Permit �
y ` . tou
CITY OF TIGARD
- � /
'AOlk
DEVELOPMENT SERVICES
-
���� ��`�. .�.�v� " ���nx�.�*�.~
--4:111-*:E. ��� Hall Blvd., Tigard, OR 97223 (503)639-4171 ELECTRICAL PERMIT„
PERMIT #: ELC96-0658
.DATE. ISSUED:`'10/\16/96 `
i 01125 PARCEL: 1S135BC-00201
SITE ADDRESS...: �21, GREENBURG RD #A
SUBDIVISION. . . .: ZONING:C—G
BLOCK ^ LOT ^
Project Description: EXTERIOR PARKING LOT LIGHT
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 SF OR LESS....: 0 0 — 200 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
7 — ELEVEN (SOUTHLAND) type amount by date recpt
10765 SW GREENBURG RD PRMT $- 35. 00 JMH' 10/16/96 96-285226
5PCT $ 1.75 JMH 10/16/96 96-285226
TIGARD OR 97223
' Phone #: •
Contractor: —
AZTECH ELECTRIC $ 36.75 TOTAL
5204 BROADWAY
------- REQUIRED INSPECTIONS — —
SPOKANE WA 99212 Underground Cove Elect'l Final
Phone #: 509-536-6200 Elect'l Service
Reg #..: 066347
This permit- is issued subject to the requlatioscontainedin the ~
Tigard Municipal Code, State of Ore. Specialty Codes and all other . Permittee Si* aturS
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started''
/ �
within 180 of issuance, or if work is suspended for more ��`*[/�/�� ` /yL//N�|.i�~ ~ �,' /
than 18N dayo. I tied By
----- — OWNER INSTALLATIOm 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 inspection — 639-4175
CITY OF TIGARD Electrical Permit Application Plan Check # - 4
13125 SW HALL BLVD. Recd By ( \'1L A'
TL( ARC OR 97223 Date Rec'd 7) I O - I , -q k .,
Date to P.E. /1 A .l
Phone (503) 639 - 4171, x304
Date to DST 7 I 7 V l
Inspection (503) 639 -4175 Print or Typ Permit # fit,( Rb - No JP
Fax (503) 684 - 7297 Incomplete or illegible will not be accept Called C-.)1' LP/lti/
1. Job Address: 4. Complete Fee Schedule Below
Name of Development 7 - I I 5 - f - 0 2.A. Number of Inspections per permit allowed
Name (or name of b usiness) 7 - I 1 Service included: Items Cost Sum
Address / .t.J, 6.2-6--em - &- ' b - 4a. Residential - per unit v
--- 1000 sq. ft. or less $110.00 4
City /State/Zip 11 C. FiR,. C Z -7 2. 2.. 3 Each additional 500 sq. ft. or
(� portion thereof S25.00 1
Commercial I Residential ❑ Limited Energy $25.00
Each Manufd 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 fi- " 7 c I-I E(.... Z 1vv.. tc.._ Installation, alteration, or relocation
200 amps or less - $60.00 2
Address • s2.o•1 220 1 201 amps to 400 amps - $80.00 2
City .5 Po (6A-,.) . State (...A:1-- Zip 9 9 Z/ z- 401 amps to 600 amps $120.00 2
Phone No .Jso9) .5 3G - 47_00 6 0 1 amps to 1000 amps - $180.00 2
Job No. - L o4,') Al o - 6,67.-e> Over 1000 amps or volts - $340.00 2
Elec. Cont. Lice. No. Sel- 44 • v
C Exp.Date /o -l- "7 '
Reconnect only - $50.00 2
OR State CCB Reg. No. D(c(o3Vi Exp.Date /o- 97 v' 4c. Temporary Services or Feeders
COT Business Tax or etro No)O 4580 Exp.Date 10 of 7 Installation, alteration, or relocation
200 amps or less - $50.00 2
���� 201 amps to 400 amps - $75.00 2
Signature of Supr. Elec'n Q � 401 amps to 600 amps - $100.00 2
Over 600 amps to 1000 volts,
License No. / S �o J Exp.Date / ��/9 7 see "b" above.
Phone No. ) g4 O- faSZGO 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 Owners Name feeder fee.
Address Each branch circuit - $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. / C7 )
First branch circuit r $35.00 "" 2
Each additional branch circuit $5.00 2
The installation is being made on property I own which is not
intended for sale, lease or rent. 4.e. Miscellaneous
(Service or feeder not included)
Owners Signature Each pump or irrigation circle 540.00 2
Each sign or outline lighting - $40.00 2
* Signal circuit(s) or a limited energy
3. Plan Review section (if required): 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:
Not required for temporary construction services. 5a. Enter total of above fee
5% Surcharge (.05 X total fees) S I. '75
NOTICE Subtot S
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 S $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account #
TIME AFTER WORK IS COMMENCED. .3(9 7.
Total balance Due s
'ASTS'.ELC96 Apo Rev 9196
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
- Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: 7 ` l I _
Date: /0/ 3/ / / (!) A. P.M. Entry:
Address: /6 !t L 1 A . ' _ J IL _,I
Tenant: / Ste: MS 1
U,P:
Con /Own: 20 C 6 .- v B MEP:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
:%c r \ �'
____,?)--) 4 -; c i. - (
Inspector: c / -L / Date:, : " 3" '
i/
�C APPROVED DISAPPROVED /CALL FOR REINSP. CO