Permit n CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC96 -0432
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/01 /96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S104BA -09100
SITE ADDRESS...: 13895 SW LIDEN DR
SUBDIVISION . CASTLE HILL #2 ZONING:R -25 PD
BLOCK • LOT •126
Project Description: Installing one branch circuit.
- -- 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: 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
SCOTT GUDEMAN type amount by date recpt
13985 SW LIDEN DR PRMT $ 35.00 CJS 07/01/96 96- 281226
SPCT $ 1.75 CJS 07/01/96 96- 281226
TIGARD OR 97223
Phone #:
Contractor:
GRF ELECTRIC $ 36.75 TOTAL
15460 SE PARADISE LN
REQUIRED INSPECTIONS
MULINO OR 97042 Wall Cover Elect'1 Final
Phone #: 503- 829 -4146 Elect'1 Service _
Reg #..: 101543
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i tt ee Signature
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 (k a Cie( (.
than 180 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 SUPR. ELEC' N : fYlc� ,l,o� DATE: 9
LICENSE NO:
Call for inspection — 639 -4175
1
• Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # q6- a 8/ aa6
,,s„ `f,l,rd Permit # FGC9r -o 43 a
,i I I Phone (503) 639 -4171 Date Issued 7/// 4f
_AIL - i (503) 684 -7297 /
Issued by rile, r LP c S_
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: (,, /�' 4. Complete Fee Schedule Below:
Name of � y -1 e/n� �S C-O I/t 0 e.�(r1� Number of Inspections per permit allowed
1 3 O
Address , ) ^ 5 (A) Li dean Dr, Service included: Items Cost(ea) Sum
City /State/Zip TT 4 1 4 rot. ' ZZ 3 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) Each additional 500 sq. N. or 1
portion thereof $25.00
-
Commercial ❑ Residential F.. Limited Energy $25.00
Each Maned Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor 6 (�.F' it CC,Y1;C� 200 amps or less $60.00 2
r G 4 r A. 201 amps to 400 amps $80.00 2
Address -(,Q 5, G� .L7 401 amps to 600 amps $120.00 2 - City MAA i i y.i 0 State _ _ Zip 1 n' -a 601 amps to 1000 amps $180.00 2 -
Phone No. c(2- Q-- �1 � � f �/1 C Over l000 amps orvolts $340.00 2
Contractor's License No. ,2(8 _. g ( Reconnect only $50.00
- Contractor's Board Reg. No. / 4151 1 - 3 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less $50.00 2
-
201 amps to 400 amps $75.00 2
License No. 3 ((�3- j one No. R2_9 -1 �f 401 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 lee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or reader flee. 2
not intended for sale, lease or rent. First branch circuit $35.00 �V 2
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 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 Pe r inspectio $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 $ 35--
5% Surcharge (.05 X total fees) $ I t ? s
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 $ ., Ia
wenneancioNalse-pnwapp
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing Mec
Plbg.Und /Flr /Slab Plbg. Top Out Insulation lect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: aa.
Date: 7 - A.M. ,6 5 P.M. Entry:
Address: / 3 8-r?..) 5 Cc) D 6 ,v
Tenant: Ste: MST:
BUP:
Con •wn: �� _ .._�.�. ��� _ MEC:, C —'O..05
PLM:
-2 35- j(J 63 ELC: 7tISPT
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspe or: . //" �/ Date: 7-8=94
APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO