Loading...
Permit CITY O F T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2002 -00503 A11 DEVELOPMENT SERVICES DATE ISSUED: 9/24/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DB-02500 SITE ADDRESS: 11636 SW PACIFIC HWY SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Install 200amp temp. for TI RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: - PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: — . - > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: NACHTIGAL, FRED C SUC PERS REP ST JOHNS ELECTRIC INC KESSLER, JULES E 4415 NE MINNEHAHA 101 SW WASHINGTON ST VANCOUVER, WA 98661 HILLSBORO, OR 97123 Phone: Phone: 360- 693 -5100 Reg #: LIC 43135 SUP 3024S ELE 37 -350C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT CTR 9/24/02 $66.85 2720020000( Elect'I Final 5PCT CTR 9/24/02 $5.35 2720020000( Total $72.20 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246.6699 or 1 -800- 332 -2344. Permit 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: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: O Ct 42p. DATE: LICENSE NO: °A 4 Call 639 -4175 by 7:00pm for an inspection the next business day • . ' Electrical PermitApplication Date received:Q c 9,1/ p z, Permit no. s� U ,p4 593 • .� :. .I C ity of Tigard Project/appl.no.: Expire date: City. of Tigard Address: 13125 SW Hall Blvd, Tigar ` 2 I V E e . issued: By j I Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: SEP 2 3 2002 V - U ... 5-, TYPE OF PERMIT . ❑ 1 & 2 family dwelling or accessory » Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction NI Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: f 4 6)36 5 W 'Cl ci,rlL )AJ • Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: Project name: star bu <5 I Description and location of work on premises: gp /nod 9I,, Ili til(Rv1(.� Estimated date of completion/inspection: � .11 GQLN.IRACCO AY� PLICA7 ION -,�,.. ,,, : . ITT, SCIIEDULE Job no: Fee Max Business name: ,�lnhng Et, MYi G line„ r Description Qty. (ea.) Total no. insp l � c,� New residential - single or multi - family per Address: `/ x415 n F, m i,n Q t . dwelling unit. Includes attached garage. City: V canal- I State: wA I ZIP: 9gabI . Serviceincluded: Phone:(3(if (pt3-6IQ I Fax 1(ffiLj -131 E -mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: L 13 5 Elec. bus. lic. no: 3"J - 3556 (,t Limited energy, residential 2 City /m ' . no.: (JO ii • I Limited energy, non- residential 2 _ r 934/0 y . Each manufactured home or modular dwelling Signature of supervising el or ian (required) Date Service and/or feeder 2 Sup. elect. name (print): p'/ R. i ur License no: •2 S Services orfeeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Tempomry services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 200 amps or less / ORS 447, 455, 479, 670, 701. WA (dp,$5 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fec for branch circuits with purchase cf Address: • service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 s ❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 t, family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: ❑ Egress/lightingplan ❑ Other. Per inspection Submit sets of plans with any of the above. Investigation fee • The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ Colo ,56 ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 5, 35 Expires accepted as complete. TOTAL $ . 1Z, 20 Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6J00lCOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES_: • Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost • Total y Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular El Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 ❑ Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less I $66.85 (p ,g5 2 (SEE OAR 918-260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. ❑ Audio and Stereo Systems Branch Circuits ❑ New, alteration or extension per panel Boiler Controls a) The fee for branch circuits • with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ El Other 8% State Surcharge $ Number of Systems 5 , 25% Plan Review Fee i See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. 1 Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts\forms\elc- fees.doc 08/30/01