Permit CITY 1 OF TIGARD ELECTRICAL PERMIT
,1;
PERMIT #: ELC2002 -00565
, .��� DEVELOPMENT SERVICES DATE ISSUED: 10/24/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DA -01400
SITE ADDRESS: 11505 SW HALL BLVD
ZONING: C -P
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Temporary power for construction of new temple. (1) 200 amp or less temp service and (1) branch
circuit. Job No. 22 -1047
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: W /SERVICE OR FEEDER: 1 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:
BRAHMAP REMANANDA ASH RAM/TEMPL E CAPITOL ELECTRIC CO INC
11515 SW HALL BLVD 11401 NE MARX ST
TIGARD, OR 97223 PORTLAND, OR 97220 -1041
Phone: Phone: 255 -9488
Reg #: ELE 26 -496C
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/24/02 $73.50
[TAX] 8% State Tax 10/24/02 $5 Elect' Service
Rough -in
Total $79.38 Elect' Final
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 a r -t forth in 0 ' •52- 001 - 0010th •ugh OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 • .99 or 1 :00-332-23 /��/,
Issu: d By: 1 /:e..! u�t Permit Signature:
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: ✓ —61 ' DATE:
LICENSE NO: � � 3 °-5
Call 639 -4175 by 7:00pm for an inspection the next business day
_OFFICE .USE -ONLY -
r Electrical Permit Application Date received: 4si![L7■ Permit no.: 44940A —
Allir. Project/appl. no.: Afjy; e date:
Ai- C ity of Tigard Date issued: B : r ' eceipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR 97223 Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960
Land use approval:
TYPE OF PERMIT .
❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement
ii New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: 11505 SW HALL City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.:
Lot: !Block: N/A (Subdivision:
Project name: HINDU CHURCH (Description and location of work on premises: NEW BLDG
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: 22 -1047 Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. insp
Address: 11401 NE Marx New residential - single or multi - family per
City: Portland State: OR ZIP: 97220 - 1041 dwelling unit. Includes attached garage.
Phone: 503 - 255 - 9488 !Fax: 257 -7121 IE -mail: darrell @cepdx.com Service included:
CCB no.: 48748 'Elec. aus. lic.no: 26 - 496C 1000 sq, ft, or less $ 145.15 4
Cj.ty /gsetro lic.no.: N/A Each additional 500 sq. ft. or portion thereof $ 33.40
.— /__ )a7Z U 10/23/02 Limited energy residential $ 75.00 2
Signature of supervising electr'' ian (required) Date Limited energy, non - residential $ 45.00 2
Sup. elect. name (print): Darrell McNe: I License no.: 3132 - Each manufactured home or modular dwelling
PROPERTY OWNER - Service and/or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: I State: "ZIP: 200 amps or less $ 80.30 2
Phone: Fax: E-mail: I 201 amps to 400 amps $ 106.85 2
Owner installation : The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 l
ENGINEER Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less 1 $. 66.85 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E -mail: 401 amps to 600 amps $ 133.75 2
PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps- commercial ❑ Health -care facility or extension per panel:
❑ Service over 320 amps - rating of 1&2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit 1 $ 6.65 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress /lighting plan ❑ Other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel,
alteration, or extension* $ 75.00 2
*Description:
Each additional inspectionover th allowable in any of the above:
Per inspection " I $ 62.50 I I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 73.50
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained State Surcharge( 8% ) $ 5.88
Name of cardholder as shown on credit card withing 180 days after it has been
$ TOTAL $ 79.38
Cardholder signature Amount accepted as complete.