Permit -`. -
_ A CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC97-0123,
.�� �1. 13125 SW Hall Glvd,�o��������6��/�
Tigard, ' ' DATE ISSUED: 03/04/97
PARCEL: 1S134AB-02900
SITE ADDRESS....: 11307 SW �RONWOOD LP ' '
SUBDIVISION, ^a/.A ENGLEWOOl} +- ' ~'' ' ' ' ` ^- ZQNING:R-4.5
BLOCK..........: LOT.............:86
Project Description:
_ _ ______
~^
---RESIDENTIAL UNIT---- ---TEMP EDERS---- MISCELLANEOUS-----
' '1000 SF OR^LESS.. � ' 0 0
'� - 200~am�
.. , .... ,.: 0 PUMP/IRRIGATION....: 0'
EACH ADD'L 500SF...: 0 201 - 400 amp.......: 0 SIGN/OUT LINE LTG..: 0
LIMITED ENERGY. ~~...: - • 401.'- 600; amp. „~.�...: 0 . SIGNAL/PANEL.......: 0
MANF. HM/ SVC/FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (10)...: 0
----SERVICEIFEEDEBr7-- � �_ - ��BgANCH'CIRCUTTS_�7 -- ���^�� '--�ADDmL INSPECTIONS---
0 - 200 amp......: 0 W/SERV ICE ' OR FEEDER: 0 PER INSPECTION.....: 0
201 - 400 'am - p..^.....:.0*,�.^..1„t.W/{}.„sRVC {]F � '
'�'��, PER:IH ..
OUR.^ ..... ..: 0
401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT...........: 0
601 — 1000. app,`. .,�,: 6:',,, , ,, , ` • PLAN. REVIEW SECTION
1000+ amp/volt.....: 0 >=4 RES UNITS........: > 600 VOLT NOMINAL..:
1 R*connect, on, �_.,SVC/FDF� 225 AMPS..�":_ ,, CLASS AREA/SPECOCC,.:. .. Owner: --- - - - ----- FEES -------
. HO �. °^ �� ` . .� ,: . �� � � !�.. - ., . type^�, an/ t� _ �1z}��7j�*te.��^' recpt' - , „ '
11307 SW IRONWOOD LP PRAT $ 35.00 JSD 03/04/97 97-291148 `'
' . ' ' _ _ • r.. 5PCT'$ . ' 1.75 JSD,683/694/97..97-291148
TIGARD OR
Phone #:
.
Contractor: --------- . - ---------
SHARPE ELECTRIC INC $ 36.75 TOTAL
22605 SW RIGGS '
, '�. ' ' . REQUIRED, INSPECTIONS
BEAVERTON OR 97007 Ceiling Cover Underground Cove
Phone #: 503-642-7937 � _ • ° L ' _ , , ._ ',.`., :~. .`:Wa,1 l Cover. Elect' 1: Final ^`
Reg #..: 81518
/
o r
This permit is issued subject to the regulations-contained.-in- the ,.•- cuutained'i� �' ' �~ ^ it,
Tigard Municipal Code, State of Ore-Specialty Codesand all other 11P itt ea Si gnat ure IF '
applicable laws. All work will be done in accordance with
approved plans. This permit milk expire, if work is not . ‘started '
within 18N days-of' issuance, pr. ifwurk^iTisuspeuded-4or mere `�''
than 186'days. ' � ' . :,,, - . . „ , . - - - • . , , , - . , �~ : :`: . �' ', Iss!ued^ ��p-_ ` ^
----- ------ -OWNER INSTALLATION ONLY--- ' --+. ,
, Thp .„,,installatio n . i,r,s , baing omade on ' roperty�I. ow��whic�� : is- not' intended for `,,
sale, lease, or rent. . �
OWNER'�� SIGNATURE� - ... DATE:.^ . ' __ ' _�' -
------------ - CONTRACTOR INSTALLATION ONLY-- ---------------.
SIGNATURE OF SUPR, ELEC'N: __ DATE: __ .
LICENSE NO _____ __ _—___- --
^ • ' :,,:!, :. •`',,_�r'_, ,_.:Ca1.1,..for inspgctign
.
'
___ . _ ' - . ��~ ^
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 S HALL BLVD. Rec'd B
TIGARD OR 97223 Date Rec'd 075
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 -4175 Permit # 1:-.-LC 97- 012
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 0 / G
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development / / Number of Inspections per permit allowed
Name (or name of business) f7� n FF�R� i Service included: Items Cost Sum
I
Address 1 1 0 7 S1N /fZO VJNJO L� oi' 4a. Residential - per unit
Y•/ e� � n 1000 sq. ft. or less $110.00 4
City /State /Zip / /t-� Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ Residential j2I 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 current licenses 4b.,Services or Feeders
A
Electrical Contractor S S CEG2 N
JC Installation, alteration, or relocation
Addre ?. 4.0 S W i 4 , G C RD 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City , &91/�121'DJV State �' Zip 97007 401 amps to 600 amps $120.00 2
Phone No. • 2'7 7 7`x6 7 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3I - 2.17 cZ Exp.Date /0 - O i . 9/ Reconnect onl $50.00 2
OR State CCB Reg. No. 47•/5/ S Exp.Date 97 4c. Temporary Services or Feeders
COT Business Tax or Metro No 2_5 3 J Exp.Date %- 4" ' Installation, alteration, or relocation
' , 200 amps or less $50.00 2
Si nature of Sur. Elec'n �1.. r h,.i� _1 4.. A , 201 amps to 400 a mp s $ 100.0 2
g p $100.00 2
Over 600 amps to 1000 volts,
License No. 334/V - S Exp.Date /D - °/- ` n see "b" above.
Phone No. `J' L 5597
7 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. ,,....
branch circuit $35.00 3 5 2
The installation is being made on property I own which is not Each additional branch circui $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: /
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ de
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 $ ............S
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96 •
, -eAC . (12,e411 ,- /
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
7
Footing Rain Drain Cover /Sgrvice FIN AL:
Foundation Water Line Ceiling Pas±.:::,
Post/Beam Mech. Shear /Sheath Framing
Plbg.Und/FIr/Slab Plbg. Top Out Insulation des'
Post/Beam Struct. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other /�( `✓J ' .�L�41 d-
Date: DA ( -/ ( / A.4. P.M. Entry:
JJ�am/
Address: J .,A t��s.. l�AI
Tenant: Ste: MST:
BUP: __
Con /Own: e r MEC: `� t
PLM: 0 - 1 •
THE OWING RR ECTIONS ARE REQUIRE ELR: v��tl�
FOL
•
In .,,Z1 Date: "1-/ 7
_'APPROVED DISAPPROVED /CALL FOR REINSP. CF CO