Permit CITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00253
l DEVELOPMENT SERVICES DATE ISSUED: 4/27/99
'l I° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102CB -02300
SITE ADDRESS: 13200 SW PACIFIC HWY
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Installation of one branch circuit.
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:
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: 1 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:
PACIFIC PROPERTIES PHOENIX ELECTRIC CO
BY MARTIN JOHNSON 7379 SW TECH CENTER DR. •
13200 SW PACIFIC HWY TIGARD, OR 97223
TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
•
PRMT DRA 4/27/99 $35.00 99- 314863 Elea! Final
5PCT DRA 4/27/99 $1.75 99- 314863
Total $36.75
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 copie : • = e rules or direct questions to OUNC at (503)
246 -1987.
Permit Signature: n Issue By: ,A.• • • 0(04_ 4
• 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: DATE: /
LICENSE NO: '/Ky0 3
•
Call 639 -4175 by 7:00pm for an inspection the next business day
r
APR - 26 - 99 MON 01:47 PM PHOENIX ELECTRIC CO FAX NO. 15036843611 P. 02/02
• •
RECEIVE- - Electrical Permit Application Plan Che
CITY OF TIGARD Recd B O�
Date Recd "' 9
13125 SW HALL BLVD. ApR 2 6 1999 Date to P.E.
TIGARD OR 97223 Date to DST
Phone (503) 639 -4171, x30, DEVELOPMENT Print or Type Permit* EI 0053
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Called
Fax (503) 684 -7297
1, Job Address: 4. Complete Fee Schedule Below:
Number of Inspections per permit allowed
Name of Development III
Name (or name of business l� < <\ `k � v�
,i��a� Service Included: Items Cost Sum
^ ) . ` • C : "` 43. Residential - per unit
Address 3
1000 sq. fL or less $110.00 4
City/State/Zip thereat $
25.00 -
• .L_ "1 a - Each additional 500 eq. ft. or $25.00 1
a l +�
Resid ntial ❑ limited Energy
Commercial rd Home or Modular $68.00 _ 2
lAA. `.k - P r r, I� � Each Manu Dwelling Service Home or
2a- Contractor Installation only: 4b. Services or Feeders
(Attach copy • I current llcen - =_ Installation, alteration, or relocation $60.00 2
A� 7 200 amps or less
• n -- I �� L. _ $80.0 2
Electrical �( ) E , ` ` e.. r / 2 01 amps t o 400 amps $ 2
Adds 401 amps to 600 amps $120.00 2
Slate Zip � 601 amps to 10 amp _ $180.00
City 6 '-r : 2
_ $340.00
Phone o• M i ' 1 Reconnect only $30.00 2
Job . Cont. ' Dom• x p.
Elec. C Lice. No. ��� Over 1000 amps or volts
EDate ra
Tempo
. c ry Feeders
Services or Fee
OR State CCB Reg. No. c a- ' t Exp.Date qTempo a ry Sv relocation $50.00 2
COT Business Tax or Metro No. 9(P- Exp.pate, 200 amps or less
201 amps to 400 amps $$1075.00 2
��� _ 0.00 2
Signature of Supr. Elec' 401 amps to amps to amps
Over 600 amps to 1000 volts,
L t� Exp.DatO • see "b" above.
Phoo ne No.
License No.G 4d. Branch Circuits
P New, alteration or extension per panel
a ) The lee for branch circuits with
2b, For owner installations: purchase of service or
loader fee. $5.00 2
Print Owner's Name E ach branch circuit
Address �� b) The Teo for branch circuits
State Zip without purchase of�
City service or feeder fee. $35.00 '. 2
Phone No. F irst branch circuit 3 $35.00 2
I own which Is not • Each additional branch circuit $
The installation is being made on property 4e, Miscellaneous •
intended for sale, lease or rent. (Service or feeder not included) $40,00 2
Each pump or irrigation circle $40.00 � — 2
Owner's Signature E ach sign or outlino lighting
Signal circuit(s) or a limited energy $40.00 2
9, Plan Review section (if required):'` i panel, alteration or extension $100.00
Minor Labols (t0)
Please check appropriate item and enter fee in section 56. 4f, Each additional Inspection over
4 e
or more and feeder ral units in one more the allowable In any of the above $35.00
— _ Service o ne 600 v It 225 amps l more Per inspection $35.00
T _ Class i over area o volts nominal special occupancy Per hour $
Classfied area or structure containing spe P cy In Plant as described in N.E.C. Chapter 5 ' 5 Fees: . ' 4--- 4--- I �
' Su 2 sets of plans with application whore any of the above apply. 5 . Enter total of above fees $
Not required for temporary construction services. 5% Surcharge (.05 X total fees) $ j
Subtotal $ alf
NOTICE, 5b. Enter 25% of line 5a for eview if uir d (SeC.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS 8 Plan unr R 1al $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK uru Account 8 `S� d �
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. Total balance Due
t:T57 SICI.C55.APP Rw MG .
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