Permit CITY OF TIGARD ELECTRICAL PERMIT
�i,, „4. DEVELOPMENT SERVICES PERMIT #: ELC98 -0212
to- '" j��l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: : 04 / 24 / 98
^
PARCEL: 2S1O2BA -01400
' SITE ADDRESS...:O9685 SW JOHNSON ST
SUBDIVISION °NO.TIGARDVILLE ADDITION AMEND. ZONING:R -12
BLOCK..........: LOT °054 JURISDICTION: TIG
Project Description Add first branch circuit to and existing bldg.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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 (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 -•
WOODARD PARK APT type amount by date recpt
9685 SW JOHNSON STREET PRMT $ 35.00 GEO 04/24/98 98- 305244
#32 SPCT $ 1.75 GEO 04/24/98 98- 305244
TIGARD OR 97223
Phone #: .
Contractor:
JPC ELECTRICAL SERVICES INC $ 36.75 TOTAL
4420 SE INTERNATIONAL WY
STE A -107 REQUIRED INSPECTIONS
MILWAUKIE OR 97222 Elect'l Service
Phone #: 654 -3325 Elect'l Final
Reg #..: 001255
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 188
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 - through OAR 952-00 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling 246 -1987.
Permittee Signature: I ssued By° / ,re__,,.__
OWNER INSTALLATION ONLY
The installation is being made on property I awn which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : �n /C�'� DATE: t/ 9
LICENSE NO: / ?-7- s
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Print or Type
Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # g_CC 9 Cr- Q A /07
Fax (503) 684 -7297 Called '
1. Job Address: 1 - r /� 4. Complete Fee Schedule Below:
Name of Development LUC)Cx1 (1rA PCII(k AO Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
4.
Address / • , a : • ' € AO *. , 4a. Residential - per unit
City /State /Zip 1 to ra c % / as 3 Each additional 500 sq. ft. or $110.00 4
CommerciakE Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all urre
t b. Services or Feeders
Electrical Contractor . H. C. F i P - t' Ca. ( rioC Installation, alteration, or relocation
200 amps or less $60.00 2
Address -O S 7i i ./ fib 7 2 01 amps to 400 amps $80.00 2
City /� 1 i )ca� -c State Zip 97- T' v> 401 amps to 600 amps $120.00 2
Phone No. lakS4 - .3,385 601 amps to 1000 amps $180.00 2
Job No. / /7 J4S Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3-i24C Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No. /,-7,751& Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 5/ 90 Exp.Date Installation, alteration, or relocation
±� 111111 200 amps or less $50.00 2
Signature of Su r. Elec'n ` 201 amps to 400 amps $75.00 2
g p 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 4/ c5 Exp.Date 0 see "b" above.
Phone No. Co(5f- 33�.�'
• 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 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. CI)
First branch circuit I $35.00 35 2
The installation is being made on property I own which is not Each additional branch circ $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature 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: 35-. c5D
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ I. 15
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. El Trust Account # C Jam• 5
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96