Permit ,* CITY OF T ELECTRICAL PERMIT
PERMIT #: ELC97 -0824
ln , ,� DEVW LOPMEN SERV I DATE ISSUED: 12/16/97
13125 PARCEL: 1S135AA -00900
SITE ADDRESS...:O895O SW LOCUST ST
SUBDIVISION -TOWN OF METZGER ZONING:R -4.5
BLOCK • LOT •004 JURISDICTION: TIG
Pro.j ect Description : Installation of one service or feeder at 280 amps or less.
- -- 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 • 1 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 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
ZEHNTBAUER type amount by date recpt
08950 SW LOCUST PRMT $ 60.00 TJH 12/16/97 97- 301817
TIGARD OR 97223 5PCT $ 3.00 TJH 12/16/97 97- 301817
Phone #:
Contractor:
PARKIN ELECTRIC INC $ 63.00 TOTAL
20250 S MOLLALA AVE
REQUIRED INSPECTIONS
OREGON CITY OR 97045 Rough —in Elect'1 Final
Phone #: 246 -1301 Elect'1 Service
Reg #..: 000351
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 permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952481 -9910 through OAR 952-91 -1987. You may obtain a copy
of these rules or direct questions to mAdC by calling (583)246 -1987.
Permittee Signature: 0 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 SUPR. ELEC' N: l/ t. . � DATE: /L/ // /2
LICENSE NO: 4 241 S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + +++
Community Development ELECTRICAL PERMIT APPLICATION
•
A 1.ii, i' 13125 SW Hall Blvd. PIA
Tigard, OR 97223 Planck/Rec. #
� . r, Permit # z,�..:�, _ a���Nb.-= l -0931'
;� �I Phone (50 639 -4171 Date Issued 12,1111 6 Y1 091*
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by 'T•
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address - 1 S) \ 0 C,u-S - Service included: Items Cost(ea) Sum
City /State/Zip \ J A_ . 4a. Residential - per unit 4
J 1000 sq. tt. or less $110.00
-
sq. Name (or name of business) Each additional 500 ft or 1
portion thereof $25.00
-
Commercial ❑ Residential' Limited Energy $25.00 - Each Maned Home or Modular 2
Parkin Electric, Inc. 20250 S Molalla Ave. Dwellin
Service or Feeder $se.00
Oregon City, OR..97045 503 -657 -4958 fax: 557 -1059 4b. Services or Feeders &V VU Shop 1
Contractors License #: 34-4C exp. 10 -01 -98 Installation, alteration, or relocation 2
200 amps or less 1 $60.00 (00 2
Supervisor: 4241 -S exp. 10 -01 -98 201 amps to 400 amps $80.00 2
Contractors Board Reg #: 35151 exp. 10 -12 -98 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Metro # 2416 exp. 11 1 - Over 1000 amps or volts $340.00 2 - Owner: Reconnect only $50.00
-
4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n tl %-- 200 amps or less 00 $50.00 2
Licen No. Phone No. 201 amps to 400 am $75.00
-
401 amps to 6amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: Bee •b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip Each branch d�� or feeder fee. $5.00 2
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35.00 2
not intended for sale, lease or rent.
Each additional branch circuit $5.00
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 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Min 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 occupancy containing special cupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $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 $60 _
5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. 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 $
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