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Permit ..,- CITYOFTIGARD 06.,071k. e DEVELOPMENT SERVICES ELECTRICAL PERMIT MrJsf� PERMIT #: ELC97 -0223 + - -.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 05/18/97 PARCEL: 2S11ODB -00200 SITE ADDRESS...:15169 SW ROYALTY PKWY #H SUBDIVISION •WILLOWBROOK FARM /ARBOR HEIGHTS ZONING:R -25 BLOCK • LOT •8 JURISDICTION: TIG Project Description : instl 1 service /feeder & 10 branch - -- 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 05/18/97 97- 294231 STE 201 PLCK $ 27.50 JMH 05/18/97 97- 294231 BELLEVUE WA 98004 SPCT $ 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 1 Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e 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 gliM Afar than 180 days. I s 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 Recd Date to P.E. Phone (503) 639 -4171, x304 Date to DST Print or Type Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit # LLR1 -� -v Fax (503) 684 -7297 Called 1. Job Address: ' 1 J 4c. ` I 4. Complete Fee Schedule Below: Name of Development PI r bw 1r-1-ei y l 4 p4-5, Number of Inspections per permit allowed Name (or name of business) RI 14 Service included: Items Cost Sum Address IS 1 1 SW. - Ro x et., 4-+..t T )(AAA/ 4a. Residential - per unit T Li. /� 1000 sq. ft. or less $110.00 4 City /State /Zip - 1 -- ; G rep l /� J J r 0 Each additional 500 sq. ft. or Commercial gi. Q Residential portion thereof $25.00 1 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 current iice ---� 4b. Services or Feeders Electrical C,gntractor k) 0 i2 'h Va f l PIi1 E 19 C.! 12_ i c- •-E 1c Installation, alteration, or relocation Address V' 3 a x MI 200 amps or less I $60.00 (0 O.0 0 2 201 amps to 400 amps $80.00 2 - Cityskl nt o . State OR_ Zip e1r7, � 8l0 401 amps to 600 amps $120.00 2 Phone No. 1 -R kB - Li St, - S, n o 601 amps to 1000 amps $180.00 2 Job No. ) O Over 1000 amps or volts $340.00 2 Elec. Cont. Lice. No. 0.E y -, 1 0- Exp.Date ID - 1 - 1 7 Reconnect only $50.00 2 OR State CCB Reg. No. g Exp.Date / - ►y - 8 4c. Temporary Services or Feeders COT Business Tax or Metro No.'? 7 -Li / 3 7 Exp.Date Installation, alteration, or relocation _ 200 amps or less $50.00 2 - Signature of Supr. Elec'n ;I/ :� /z� /! / / / /� /./ 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. q O be) - S Exp.Date 10- 1 -92 see "b" above. Phone No. 1 - &88- US - SAOD 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 /0 $5.00 SO a) 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 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. S. Fees: Not required for temporary construction services. 5a. Enter total of above fees $ 1 0 .00 5% Surcharge (.05 X total fees) $ S.50 NOTICE Subtotal $ / 15 . Sa 5b. Enter 25% of line 5a for � -., S° PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ 1 ,; o0 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 $ ) tl3 0o 1: \DSTS \ELC96.APP Rev 9/96