Permit CITY OF TIGARD ELECTRICAL PERMIT
0,40 1 , DEVELOPMENT SERVICES PERMIT #: ELC97 -0803
I �� 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 12/08/97
PARCEL: 2S11ODC -02200
SITE ADDRESS...:1557O SW PACIFIC HWY
SUBDIVISION •WILLOW BROOK FARM ZONING:C —G
BLOCK • LOT •011 JURISDICTION: TIG
P ro j ect De scr i pt ion : Installation of twenty (20) branch circuits.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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-- -
O — 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: 19 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION 1
1000+ amp /volt • 0 > =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
STERLING DEVELOPMENT CORPORATION type amount by date recpt
LA JOLLA CORPORATE CENTER PRMT $ 130.00 TJH 12/08/97 97- 301509
3252 HOLIDAY COURT, SUITE 225 5PCT $ 6.50 TJH 12/08/97 97- 301509
LA JOLLA CA 92037
Phone #:
Contractor:
ELECTRICAL DIMENSIONS INC $ 136.50 TOTAL
PO BOX 12146
3961 SW WILLAMS AVE REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Elect'l Service
Phone #: 282 -7255 Wall Cover Elect'l Final
Reg #..: 000440
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 (503)246 -1987. //
Permittee Signature: Ol7lt0 /�YiQlX/dIssued By: AtZ1/
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
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
id
4- Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. L C,? ) ' - OQO%j
Tigard, OR 97223 Permit # U
/ �� Date Issued
„�dpl�.li, �,
,� i I Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
ik
Name of Development 5 - el.A0G,y `1323 Number of Inspections per permit allowed
Address 2Sb 1 y u & P Iaz4 Iu S() Service included: Items Cost(ea) Sum
City /State /Zip 'ri crk Or 9722.3 c 4a. Residential - per unit
1000 sq. ft. or less $110.00 _ 4
Name (or name of business) SQfr Each additional 500 sq. ft. or
[XI portion thereof $25.00 1
Commercial [XI Residential Limited Energy $25.00
Each Maned Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
' Installation, alteration, or relocation
Electrical Contractor C I Lc# ✓ t c.ck- 1 D ‘ Leh Sl ow5 the 200 amps or less $60.00 2
Address lP o 6 o)t 1 2-i ti 6 201 amps to 400 amps $80.00 2
City P 401 amps to 600 amps $120.00 2
W' t‘ Gr✓� d State OR Zip 9 �� t 2 601 amps to 1000 amps $180.00 2
Phone No. 242.. 7 2.. S S Over 1000 amps or volts $340.00 2
Job NO. 7 Z.5? Reconnect only
$50.00 2
contractor's license NO. d6 • L j 2 c 4c. Temporary Services or Feeders
Contractor's Board Reg. No. o Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less 2
License No. 296 4 Phone No. A i Z - 7255"' 201 amps to 400 amps $50.00 2
PJ 401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see „b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
p urchase of service or feeder fee. 2
The installation is being made on property I own which is o0 2
not intended for sale, lease or rent.
First additional circuit 4 $35.00 35
Each additional branch circuit / $5.00 95• do
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 $40.00
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 inspection $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:
5a. Enter total of above fees $ 3a b ,00
NOTICE 5% Surcharge (.05 X total fees) $ 6,5"4
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
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. wordhcorndeNe&eo- ❑ Trust Account # $
prm.epp
Balance Due $ / 3C. 5-0
1/21/00 Activities for Case #: ELC97 -00803
4:26:34 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 12/8/97 TJH RECD TJH 12/8/97
ELCC003 Permit seated 12/8/97 TJH PASS TJH 12/8/97
ELCC799 Elect'I Final 1/30/98 RC PASS JT 1/30/98 per conversation with Ron •
Church this date. When he did
final on T.I. he saw that
electrical had been signed off.
ELCC500 (F)Issue permit 12/8/97 TJH PASS TJH 12/8/97
ELCC800 Case Finaled • 1/30/98 JT 1/30/98
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