Permit CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC96 -0805
'__.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/23/96
PARCEL: 2S110DB -00700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION ° WILLOW BROOK /TIGARD PROMENADE ZONING:C –G
BLOCK LOT •10
Project Description: Installing four permanent wall signs
- -- 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..: 4
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.: 0 PER HOUR ° 0
I 401 – 600 amp : 0 EA 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
CARL KARCHER ENTERPRISES type amount by date recpt
800 MELLON AVENUE PRMT $ 160.00 JH 12/19/96 96- 287994
SPCT $ 8.00 JH 12/19/96 96- 287994
MANTECA CA 95337
Phone #: 823 -9251
Contractor:
ES & A INC $ 168.00 TOTAL
1210 OAK PATCH RD
REQUIRED INSPECTIONS
EUGENE OR 97042 Elect'1 Service
Phone #: 541 - 485 -5546 Elect'1 Final
Reg #..: 111286
rr ,
This permit is issued subject to the regulations contained in the . /�✓�- . 1 11 C4gn
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permit , :e Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started MAAthegh/G—_-•
within 180 days of issuance, or if work is suspended for more
than 180 days. Issued B y
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: CIA GL7 I 1 C 077\ DATE:
LICENSE NO:
Call for inspection – 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Ail ;.L Permit # CLG q b - (�`dD5
1i ; l' 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: n ! 4. Complete Fee Schedule Below:
n
Name of Dey lo ment L 1j�l -t � 1 � _ (i 2 • Number of Inspections per permit allowed
Address + Service included: Items Cost(ea) Sum
City /State/Zip U' D Dn 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) CAru,'s - Each additional 500 sq. ft. or
portion thereof $25.00 1 -
Commercial El Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor 200 amps or less $60.00 2
Address I I-I c 0 4(e- 1 H (t) 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2 -
City PU Fi N State fOtt- q Zip /Z 02-
601 amps to 1000 amps $180.00 2
Phone No. 911 - ' � _ ci Ca' Over 1000 amps or volts $340.00 2
Contractor's License No. aO- ASS CLS Reconnect only $50.00
Contractor's Board Reg. No. I 112S (,, 4c. Temporary Services or Feeders
-) j' Installation, alteration, or relocation 2
Signature of Supr. Elec'n y � T,A/ ' ./1,1 200 amps or less $50.00 2
License No. LI LI C 4
SI (t) dIShone NO. VO - --i4G 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' above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of serve or feeder fee. 2
•7 p Each branch circuit $5.00
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 fee. 2
not intended for sale, lease or rent. First branch circuit $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 G{ $40.00 /60 .
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:
NOTICE 5a. Enter total of above fees $ /0
5% Surcharge (.05 X total fees) $ v .
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. 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 $ / L - ) J
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Page No. 1 CASE HISTORY FOR CASE NO.: ELC96 -0805
CARL KARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D
09/16/97
Action Description Reg/ Schd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
-- -- --- -- ------ ---
ELCC001 Application received 12/23/96 / / 12/19/96 RECD JH 12/23/96 BON
ELCC003 Permit created 12/23/96 / / 12/23/96 PEND B 12/23/96 BON
ELCC500 (F)Iesue permit / / / / 12/23/96 PASS B 12/23/96 BON
ELCC799 Elect'l Final 12/23/96 / / 02/11/97 PASS MJR 02/12/97 MJR
ELCC800 Case Finaled / / / / 02/12/97 PASS MJR 02/12/97 MJR
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