVISION....: 429'340 .5^- e-i'itil-/-C FE./ZR/ ZONING:R-7
BLOCK..........: LOT •
Project Description: Installing one branch circuit.
_____________________ __ _______ ___________________
---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.... ... : 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 OR FDR. : 1 PER HOUR ^ 0
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 ----
WESTGATE BAPTIST type amount by date recpt
12930 SW SCHOLLS FEERY ROAD PRMT $ 35.00 CJS 07/26/96 96-282177
5PCT $ 1.75 CJS 07/26/96 96-282177
TIGARD OR 97223
Phone #: 524-3500
/
Contractor: --' ------- — --- —
ELECTRICAL CONTRUCTION CO $ 36.75 TOTAL
PO BOX 10286
-- REQUIRED INSPECTIONS -------
PORTLAND OR 97296 Wall Cover Elect'l Final
Phone #: 503-244-3511 Elect'l Service
-
Reg #..: 49737
.
This permit is issued subject to the regulations contained in thp ______ ____ (.. ____ Tigard Monicipal Code, State of Ore. Spocia\ty Code and all othm^ Permittee Signature
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. 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: ��&l /— ^� DATE:
'_ ____' �� �,___ -
. ,
LICENSE NO: ____ ___ ___ __ __
Call for inspection — 639-4175
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Community Development ELECTRICAL PERMIT APPLICATION
x A
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # a 96- mai 7
Permit # ELCQ6 -0LRP
//6
�i Phone (503) 639 -4171 Date Issued 7 ,// 5 /96
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by Cho c ie < Sc h m f �l�
Inspection (503) 639 -4175
1. Job Address: DATE: 7 -12 -96 4. Complete Fee Schedule Below:
Name of Development 130Th & SCHOLLS FERRY ROAD .
Number of Inspections per permit allowed -
Address SE CORNER, 151 33AD TAX :4: LOT 2200 Service included: Items Cost(ea) Sum
City/State/Zip TIGARD, OR 97223 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business)/t) ' f ) S(A.> ) "- j }41 Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ® Residential ❑ Limited Energy $25.00
JOB �O . 62021 Each Maned Home or Modular 2
11 Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor LINNCO ELECTRIC CO . 200 amps or less $60.00 2
Address PO BOX 925 201 amps to 400 amps $80.00 2
City AL BANY 401 amps to 600 amps $120.00 2
ty State OR Zip 97321 601 amps to 1000 amps $180.00 2
Phone No. 541 - 926 -4266 Over 1000 amps or volts $340.00 2
-
Contractor's License No. 22 -15C Reconnect only $50.00
Contractor's Board Reg. No. 49737 4c. Temporary Services or Feeders
JOB N0. 62021 Installation, alteration, or relocation 2
Signature of Supr. Elec' 200 amp or less $50.00 2
License No. 3257S Phone No.926 -4266 201 amps to 400 amps $75.00 2
1. amps to 600 amps $100.00
. Over 600 amps to 1000 volts
2b. For owner installations: see "b" above
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
ty p Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit 1 $35.00 35.00 2
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per ins $35.00
Per hour $55.00
In Plant $55.00
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 $ 35.00
5% Surcharge (.05 X total fees) $ 75
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # $
Balance Due $ 36.75
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