Permit CITY OF T ELECTRICAL PERMIT
�4i�,,,,d, DEVELOPMENT SERVICES PERMIT #: ELC97 -0611
x'11 lii DATE ISSUED: 09/11/97
r 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2511OBB- 01800
SITE ADDRESS..•:12395 SW CORYLUS CT
SUBDIVISION °AMES ORCHARD ZONING:R -1
BLOCK LOT :7 JURISDICTION: TIG
Pro.j ect Description : Installing first 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
MANE. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (1O)...: 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/0 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 -
KAY MCGARRY type amount by date recpt
12395 SW CORYLUS CT PRMT $ 35.00 B 09/11/97 97- 299131
TIGARD OR 97223 5PCT $ 1.75 B 09/11/97 97- 299131
Phone #:
Contractor:
OWNER $ 36.75 TOTAL
REQUIRED INSPECTIONS
Rough —in Elect'1 Final
Phone #: Elect'1 Service
Reg #..: 999999
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC b calling (503)246 -1987. ‹. Permittee Signature: v.///, 0,► /. Issued By:' �( "lika`e - �
OWNER INSTALLATION ONLY
The installation is bein made on property -I own which is not intended for
sal e, 1 ease, or rent.
OWNER' S SIGNATURE : 5( � DATE: ) 9/ii 7
CONTRACTO INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m• for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check
,
13125 SW HALL BLVD. Recd By • / moth l/
TIGARD OR 97223 Date Recd '' - 11 -° I ' l
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # OWN/
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: //�� 4. Complete Fee Schedule Below:
Name of Development A - C. / 2/C? Number of Inspections per permit allowed
Name (or name of business) Mc6/Yr Service included: Items Cost Sum
I
Address / Z 3 t
-- 1/1 t' , (/ (r ../z_ 4a. Residential - per unit
/02--. ' 1000 sq. ft. or less $110.00 4
"/
City /State /Zip / Each additional 500 sq. ft. or
Commercial El Residential portion thereof $25.00 1
Li mited Energy $25.00
Each Manuf'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
Electrical Contractor Installation, alteration, or relocation
200 amps or less $60.00 2
Address ____
201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. • 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. Exp.Date Reconnect only $50.00 2 -
OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
' 201 ams to 400 ams $75.00 Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Exp.Date see "b" above.
Phone No.
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's N e 1. . ' �, t, -1 feeder fee.
Addres _ ' __ affi a
Each branch circuit $5.00 2
b) The fee for branch circuits
City /,/LL ! _ Sta 4.7 'If /�I- without purchase of
PhoneVo. - / 1= service or feeder fee. ' plf
First branch circuit / $35.00 l 2
The 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 feeder not included)
Owner's Signature L��� Each pump or irrigation circle $40.00 2
� Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* 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 in 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: 10Q--
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ II
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 # /)
(� I
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
41)L OFF At)4..� rW
CITY OF TIGARD BUILDING INSPECTION DIVISION -ry
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 1 — 31 ^ 97 A.M. P.M. MST:
Location: / c (3 C 1.5 S i r BUP:
Tenant: Suite: Bldg: MEC:
Contractor: _ ili . I / ■ _ Jt _1 J 4_ : A / .. 'hone: ! ,� 3 l ? PLM:
Owner: I Phone: ! ELC: / 7-) b / 1
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL LECTRI 2 ) SITE
Site Post/Beam . Post/Beam Post/Beam Co ver /Serv Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved • Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL - FINAL / v.411117MD FINAL
•
•
0 Call for reinspection einspection fee of $ required before next inspection 0 Unable to inspect
Inspector: reinspection
Date: / 2 -3/-9 7 Page of
7 g