Permit . .
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
-e'1-12 13125 SVK Hall BAvd.,Tio���R�Q�/8�U�g��7/ PERMIT #: ELC97-0266
Tigard, DATE ISSUED: 05/06/97
PARCEL: 2S112CC-11000
SITE ADDRESS...:08261 SW LANGTREE ST
SUBDIVBSIONLANGTREE ESTATES ' ' ZONING:R-12
BLOCK...... ^ LOT.............:42 JURISDICTION: TIG
Project Descri pt. konl 2 branch s // job # 2059-166
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MI SCELLANEOUS
1000 'SF OR LESS ~ 0 0 - 200 ampi ' ^' 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 NOMINAL4.:
Reconnect only.....: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Owner: . - FEES --
STEVE CASE ' type amount by date recpt
8261 SW LANGTREE PRMT $ 40.00.TAT 05/06/97 97-294184
TIGARD OR 97224 5PCT $ 2.00 TAT 05/06/97 97-294184
Phone #:
Contractor: - - ---
PHOENIX ELECTRIC CO $ 42.00 TOTAL
7379 SW TECH CENTER DR.
------- REQUIRED INSPECTIONS
__
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 are: .Specialty Codes andvall'other ` t e Si gnature
applicable laws. All work will be done in accordance with
approved plans. ^ This-permit will expire if work is not started
� � �
within18N days ofism 'i
ance,orif'workssuspooded''for',�re �� ''''� � _ =�4~ �^ = (
I
than 180 days. . ^� � ' 1.. ` ^ sued By
OWNER INSTALLATION ONLY / ' '
The installationis� be^ino 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'
'0_4 ��`
N: �� ^ / DATE: �� -^ �
. , /,
LICENSE NO:
qJO3 '
Call for inspection - 639-4175
MAY -06 -97 TUE 08:43 AM PHOENIX ELECTRIC FAX NO, 503 684 3611 P.02/02
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Recd By
Date Rec'd
TIGARD OR 97223 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 #
Fax (503) 684-7297 - Call i✓LL
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) S..,\J \ � Service included: items Cost Sum
Address t0"�� 0 t 4a. Residential -per unit •
/StatelZl 1 n ( Each additional it or less $110.00 4
Ci
ty p, r + �� q Each additionaE 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ R251denAal0 limited Energy 525.00
t't-Ci.t•.agola.- 1 Each Maned Home or Modular
. 40- L e j l 0�,` Dwelling Service or Feeder x.00 2
a . C tractor Installation only: •
(Attach copy aLa current licenses) 4b. Services or Feeders
Electrical Contractor h • motet �"1j` , V Installation, alteration, or relocation
_ 4 200 amps or less $60.00 2
S
Add SS 201 amps to 400 amps $68.00 2
Ci 1 i...s ,a • State il`! ZrP neit11 401 amps to 600 amps $120.00 2
a
Phone No.1 .. • ` . A .4 ' . - - 7 601 amps to 1000 amps 5180.00 2
Job No. - Jt /o Over 1000 amps or volts $340.00 2
` Reconnect only $50.00 2
Elec. Cont. Lice. No. - 1C-' Exp -Date I) ► '
OR State CCB Reg. No. p.Datet _.rr1]
r 4c. Temporary Services or Feeders •
COT Business Tax or Metro No. - Exp.Datel -.E. a Installation, alteration, or relocation
200 amps or less 550.00 2
-
Signature of Sur. Elec'n eg 201 amps to 400 amps $75.00 . 2
9 P 501 amps to 600 amps $100.00 . 2
-
•
Over bob amps to 1000 volts,
•
License No. 1 Exp -Date see "D" 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 circuit $5 -00 2
b) The fee for branc circuits
City State Zip without purchase of
Phone No_ service or feeder fee.
First branch circuit _l__ $35.00 2
The installation is being made on property I own which is not Each additional branch circus _i__ $5.00 Ol
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 energ
panel, alteration or extension $441.00 2
- Minor Labels (10) $
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 c ontaining special occupancy - Per hour $ 55 . 00
as describ6d in N.E.C. Chapter 5 In Plant $
' Submit 2 sets of plans with application where a ny o f the above apply. 5. Fees: 00
Not required for temporary construction services. 5a Enter total of above fees $ •
5% Surcharge (.05 X total fees) $ ' 5 Y
NOTIcq Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME IF WORK OR CONSTRUCTION AUTHORIZED IS Plan if nequired (Sec.3) $ - - - - NOT COMMENCED WITHIN 180 DAYS. OR IR CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. Trust Account #S Q Q
Total balance Due
Case Activity Listing 1/4/2005
TIDEMARK Case #: ELC97 -00266
COMPUTER SYSTEMS, INC.
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ELCA001 Application received 5/6/1997 5/6/1997 None 5/6/1997
TAT
ELCA003 Permit created 5/6/1997 5/6/1997 None 5/6/1997
TAT
ELCA500 (F) Issue permit 5/6/1997 None PASS TAT 5/6/1997
TAT
ELCA799 Elect'! Final 6/13/1997 None PASS TLP 8/26/1997 Corrections made.
J *H
ELCA800 Case finaled 6/13/1997 None PASS TLP 8/26/1997
J *H
ELCA799 Elect'! Final 5/6/1997 6/13/1997 None FAIL BRP 6/18/1997 unable to inspect, no one home (3:40
J *H pm)
Page 1 of I CaseActivity..rpt