Permit -- /
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ELECTRICAL PERMIT
C � ��� OF TIGARD PERMIT #: ELC96-0326 � � l� � � � DATE ISSUED: 05/21/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 972e3°819e (503) 639-4171 PARCEL: 2S104CA-10300
SITE ADDRESS...: 13691 SW JENNA CT
SUBDIVISION....: HILLSHIRE ZONING:R-7 PD
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :103
Project Description: Installing one branch cirucit.
---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 .
ERIC JENSON type amount by date recpt
13961 SW JENNA CT PRMT $ 35.00 CJS 05/21/96 96-279665
5PCT $ 1.75 CJS 05/21/96 96-279665
TIGARD OR 97223
Phone #:
Contractor: — — — — �---
PHOENIX ELECTRIC CO $ 36.75 TOTAL
PO BOX 1432
— .REQUIRED INSPECTIONS -------
TUALATIN OR 97062 Wall Cover
Phone #: 503-692-5882 Elect'l Final
Reg #..: 52288
This permit is issued subject to the regulations contained in the
• Tigard Municipal Code, State. of Ore. Specialty Codes and all other 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 18N 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: ao C/ ° DATE:
LICENSE NO:
Call for inspection — 639-4175
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # ELC9( -03 a.6
A � \ Date Issued s - A f - 96
��� �� I I Phone (503) 639 -4171
`.J"4, ■ FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development b_o 8 VT Number of Inspections per permit allowed
Address I & t, --n06).4, C1� \ S�� Te rh e Q 3r Service included: Items Cost(ea) Sum
City /State /Zip f . co-g_ 4a. Residential - per unit
. 1000 sq. ft. or less $110.00 4
Name (or name of business) _ I _ _ • ,��. • A. Each additional 500 sq. ft. or
lr portion thereof $25.00
Commercial El Residenti. GI Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
` Installation, alteration, or relocation
Electrical Contractor • t. • _ ` 200 amps or less $60.00 2
Address • MS , �� 11 . • . 201 amp to 400 amps $80.00 2
$120.00 2
City �! i v �� , III IP " - Zip �' a 401 amps to 600 amps
601 amps to 1000 amps $180.00 2
ig
Phone No. f I - • Over 1000 amps or volts $340.00
Job NO. ■ O 5 5 --.t) a Reconnect only $50.00 2
contractor's license NO. ,/q _ c2 y 7 Ci 4c. Temporary Services or Feeders
Contractor's Board Reg. No. a Installation, alteration, or relocation 2
Signature of Supr. Elec'n -- 200 amps or less 2
License No. £1/ 3 one No. -34, p�� 201 amps to 400 amps $50.00
401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
_ 2b. For owner installations: see „b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
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 additional circuit ( $35.00 cJ`�
Each additional brranch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
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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 inspection $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: ocj
5a. Enter total of above fees $
NOTICE 5% Surcharge (.05 X total fees) $ 4ta,..---
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 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. wordlcomdev\eiec- ❑ Trust Account #
prm.app $
Balance Due $ .....S_
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 I'.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: /
Date: � ' (9 ( Q A.M.)( P.M. Entry:
Address: (a CQ- - I (
Tenant: Ste: MST:
B
Con /Own: ` M UP: EC:
PLM:
ELC: 7 O _ —
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
?c T/
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Inspector: / �' a —
D ate:
, )APPROVED DISAPPROVED /CALL FOR REINSP. 6 CO