Loading...
Permit MS T9s- 0262 i Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # ,�+xr _ , .� Permit # ELGjS- 0206 '': `I Phone (503) 639 -4171 Date Issued - 7 T _.� I - ' FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Issued by Inspection (503) 639 -4175 ! 1. Job Address: y 9 4. Complete Fee Schedule Below: Name of Development g ai` S nt7rri e�2- Number of Inspections per permit allowed Address /q3 6 S S, (4), Pat, c >` 1 1 I: - . m 1 I Service included: Items Cost(ea) Sum City /State/Zip - 1"%► mss c& vcti ©2, 4a. Residential - per unit 3`/2 3 7 4 0 1000 sq. ft. or less / $110.00 (1 0. Name (or name of business)/ /7(t ersi 1-x7 c • Each additional 500 sq. n. or portion thereof S $25.00 / 5"w 1 Commercial ❑ Residential IS. Limited Energy I $25.00 Each Maned 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 B ilckA.froo l / 'ec= ei"r c- 200 amps or less $60.00 2 Address it) 72 D $, u N t d k MI 116 R d , 201 amps to 400 amps $60.00 2 City '1 ) 1 K I I M b State e9 R Zi 970 9 -2- 401 amps to 1000 amps $120.00 2 - P 601 amps to 1000 amps $180.00 2 Phone No. ' �.'- 5 - 2 - o 7 Over 1000 amps or volts $340.00 2 Contractor's License No. 3 4 1- 3 6/ C Reconnect only $50.00 Contractor's Board Reg. No. $95'2 9 4c. Temporary Services or Feeders Installation, alteration, or relocation 2 Signature of Supr. Elec'n 110 --_ 200 amps or less $50.00 2 - / License No. 395 S Phone No. ? 9- SD o f 201 amps to 400 amps $75.00 2 - 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 service or feeder fee. 2 Each branch circuit $5.00 Phone No. b) The tee 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 2 Each additional branch circuit $5.00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 • circle $40.00 2 3. Plan Review section (if required): Each pump or irrigation circle 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 i 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 inspectio $36.00 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 a e 00 5% Surcharge (.05 X to fees) $ / 3., oO PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtota I ] $ ,co AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for I CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ - O^ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal - w 1 �($ 00 COMMENCED. ❑ Trust Account # l $ - O Balance Due 9,4 1-1 $ a_ wordtomd,NNsopm,app CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk Foundation Plbg. Underslab Mech. Rough -in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough -in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -11411 Alarm Water Line Insulation -Mech. Underflr. Insul. Shear W II Gyp. Bd. lec ' Date Requested: �3 I,9 (o Time: AM PM Address: ( 43c, 5 (C)- -c- � � BuilderL. 1+ L ‘ Perr f : c 5 ' O -� � tic IF - 6 THE FOLLOWING CORRECTIONS ARE REQUIRED: 4 ' frC Z'D ' C_3 /l /1 i-es r) itenN e h , s P7 -e -- (7 AL. -._ d r c Inspector tl / - iq (.-t c1 Date: I — 3^2( X APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE _Call For Reinsp. PA-.5