Permit •
OF � ELECTRICAL PERMIT
alY
PERMIT #: ELC96-0433
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/01/96
1o1uaow Hall Blvd. Tigard, Oregon 972230819e (503) 639-4171
PARCEL: 2S114BC-00700
SITE ADDRESS...: 10185 SW RIVERWOOD LN
SUBDIVISION....: PICKS LANDING NO.1 ZONING:R-4.5
BLOCK..........: LOT.............:62
Project Description: Installing one branch circuit.
Electrical to gas furnace.
•
---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..: 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---
0 — 200 amp......: 0 W/SERVICE OR FEEDER: 0 PER INSPECTION : 0
201 — 400 amp ^ 0 1st W/O SRVC OR FDR. : 1 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 -----
PAT FROST type amount by date recpt
10185 SW RIVERWOOD LN PRMT $ 35.00 CJS 07/01/96 96-281228
5PCT $ 1.75 CJS 07/01/96 96-281228
TIGARD OR 97224
Phone #:
Contractor: — — — ----- --------�
HEBERLE $ 36.75 TOTAL
11610 SW 135TH AVE
— REQUIRED INSPECTIONS -------
TIGARD OR 97223 Wall Cover Elect'l Final
Phone #: 503-524-7059 Elect'l Service
Reg #..: 42841
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 \8N days. 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 for inspection — 639-4175
'
Community Development ELECTRICAL PERMIT APPLICATION
• A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # c16- ? -) aaR
� Permit # ELCc1C -0
/�
'�I' Phone (503) 639 -4171 Date Issued _ ,7 i 96
CITY OF ~ TIGARD FAX (503) 684 -7297 Issued by rile-, S.
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
1 �"
Address 1 O�I , 5 1 -^ 5 g ic7 V 1-P.'-'41----- Service included: Items Cost(ea) Sum
City /State/Zip ‘..13-12.-1 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) Each additional 500 sq. ft or 1
portion thereof $25.00
Commercial ❑ Residential Limited Energ $25.00 2
Each Manuf Home or Modular
V "T -4 Id ' -- ` Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
ff ``,�. nn Z Installation, alteration, or relocation 2
Electrical Contractor�l" ��- -� L.� 200 amps or less $60.00 2
Address i IL t o Si J t l.' ---mot J._ 201 amps to 400 amps $80.00 2
_
401 amps to 600 amps $120.00 2
City "Tl (a Ave. - 9 State cslL_ Zip 51.1 --Z3 601 amps to 1000 amps - $180.00 2
Phone No. 51- - -1 5 ) Over 1000 amps or volts $340.00 _ 2
Contractor's License No. '3'-t --‘1,40 c,- Reconnect only $50.00 -
Contractor's Board Reg. No. L'Z l I 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n , / 200 amps or less $50.00 2
W A Over License No- S - ' a No.�� - l a 201 amps to 400 amps $75.00
401 amps to 600 $100 00
Over soo amps ps to 1 000 volts
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name tea, 1 New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zi purchase of service or feeder fee. 2
/I _ �� p Each branch circuit $5.00
Phone No. (a q b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder lee. . ‘Z-..-7t:1 2
First branch circuit $35.00 2
not intended for sale, lease or rent. 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 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: - 3 , 0
NOTICE 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ t /
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 $ co . -
word\ ccnMaWabcprm.app (_ `r .. •-1.7 c 4_4 G.--
5/23/00 Activities for Case #: ELC96 -00433
2:17:03 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 7/1/96 CJS RECD CJS 7/1/96
ELCA003 Permit created 7/1/96 CJS PEND CJS 7/1/96
ELCA500 (F) Issue permit 7/1/96 CJS PASS CJS 7/1/96
ELCA800 Case finaled 7/29/96 MJR PASS MJR 7/29/96
Page 1 of 1 •
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service / FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation a t.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: . 'mil /
Date: 7 — z- —1 6, A.M. P.M. Entry:
Address: / /, / e.) o i
Tenant: Ste: MST:
BUP:
Con wn: 5 F./Lira-4—
MEC:
t‘23 -(07u PLM:
S ELC: 6 -O ci
T E FOLLOWING CORRECTIONS ARE REOUI D: ELR:
S /-7,7 4747//4/4 ezt/orgt 4..)
Inspector: �/ r _4,. _ D ate : 7` "ma or
APPROVED DISAPPROVED /CALL FOR REINSP. 4110 CO
PS