Permit CITY OF TIGARD ELECTRICAL PERMIT
i ��, „d , DEVELOPMENT SERVICES PERMIT #: ELC98 -0509
t �l��l
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/26/98
PARCEL: 25102BD -00100
SITE ADDRESS...: 1`645 SW PACIFIC HWY
SUBDIVISION -NO. TIGARDVILLE ADDITION AMEND ZONING:R -12
BLOCK • LOT •052 JURISDICTION: TIG
Project Description: Alteration of electrical service. Job No. 23120.
- -- 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
ROMAN CATHOLIC ARCHBISHOP OF type amount by date recpt
PORTLAND IN OREGON PRMT $ 35.00 DLH 08/26/98 98- 308613
2838 E BURNSIDE SPCT $ 1.75 DLH 08/26/98 98- 308613
PORTLAND OR 97214
Phone #:
Contractor:
GRAND ELECTRIC $ 36.75 TOTAL
PO BOX 12253
REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Elect'l Service
Phone #: 234 -9329 Wall Cover Elect'1 Final
Reg #..: 64378
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 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5031246 -1987.
Permittee Signature: /1,9 /LE 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: 4//9- DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUP R. ELEC' N : D7J /97 L/ e 977OAJ DATE: �� !q
�,
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
PITY OF TIGARD Electrical PermikApptisation Plan Check #
13125 SW HALL BLVD. Rec'd By 2_ L/,
Date Rec'd F/2 (o 9�
TIGARD OR 97223 AUG 2 0 1998 Date to P.E.
Phone (503) 639 -4171, x304 �/ Date to DST &
Inspection (503) 639 -4175 Printa:rTypq DEVELOPMENT Permit # Ec.c_94? d 3 `J
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ,/) �} Number of Inspections per permit allowed
Name (or name of business) ST‘ A /U th A (( S Service included: Items Cost Sum
Address ( G (Li S 6 r (,fie. t (J '\ C I -L( 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip 't c (. r-e Each additional 500 sq. ft. or
Commercial Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
14 1 r vl.N G p N ✓) �e.-t Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licensesi 4b. Services or Feeders
Electrical kntractor Cr (r0... vLeA E (4 e-t r ■ L Installation, alteration, or relocation
Addre s Y40. (SOX 1 2 2 3 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City r1 r - - State l7 r Zip j 7 212 401 amps to 600 amps $120.00 2
Phone No. 238 - 601 amps to 1000 amps $180.00 2
Job No. 2 31 2.0 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. - S Exp.Date !U - 9 _
OR State CCB Reg. No. Exp.Date 3 - 9 ' ✓ 4c. Temporary Services or Feeders
COT Business Tax or Metro No Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps 75.00
Signature of Supr. Elec'n 401 amps to 600 amps $100 00 2
�`� t 2 - 5 Exp.Date /0 - I R Over 600 amps 1000 volts,
License No. p. see "b" above.
Phone No. 7 `c(-4 `e 3`7 CI 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 circuit $5.00 2
-
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. service or feeder fee. 2
First branch circuit ( $35.00 2
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:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ I
NOTICE Subtotal $
5b. 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. ❑ Trust Account # 3 `-
11� ?
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
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05/15/2000 Activities for Case #: ELC98 -00509
2:54:48 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 08/26/1998 DLH RECD DLH 08/26/1998
ELCC003 Permit created 08/26/1998 DLH DONE DLH 08/26/1998
ELCC500 (F)Issue permit 08/26/1998 DLH DONE DLH 08/26/1998
ELCC799 Elect'I Final 08/31/1998 CD PASS CD 08/31/1998 circuit to f.a. panel
ELCF800 Case Fineled 08/31/1998 CD PASS J'H 08/31/1998 POWER SUPPLY FOR FIRE
ALARM AT NEW MODULAR
CLASSROOM
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