Permit CITY OF TIGARD
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/,.y, ; DEVELOPMENT SERVICES ELECTRICAL PERMIT
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PERMIT #: ELC97 -0224
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/18/97
PARCEL: 2S11ODB -00200
SITE ADDRESS...:15175 SW ROYALTY PKWY #J
SUBDIVISION •WILLOWBROOK FARM /ARBOR HEIGHTS ZONING:R -25
BLOCK • LOT -8 JURISDICTION: TIG
Project Description : instl 1 service /feeder & 19 branch curcuits
- -- 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 • 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 05/18/97 97- 294231
STE 201 PLCK $ 27.50 JMH 05/18/97 97- 294231
BELLEVUE WA 98004 5PCT $ 5.50 JMH 05/18/97 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'1 Service
Reg #..: 000883
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e i nature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 18a days of issuance, or if work is suspended for more ��
than 18a days. I ued 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
.. - . _ . . •
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304
( ) Print or Type Date to DST , - b i �
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # '
Fax (503) 684 -7297 Called
1. Job Address: (� 4. Complete Fee Schedule Below:
Name of Development v' 6o r^ 1-pl1 y 1 �t F-1 p 43 Number of Inspections per permit allowed
Name (or name of business) R V (1)6 3' Service included: Items Cost Sum
I
Address IS I S S • W • 12 0 54 l 44-c,� P kw./ 4a. Residential - per unit
J 1000 sq. ft. or less $110.00 4
City /State /Zip I ( gyp! l J / rel) 6 I.1. Each additional 500 sq. ft. or
Commercial. 1=1 o Limited portion thereof $25.00 1
mited Energy $25.00
Each Manuld Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all urrent licenses) 4b. Services or Feeders
Electrical Cpotractor N n tZ-I-‘ Ua 1 1 eq e t 2 t c , MK L. Installation, alteration, or relocation
Address 0 • 2,,.., x y4�/ (J 200 amps or less 1 $60.00 la D 0 O 2
r) 201 amps to 400 amps $80.00 2
d m
City cl.op,- 4- J -r+,-0 State 1.. Zip q-7 3 R10. 401 amps to 600 amps $120.00 2
Phone No. f - 8 ?f e - y s - S.Uda 601 amps to 1000 amps $180.00 2
Job No. ,a 1? g Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 02 (/ iso dC Cr Exp.Date In - I - 7
OR State CCB Reg. No. 8'. b n_ Exp.Date I - )4-9 $ 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 97- to /3 7 Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
-
Signature of Supr. Elec'n 41." //� . 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
-
Over 600 amps to 1000 volts,
License No 1 1 0 0 0 - S Exp.Date I 0 - I - 9s see °b" above.
Phone No 1 - 8 &R- 4 sip - 53oa
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. .00
Address Each branch circuit JO $5.00 s 2
b) The fee for branch circuits
City State Zip 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 circuit $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:
Not required for temporary construction services. 5a. Enter total of above fees $ 1 10 .00
5% Surcharge (.05 X total fees) $ S •')
NOTICE Subtotal $ J 1.S .So
5b. Enter 25% of line 5a for a7
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ i LI
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 $ f q 3,.00
1: \DSTS \ELC96.APP Rev 9/96
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0224
ARBOR HEIGHTS APARTMENTS
15175 SW ROYALTY PKWY Unit: J
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 re -do after 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'' Service 04/11/97 / / 10/28/97 PASS MJR 11/04/97 MJR
ELCC799 Elect'' Final 04/11/97 / / 10/28/97 PASS MJR 11/04/97 MJR
ELCC800 Case Finaled / / / / 10/28/97 PASS MJR 11/04/97 MJR
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