Permit CITY O TIGARD
ELECTRICAL PERMIT
DEVELOPMENT ~�"�� n�u~.�u "�."�n� . ~~v�" "�"��n�~� PERMIT #: ELC97-0352
13125 SWHa!I Blvd., Tigard 013 97223 (503) 639-4171 DATE ISSUED: 06/09/97
PARCEL: 25111CB-01726
SITE ADDRESS...:10470 SW KABLE ST
SUBDIVISION ^HOOD VIEW NO.2 ZONING:R-3.5
BLOCK • LOT.... ..... ....:25 JURISDICTION: TIG
Pro j ect Description : im±1 2 branch circuits // job 02059-319
---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: 1 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
TERRY/FERN SMITH • type amount by date recpt
10470 SW KABLE ST PRMT $ 40.00 TAT 06/09/97 97-295675
TIGARD OR 97223 5PCT $ 2.00 TAT 06/09/97 97-295675
Phone #:
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Contract or:
PHOENIX ELECTRIC CO $ 42.00 TOTAL
7379 SW TECH CENTER DR.
------- REQUIRED INSPECTIONS
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TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 684-3600 Wall Cover Elect'l Service
Reg #..: 000522
This permit is issued subject to the regulations contained in the `/ '�~�^�[ /
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitte i gnat ur
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. Issu''d By �
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OWNER INSTALLATION ONLY �
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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
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SIGNATURE OF SUPR. ELEC' N: // DATE: ���9�'" ^/
° - 7/- ^ ^�r / / �
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LICENSE NO: /Y/0u
Call for inspection - 639-4175
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CITY Of TIGARD Electrical Permit Application Plan Check #
1 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 4175 Permit # (.cq -O352. -
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of si busines • . , c ` Service included: Items Cost Sum
I
Address \4'1 U a(� ktiL1
� 2(i o �n 4a. Residential - per unit
�''�(�`� c 1000 sq. ft. or less $110.00 4
City /State /Zip
l ` lJ `L 1 1 �d� I Each additional 500 sq. ft. or
I' Commercial ❑ v Residential portion thereof $25.00 1
Limited Energy $25.00
a Each Manuf'd Home or Modular
V Dwelling Service or Feeder $68.00 2
2a. Con actor installatio 7y:
(Attach copy o' f�. II current licenses) 4b. Services or Feeders
Electrical Contractor0- E, et✓. ‘�` -1c•1 Installation, alteration, or relocation
Addres 4 1 Sf� .4 Lo e.V 200 amps or less $60.00 2
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201 amps to 400 amps $80.00 2
C .•�+_ State Zips -3 401 amps to 600 amps $120.00 2
I lk. . i . _ NOW 601 amps to 1000 amps $180.00 2
Ov er 1000 amps or volts $340.00 2
Job No.._ L - ... Reconnect only $50.00 2
Elec. Cont. Lice. No. -- I xp.Date l04
OR State CCB Reg. No. 'lit g _��- . � t � • ��� _ l�/G1
E� , 31� 4c. Temporary Services or Feeders
COT Business Tax or Metro NcF -) 4 Exp.Date a'' Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 401 amps to 600 amps $ 2
� [l/B Over 600 amps to 1000 volts,
License No. S Exp.Date see "b" above.
Phone No.
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 cir $5.00 2
City State Zip b) The fee for branch circuits
y p without purchase of
Phone No. service or feeder tee.
First branch circuit $35.00 f5 2
The installation is being made on property I own which is not Each additional branch circuit $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: 40. .
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ n
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. ❑ Trust Account # 4c91-00
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: --77 / (p /�6/! 7 A.M. ir P.M. MST:
Location: /C'' (170 c kl.0 C J BUP:
Tenant: Suite: Bldg: MEC: 17' 6 /S
Contractor: C ,e �_.e1711;1., L_.-- Phone: 2 Z3 9(3 9'3 .kR4I PLM:
Owner: Phone: ELC 7r'
ELR:
_ SIT:
BUILDING BLDG (con't) PLUMBING ,_...
LUMBING .4i51 x \�I CM! �' • • a • , SITE
Site Post/Beam Post/Beam 'os :earn . - ice Sewer /Storm
Footing Roof UndFUSlab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved •%,iproved, , • •.rov•.s• Approved
Appr /Sdwlk Not Approved Not Approved No i►_ L. 6 ved 1 o • , a t d Not Approved
FINAL FINAL - INAL 1`` FINAL
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57-72, r/ p J 77 /4-,' / l / -rr 7D �» �i c' /, , '
/Z'l/(( -7 ,'/sCz -
0 Call for reinspect Cl Reinspection fee of $ required before next inspection Cl Unable to inspect
Inspector: LL.■ Date: „ �( I 12 Page of
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