Permit CITY OF TIGARD PERMIT
PERMIT #: ELC1999 -00512
� j•• . A DEVELOPMENT SERVICES DATE ISSUED: 8/19/99
C M S 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 208
SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Add signal circuit or limited energy panel.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: 1
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:
TIGARD PROPERTIES INC ESP COMMUNICATIONS INC
2106 SE OCHOCO ST 28170 SW BOBERG RD
MILWAUKIE, OR 97222 WILSONVILLE, OR 97070
Phone: Phone: 682 -4195
Reg #: LIC 00073872
SUP 2281JLE
ELE 34269CLE
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT GEO 8/19/99 $60.00 99- 317768 Elect'l Final
5PCT GEO 8/19/99 $4.20 99- 317768
Total $64.20 ORIGINAL
•
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 •uestions to OUNC at (503)
246 -1987. �j
P
/
ermit Signature: � Issued By: �
J '
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: frL ) , DATE: 7� n' — ` / ` 99
LICENSE NO: 766 — 7 LE
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Permit Applic, Plan Check #
N
13125 $W HALL BLVD. IVE Recd By
TIGARD OR 97223 Date Recd
Phone (503) 639 -4171, x304 AUG 19 1999 Date to P.E.
Date to DST
Inspection (503) 639 -4175 Print of TypeCOMMUNITY DEVELOPMEili Permit # Oceif! 1f- 07378
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: AA A�, 4. Complete Fee Schedule Below:
Name of Development /'{Ni.l 7Or�✓, -2-1-4C. Number of Inspections per permit allowed
Name (or name of business) `' • ' ' Service included: Items Cost Sum 4'
Address ) 1 )L5 c ) L/r,') >PACt PIC. /-} wH 4a. Residential - per unit
City /State /Zip j, -,, fet) Q 9'? ? 3 1000 sq. ft. or less $ 117.75 4
/ Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial Residential ❑ Limited Energy $ 60.00
Each Manut'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provida contractor license 45. Services or Feeders
information for COT data base) Installation, alteration, or relocation
Electrical Contractor • Q tr , _ , O 200 amps or less $ 64.25 2
Address ,2)3 G U ESE 201 amps to 400 amps $ 85.50 2
City 1 Lt. State 0' Zip 9/7^^2]Q 401 amps to 600 amps $ 128.50 2
C� 601 amps to 1000 amps $ 192.50 2
Phone No. ��,3 -- L-o -„2-4-i, 4 5 - Over 1000 amps or volts $ 363.75 2
Job No. f Or7 s ! r• _ 1 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. , .WI l xp.Date 0 4c. Temporary Services or Feeders
OR State CCB Reg. No. q g EX .Date i Installation, alteration, or relocation
COT Business Tax or Metr. No. (k/(pe' Exp.Date (p CZ, 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
/ / 401 amps to 600 amps $ 107.00 2
ignature_of_Supt _Elec'm _ Over 600 amps to 1000 volts,
License No..,,
1 Exp.Date )Q) 99 see "b" above.
Phone No. , 'I_ :-.- 9 ' ?- )9,1- 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, a alteration or extension $ 60.00 Loa 0
Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable In any of the above
Per inspection $ 50.00
Service and feeder 225 amps or more Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as ,
described in N.E.C. Chapter 5 5. Fees: m)
6a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. urcharge (Al( total fees) $ Lr ,an
Not required for temporary construction services. Subtotal ' $
5b. Enter 25% of line 5a for XJ NOTICE Plan Review if required (Sec. 3) h ' $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal / (0 $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR J/
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ l "'l 2D
D �
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