Permit PERMIT CI1Y OF TIGARD ELECTRICAL EF "RMIT #: ELC96 -0557
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/26/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 1 — PARCEL: '51 10DC- 012120121
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SITE ADDRESS...: .tea , SW PACIFIC HWY * REV
SUBDIVISION • WILLOW BROOK FARM ZONING:C —G
BLOCK.„ • LOT •11
Project Description: Installing two sevrvices or feeders to 200 amps and 55 bran
ch
circuits.
- -- 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. • : Q1
LIMITED ENERGY 0 401 — 600 amp • 0 SIGNAL /PANEL 0
MANF. HM/ SVC /FDR..: 0 601 +amps- 11Z100 volts.: 0 MINOR LABEL (10). • . : 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 2 W /SERVICE OR FEEDER: 55 PER INSPECTION : 0
21211 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 -- 600 amp......: 0 EA ADD' L BRNCH C I RC : 0 I N PLANT 0
61211 — 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 --
NOAH' S BAGELS type amount by date recpt
15560 SW PACIFIC HWY PRMT $ 395.00 CJS 08/26/96 96- 283298
5PCT $ 19.75 CJS 08/26/96 96- 283298
TIGARD OR 97223
Phone #:
Contractor:
FRAHLER ELECTRIC CO $ 414.75 TOTAL
• 11860 SW GREENBURG RD
REQUIRED INSPECTIONS - --
TIGARD OR 97223 Wall Cover Elect'l Final
Phone #: 503 -639 -4627 Elect'l Service
Reg #..: 37410
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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. Issued 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 SUP R. ELEC' N : nna.; ,1 DATE: R- 6- 46
LICENSE NO:
Call for inspection — 639 -4175
i
. r Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 4r- ?Q 3aW
"il Permit # coQ -ns
� �' ',Ili'h
` Phone (503) 639 -4171 Date Issued 8- ob- 96
-" FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by�h�� /e s S�fvrl fob
Inspection (503) 639 -4175
1. Job Address: WWI 5 6 4 4 2 4. Complete Fee Schedule Below:
Name of Development TIGARD P R O M A N A D E Number of Inspections per permit allowed
Address 15660 S. W. PACIFIC HIGHWAY STF A -4 Service included: Items Cost(ea) Sum
City /State/Zip TIGARD, O R E G O N 97224 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) NOAH'S BAGELS Each additonal soo sq. n . or 1
portion thereof $25.00
Commercial ® Residential ❑ Limited Energy $25.00
Each Manufd 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 F R A H L E R ELECTRIC CO. 200 amps or less 2 660.00 1 20.00 2
Address 11860 S W G R E E N B U R G ROAD 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City TIGARD State O R Zip 9 7 2 2 3 601 amps to 1000 amps $180.00 2 -
Phone No. 639-4627 Over 1000 amps or volts $340.00 2
-
Contractor's License No. 34-13C Reconned only $50.00 -
Contractor's Board Reg. No.
Aj 3 , 7 41 0 4c. Temporary Services or Feeders
//'�'�/ / r ^SV"
Installation, alteration, or relocation 2
Signature of Supr. Elec'n ' 200 amps or less $50.00 2
-
License No. 181 6 S Phone No. 6 3 9 - 4 6 ? 7 201 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.
Print Owner's Name RE1'UP APPLICATION 4d. Branch Circuits
New, alteration or extension per panel
Address , a) The fee for branch circuits with
City St Zip pus, a e of service or feeder fee. 5 $6.00 275.00 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 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 $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 Mi 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 655.00
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 $ 395.00
5% Surcharge (.05 X total fees) $ 19 . / 5
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. ❑ Trust Account # $
Balance Due $ 414.75
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•
Page No. 1 CASE HISTORY FOR CASE NO.: ELC96 -0557
NOAH' S BAGELS
15660 SW PACIFIC HWY Unit: 4
09/17/97
Action Description Req/ Schd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
ELCC001 Application received / / / / 08/26/96 RECD CJS 08/26/96 CJS
ELCC003 Permit created / / / / 08/26/96 PEND CJS 08/26/96 CJS
ELCC500 (F)Issue permit / / / / 08/26/96 PASS CJS 08/26/96 CJS
ELCC700 Ceiling Cover / / / / 10/08/96 PASS MJR 10/10/96 MJR
ELCC720 Wall Cover 08/26/96 / / 09/09/96 PASS MJR 09/09/96 MJR
ELCC800 Case Finaled / / / / 10/11/96 PASS MJR 10/11/96 MJR
ELCC920 Miscellaneous action / / / / 09/06/96 UNG MJR 09/09/96 MJR
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