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Permit CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97 -0372 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06 / 13 / 97 PARCEL: 2Sl04BA -15400 SITE ADDRESS...:13546 SW LIDEN DR SUBDIVISION •CASTLE HILL NO.3 ZONING:R -12 PD BLOCK • LOT •184 JURISDICTION: Project Description : Installing first branch circuit - -- 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 (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/0 SRVC OR FDR.: 1 PER HOUR • 0 401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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 LINDA FOSS type amount by date recpt 13546 SW LIDEN DR PRMT $ 35.00 B 06/13/97 97- 295928 TIGARD OR 97223 5PCT $ 1.75 B 06/13/97 97- 295928 Phone #: Contractor: SUNRISE ELECTRIC $ 36.75 TOTAL 12755-B SW BEAVERDAM RD REQUIRED INSPECTIONS BEAVERTON OR 97005 Ceiling Cover Underground Cove Phone #: 643 -5277 Wall Cover Elect'1 Service Reg #..: 000157 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issuance, or if work is suspended for than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center ose rule u in OAR 952 -001 -0010 through OAR 952 -001 -1987. You my obtain a copy of these rules or direct questions , OUNC by ca Permittee Signature: - -- 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: CO RACTOR INS ONLY SIGNATURE OF SUPR. ELEC' N: DATE : I 3' - -.. _' LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ • CITY' OF TIGARD Electrical Permit Application Plan Check 13125 SW HALL BLVD. Rec'd By (5 dil ) Date Rec'd 13 TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print or Type Permit # r aq 7 - 0 Z_ 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 business) kabi - F9S5 Service included: Items Cost Sum Address L L(f. , L CA -ED7 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 City /State/Zip ' C-n 7 r) Each additional 500 sq. ft. or Commercial ❑ Residential '' portion thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders (Attach copy of all current licenses) Electrical Contractor r r . _ Installation, alteration, or relocation ' 200 amps or less $60.00 2 Address ±'YI �?1 - �£9J 201 amps to 400 amps $80.00 2 City Zthittlt - 7, State Zip Cl,Lfr'7c. 401 amps to 600 amps $120.00 2 Phone No. 64Z- <2.) 7 601 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. .3 Exp.Date /OR State CCB Reg. No. 01<74 xp.Data 4c. Temporary Services or Feeders ,,COT Business Tax or N• Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 201 amps to 400 amps $75.00 2 Signature of Supr. Elec'n _� 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, i License No. t Exp.Date see "b" above. Phone No. I(--e! Z2-.71 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. i 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. per' First branch circuit L $35.00 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: �r� Not required for temporary construction services. 5a. Enter total of above fees $ 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 180 DAYS, OR IFCONSTRUCTION"OR WORK Subtotal $ - _ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # -16 $ Total balance Due Ai Lej I: \DSTS \ELC96.APP Rev 9/96