Permit CITY OF TIGARD ELECTRICAL PERMIT
/ .
! DEVELOPMENT SERVICES PERMIT #: ELC98 -0678
+L �I�� 13125 SW Hall Blvd., Tigard, OR 97223(503) 639 -4171 DATE ISSUED: 11/09/98
PARCEL: 1S136CA -01800
SITE ADDRESS...:11643 SW PACIFIC HWY
SUBDIVISION • ZONING:C -G
BLOCK • LOT • JURISDICTION: TIG
Project Description : Add first branch circuit.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1 000 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 INSPECTION -
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
AMA AUTO BODY type amount by date recpt
11643 SW PACIFIC HWY PRMT $ 35.00 GEO 11/09/98 98- 310649
#B & C 5PCT $ 1.75 GEO 11/09/98 98- 310649
TIGARD OR 97223
Phone #:
Contractor:
BECK ELECTRIC INC $ 36.75 TOTAL
9318 SE CHURCH ST
REQUIRED INSPECTIONS
CLACKAMAS OR 97015 Elect' 1 Service
Phone #: 656 -7396 Elect'1 Final
Reg #..: 000086
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 952-001-0010 through OAR 952-001-1387. You may obtain a copy
of these rules or direct questions to OUNC by calli (503)246 -1987.
Permittee Signature: Issued B
e mittee Sign :
y
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 : 6 DATE: //"
LICENSE NO: ! 3/?o
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD ' lectrie efrmit Application Plan Check #
13125 SW HALL BLVD. , : Rec'd By
TIGARD OR 97223 - 1998 NOV G 6 1998 Date Rec'd
Date to P.E.
Phone (503) 639 - 4171, x30" _,.,,, LOELOPMENT COM t
�,. iAU.aIP1515t EOlr'ifyp'e Date to DS;
Inspection ��
Inspection (503) 639 -4175 Permit #
Incomplete or illegible will not be accepted
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ,J 1 Number of inspections per permit allowed
Name (or name of business) AMA A 14° 4 %./ Service included: Items Cost Sum
I
Address / /6'0 5 4c, (c 667 voi / 4 4a. Residential - per unit
�
/ 9 1000 sq. ft. or less $110.00 4
City /State /Zip ?7 5a- ` '` i U/ / 3 Each additional 500 sq. ft. or
Commerciai,� Residential 1=1 Limited 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:
(Attach copy of alla/ rrent icenses) ,, 4b. Services or Feeders
Electrical Contractor age e /cc /r/ c Installation, alteration, or relocation
Address ‘73/1( 5( , C hrrl- 6 ST. • 20 amps to or less $60.00 2
f 201 amps to 400 amps $80.00 2
City r/g c%G i4r4 t State L Zip 9 7C2 /„5 401 amps to 600 amps $120.00 2
Phone No. 5'& - 7? `& 601 amps to 1000 amps $180.00 2
Job No. r- - fa 71 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. - -- ' Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 2 1C. Ex • Dat: Installation, alteration, or relocation
/ 200 amps or less $50.00 2
Signature of Supr. Elec'n ` , // - �d `1
1t, 201 amps to 400 amps $75.00 2
/
401 amps to 600 amps $100.00 2
? 7 /' _ Over 600 amps to 1000 volts,
License Nr ✓ occo Exp.Date see "b" above.
Phone N( 6254.- 739"6
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 circui $5.00 2 -
b) The fee for branch circuits
City State Zip without purchase of •
Phone No. service or feeder fee. / $35.00 2
First branch circuit l
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: 5.
Not required for temporary construction services. 5a. Enter total of above fees $ J
5% Surcharge (.05 X total fees) $ "-
NOTICE Subtotal $
sb. 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 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY /
TIME AFTER WORK IS COMMENCED. 1=1 Trust Account # 3 ` 75
$
Total balance Due
I: \DSTS\ELC96.APP Rev 9 /96 - _ _