Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC98 -0493
r r y i ( DEVELOPMEN SERVICES DATE ISSUED: 08/19/98 -4171
— 13125 PARCEL: 2S1O2CB -01800
SITE ADDRESS...:13473 SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK • LOT - JURISDICTION: TIG
Pro.j ect Description : Permanent sign
- -- 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..: 3
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/0 SRVC OR FDR.: 0 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
PUBLIC STORAGE type amount by date recpt
13473 SW PACIFIC HWY PRMT $ 120.00 DRA 08/13/98 98- 308253
TIGARD OR 97223 5PCT $ 6.00 DRA 08/13/98 98- 308253
Phone #:
Contractor:
MARTIN BROS INC $ 126.00 TOTAL
3165 COMMERCIAL ST SE
REQUIRED INSPECTIONS
SALEM OR 97302 Ceiling Cover Elect' 1 Service
Phone #: 364 -2211 Wall Cover Elect'1 Final
Reg #..: 000647
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 sore 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 say obtain a copy
of these rules or direct questions to OLAIC by calling (503)246 -1987.
Permittee 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: DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
,t.Ggg- c4ti
.- Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
• Ai h + Permit #
• Phone (503) 639 -4171 Date Issued
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development `�.( 1 0 ,,54-6 4. • . Number of Inspections per permit allowed
■
Address 13 7 3 SCJ 4 C 4Ii., 4 (.L) Service included: Items Cost(ea) Sum
4a. Residential - unit 4
City/State/Zip �'l Odr� f Die 1000 sq. ft. or less $110.00
( )� , I„^ y ' �r Each add
n tiorel 500 sq ft. or
Name or name of business T IA�CIX 0. 1
U portion thereof $25.00
-
Commercia Residential ❑ Limited Energy $26.00
Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
�
.��� Installation, alteration, or relocation 2
Electrical Contrac Y 1 l(L4 inn A n �1. p�v� 200 amps or less $60.00 2
Address.3 tog (r5YY1 yr, OA CA 4_ ,a4 S.. O 201 amps to 400 amps $80.00 2
-
City n 401 amps to 600 amps $120.00 - ty E0.�.om-, State t R. Zip Q � 3 Oo 1 601 amps to 1000 amps $180.00 2 -
Phone No. 5h.'Z - .Rlnki -.Z) I I Over 1000 amps or volts $340.00 2
- Contractor's License No. a y -zA CAS Reconnect only $50.00 -
Contractor's Board Reg. No. („y 1 b 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n 4 ei---____ 200 amps or less $50.00 2
License No. 3951 ho e No. Ja f ZZ( / 201 amps to 400 amps $75.00
401 amps to 600 amps $100.00
• Over 600 amps to 1000 volts
2b. For owner installations: see •b
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip Each branch circuit or feeder fee. $5.00 2
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is Purchase of service or feeder tee. 2
not intended for sale, lease or rent.
First additional circuit br $35.00
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) . 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting .7" . I ZO.
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per ins $35.00
Per hour $55.00
-
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ 1_0211.
5% Surcharge (.05 X total fees) $ _ _ _ _ _ ( - - -
P E BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ /a -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # $
Balance Due $ k.
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