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Permit I . CITY OFTIGARD �� „ei a ;, DEVELOPMENT SERVI ELECTRICAL PERMIT J' ��u � +��� 1 3125 SW Hall Blvd., Tigard, 0R 97223 (503) 639 -4171 DATE PERMIT ISSUED : 06/02/97 PARCEL: 1S133DC -16700 SITE ADDRESS...:13112 SW LAURMONT DR SUBDIVISION °VILLAGE AT SUUMMER LAKE PARK ZONING:R -12 BLOCK - LOT JURISDICTION: TIG Project Description: INSTL 2 BRANCH CIRCUITS I/ JOB g ? - -- 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 DR 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 PAUL EVERETT type amount by date recpt 13112 SW LAURMONT DR PRMT $ 40.00 TAT 06/02/97 97- 295317 TIGARD OR 97 223 SPCT $ 2.O0 TAT 06/02/97 97- 295317 Phone #: Contractor: GRF ELECTRIC $ 42.O0 TOTAL 15460' SE PARADISE LN REQUIRED INSPECTIONS MULINO OR 97042 Ceiling Cover Underground Cove Phone #: 503 -829 -4146 Wall Cover Elect'1 Service Reg #.. : 001015 This permit is issued subject to the regulations contained in the dint eL f Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i to- S i gnat qre applicable laws. All work will be done in accordance with I approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more. / , than 1:' days. I ssL ed 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 SUPR. ELEC'N: h � e , . 4 4 . . i . /�/ DATE: 6 - 2 -97 LICENSE NO: t,S Call for inspection - 639 -4175 CITY ,OF TIGARD Electrical Permit Application Plan Check # 1 ?1 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Rec'd Date to P.E. Phone (503) 639 -4171, x304 D ate to DST Print or Type , Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # -- - '1 � - r� Fax (503) 684 -7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed u Name (or name of business) Pa I a/c y et-t Service included: Items Cost Sum Address 1 3 11 2 S (,J L q IA 1/ ' v1.--7-a - hr 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 City /State /Zip / i Gi 6' Each additional 500 sq. ft. or Commercial ❑ J Residential � 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 Electrical Contractor e7 t I E? e-c ., c_... Installation, alteration, or relocation 200 amps or less $60.00 2 Address rQ () P6 r 0 ti x .4' -1 201 amps to 400 amps $80.00 2 City M t 1 i v, C State Zip q7n Z 401 amps to 600 amps $120.00 2 Phone No. 57 - k.Y -1 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. ,?(J) - S ,r( L` - Exp.Date OR State CCB Reg. No. it)/ 3 Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro Signature No. Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 Si of Su r. Elec'n 201 amps to 400 amps .$75.00 2 g p 2/7---- 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. S a 3 - S Exp.Date see "b" above. Phone No. EID-Q-I -c-1- 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 circ $5.00 2 b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. 5 First branch circuit 1 $35.00 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 5 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: i y /, Not required for temporary construction services. 5a. Enter total of above fees $ '[ Z 5% Surcharge (.05 X total fees) $ -- 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 - DAYSOR IF CONSTRUCTION - OR WORK -- - - -- - Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # (-f-O Total balance Due $ I: \DSTS \ELC96.APP Rev 9/96 • -r= CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 eL.0 1 " rr p Date Requested: • �J' 02 1 ? 1 A.M. P.M. MST: Location: I '' I ,54 Activ ,An07,4- 23A , BUP: Tenant: Suite: Bldg: MEC: Contractor: r - k �.C.L . — -/ I sr - C MC. - LCPhone: „ 2-3- I ' . 31 1 PLM: Owner: C C EL- C, Phone: ELC: /1/4 - ,L d O( ITT© # YE - CQ3MPCtreg- PEAt. ELR: - - - - SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL _ SITE Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab 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 Approved Approved Approved Appr /Sdwlk Not Approved Not Approved Not Approved o pp Not Approved FINAL FINAL FINALFIN FINAL A u A Av /C - ,-if) 4 uxi / T 2_0 (MP rt p-g ) • '\ • • C. '..----- 4 v -O -Call for - reinspection - - 53 Reinspection fee of $- - required befo a next inspection 17I to inspect - - - Inspector: Inspec c. �.tL Date: Page of