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Permit CITY OF TIGARD tiAQ,crr , , ; 1 DEVELOPMENT SERVICES ELECTRICAL PERMIT �l PERMIT #: ELC97 -0228 13125 SW Hall Blvd., Tigard, OR 97223 (503)639 - 4171 DATE ISSUED: 05/18/97 PARCEL: 2911ODB -00200 SITE ADDRESS...:15O25 SW ROYALTY PKWY #N SUBDIVISION •WILLOWBROOK FARM /ARBOR HEIGHTS ZONING:R -25 BLOCK LOT :8 JURISDICTION: TIG Project Description : JOB 1288 - Install service /feeder & 10 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-- - 0 — 200 amp • 1 W /SERVICE OR FEEDER: 10 PER INSPECTION • 0 201 — 400 amp • 0 1st W/0 SRVC OR FDR.• 0 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 SECURITY CAPITAL PACIFIC TRUST type amount by date recpt 330 112TH AVE NE PRMT $ 110.00 JMH 05/08/97 97- 294231 STE 201 PLCK $ 27.50 JMH 05/08/97 97- 294231 BELLEVUE WA 98004 5PCT $ 5.50 JMH 05/08/97 97-294231 Phone #: F2O6- 451 -2692 Contractor: NORTH VALLEY ELECTRIC INC $ 143.00 TOTAL PO BOX 444 REQUIRED INSPECTIONS SWEETHOME OR 97386 Ceiling Cover Underground Cove Phone #: 541 - 982 -5916 Wall Cover Elect'l Service Reg #..: 000883 pp This permit is issued subject to the regulations contained in the ,C 4,44) Tigard Municipal Code, State of Ore. Specialty Codes and all other P e r m i tee � a t ur e applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started d(444Adt within 180 days of issuance, or if work is suspended for more than 180 days. Is ued By OWNER INSTALLATI0 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 `CITY OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By Date Rec'd TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST ., �/ Inspection (503) 639 -4175 Print or Type Permit # -(.,I '1- 062 -2-d Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 1 4. Complete Fee Schedule Below: Name of Development Rr lOo Y' i I`t _ 'k 1 s 14- Number of Inspections per permit allowed Name (or name of business) P) I et N Service included: Items Cost Sum Address ISO 5 S T KW 4a. Residential - per unit � (� 1000 sq. ft. or less $110.00 4 - City/State/Zip 1 1' a r t f ©'P h Each additional 500 sq. ft. or Commercial in- ( � Residential Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all Ilce s s 4b. Services or Feeders Electrical ontractor ND IZ.'l{ l la. I I € j ) et I c- c • Installation, alteration, or relocation •O �AX U t/ �1 200 amps or less 1 $60.00 if 0 • Do 2 Address n 201 amps to 400 amps $80.00 2 City . yl?as I-k w. a - State _ ()1? _ Zip 13R(Q 401 amps to 600 amps $120.00 2 Phone No. 1- t Per- t/S0 -- ,S 0 601 amps to 1000 amps - $180.00 2 Job No. I e). Over 1000 amps or volts - $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. a - 0 a. t. Exp.Date /0- - i 17 OR State CCB Reg. No. 077,3 0� Exp.Date I - I Y -9$ 4c. Temporary Services or Feeders COT Business Tax or Metro No.`ii- 4 - )Exp.Date Installation, alteration, or relocation - 200 amps or less $50.00 2 01 amps to 400 amps _ $75.00 Signature of Supr. Elec'n ..A" _.. < % ! • /, 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No c2 Aaa G Exp.Date I t - /' 9 ' see ..b.. above. Phone No l -Rre - N , p - 53 Do 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit 10 $5.00 S 2 City State Zip b) The fee for branch circuits ty p without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 - 3. Plan Review section (if required):* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) - $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional Inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. 5. Fees: o _ d Not required for temporary construction services. 5a. Enter total of above fees $ / 10 sb 5% Surcharge (.05 X total fees) $ S - NOTICE Subtotal $ // S 5b. Enter 25% of line 5a for al So PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ I Q 1 .00 NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # Total balance Due I q 3 •o>7 I: \DSTS \ELC96.APP Rev 9/96 • Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0228 ARBOR HEIGHTS APARTMENTS 15025 SW ROYALTY PKWY Unit: N 07/20/98 Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd . Code Sent Done Done Date By - - -- --- -- --- --- --- ELCA500 (F) Issue permit / / / / 05/20/97 this is a re -do from tidemark dump /tat PASS TAT 05/20/97 TAT ELCC001 Application received 04/11/97 / / 04/11/97 04/11/97 TAT ELCC003 Permit created 04/11/97 / / 04/11/97 04/11/97 TAT ELCC730,Elect'1 Service / / / / 10/28/97 PASS MJR 11/04/97 MJR ELCC799 Elect'l Final / / / / 10/28/97 PASS MJR 11/04/97 MJR ELCC800 Case Finaled / / / / 10/28/97 PASS MJR 11/04/97 MJR •