Permit 7 _'9 • .
I • ELECTRICAL PERMIT ^/
PERMIT #: ELC96-0(D15 ~-
'' CITY OF T I ��C�-�� DATE ISSUED: 01/10/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (5o3)m39-4,r1 PARCEL: 1S135CC-03000
SITE ADDRESS...: 10135 SW KATHERINE ST . - .'
SUBDIVISION ^ GREENBURG HEIGHTS ADDITION ZONING:R-4.5 .
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :11 •
Project Description: Install three branch circuits.
|
I ___ _ _ _ _
---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: 2 IN PLANT ^ 0
601 - 1000 amp.....: 0 - ---PLAN REVIEW SECTION----- ' --
1080+ amp/volt.....: 0 }=4 RES UNITS........: > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Owner: -------- • - FEES - ------
�
ELECTRICAL CONTRACTORS type amount by date recpt
150 NE VICTORY PRMT $ 45.00 CJS 01/10/96 96-274788
SUITE A 5PCT $ 2.25 CJS 01/10/96 96-274788
GRESHAM OR 97030
Phone #: 503-666-9358
Contractor: - - - - - ---
ASDF $ 47.25 TOTAL
REQUIRED INSPECTIONS
Elect'l Service ______ _
Phone #: Elect'l Final . __
Reg L.
This peroit is issued subject to the regulations contained in the _ ____ __ ---
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 peroit will expire if work is not started
�
within 180 days of issuance, or if work is suspended for more _/��y��J�/��J' x�c��/��/��7 _ _-_
than 18W 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 SUP R. ELEC' N: _Pin, _ __ DATE: y �« � __
LICENSE NO: ____ , _ �___________.____ _ __ ___
Call for inspection - 639-4175 '
_ '---
Y.
k
, i. Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 96-/i/7 81?
PX � \ Permit # r'LC96 -oni s
AIi'l Phone (503) 639 -4171 Date Issued /- /o - 96
^ FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by CLa -�� r _53- h.�, 24
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address 1 0 1 3 5 S . W . K a t h e r i n e Service included: Items Cost(ea) Sum
City /State/Zip T i g a r d 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) Each additional 500 sq. ft or 1
portion thereof $25.00
Commercial ❑ Residential ® Limited Energy $25:00 - Each Manufd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Electrical F e tFaat~o? cal Contractors & Design Installation, alteration, or relocation 2
h
200 amps or less $60.00
Address 150 N. F. Victory suite i t e A 201 amps to 400 amps $80.00 2 - 401 a to 600 amps $120.00 -
City (r e c ham State n y p ,Zip C) I n n 601 amps to 1000 amps $180.00 2
Phone No. 666-9358 Over 1000 amps or volts $340.00 2
Contractor's License No. 26-466 C Reconned only $50.00
Contractors Board Reg. No. 4 7 7 12 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n
200 amps or less $50.00 2
l� 2
201 amps to 400 amps $75.00
License No. 1 FIR ? S Phone No 6-9358 4 01 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see •b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
Ci State Zi purchase of service or feeder fee. 2
ty p Each branch circuit $5.00
Phone No. b) The tee for branch circuits withou
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 branch circuit 1 $35.00 3 5
Each additional branch circuit - 2 - $5.00 1 U . 88 2
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
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 58. 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 ins $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:
NOTICE 5a. Enter total of above fees $ 4 5 .. n n
5% Surcharge (.05 X total fees) $ 2 . 2 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% 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. ❑Trust Account # $
Balance Due $ 12,21_
wo dvonMONWx pmapp
Case Activity Listing 1/6/2005
1/11111 12:50:49PM
TIDEMARK Case #: ELC96 -00015
COMPUTER SYSTEMS, INC.
...:,: . ��� �,. y��r�.:''�:•Assi ned.- _Doire, �::U - dated,
� D ' i
ate:2� � ate"3� "- .. ,. «:Hold•: � o =' "B B: ates;?,
� at Descr -t Lion h�'F Date 1 .. �D :b T
.ELCA001 Application received 1/10/1996 None RECD CJS 1/10/1996
CTR
ELCA003 Permit created 1/10/1996 None PEND CJS 1/10/1996
CTR
ELCA730 Elect'l Service 1/10/1996 4/22/1996 None APP GS 4/22/1996
GES
ELCA500 (F) Issue permit 1/10/1996 None PASS CJS 1/10/1996
CTR
ELCA500 (F) Issue permit 1/10/1996 None PASS CJS 1/10/1996
I CTR
ELCA730 El'ect'l Service 1/10/1996 None PASS MJR 1/10/1996 reconnect and contractor will check
MJR for problems
ELCA720 Wall Cover 4/22/1996 None APP GS 4/22/1996
GES
ELCA800 Case finaled 4/22/1996 None OK MJR 12/31/1996
MJR
Page 1 of 1 CaseActivity..rpt