Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00604
/ ` ' ' A DEVELOPMENT SERVICES DATE ISSUED: 10/27/00
'�" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DD -01600 •
SITE ADDRESS: 15495 SW SEQUOIA PKWY 190
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: One (1) branch circuit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ELECTRICAL CONSTRUCTION CO
15350 SW SEQUOIA PKWY #300 -WMI. PO BOX 10286
PORTLAND, OR 97224 PORTLAND, OR 97296
Phone: Phone: 224 -3511
Reg #: LIC 049737
SUP 2986S
ELE 26-45C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 10/27/00 $46.85 2720000000( Elect'I Final
5PCT CTR 10/27/00 $3.75 2720000000(
Total $50.60 E XPIRED
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other 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 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ail/ j, / 6.9-7c-71 x E D ISSUED BY: L -41
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 639 -4175 by 7:00pm for an inspection the next business day
10/20/2000 11:22 15032953012 E C COMPANY PAGE 01
CITY OF TIGARD ectrical Permit Application P1 ' d B
13125 SW HALL BLVD. RECEIVL Pp Recd By f 1 - >e
Date Rec'd A0 /
' TIGARD OR 97223 OCT 2 ®200o P rint of Type Date to P.E.
Phone (503) 639 -4171. x304 Date to DST
Inspection (503) 839-417S MMUNIiY DEVELOPMENT plete or Illegible will not be accepted permit* EGGZ�DD -0„04,0V
Fax (503) 598 -1960 Celled
1, Job Address: 4. Complete Fee Schedule Below:
Number of Inspections per pnnnit allowed
Name of Development QoILQIr1 s erv i ce included: Items Cost Total 1
Name (or name of business) //�� �y�r�i��� Q
/ ;✓ 4 S)✓ S uo /a Park.," J 7 O 4a. Residential criers - Per unit
Address • 1000 sq. ft. or leas $147.15 4
City /State/Zip 'f % 12Yd Each
t sq. C. or
$33A0 ,
Commercial Er Residential ❑ Limited Energy $75.00
Each Manurd Home or Modular
Dwelling Service or Feeder $90.90 2
2a. Contractor installation only: Lb. servroes or Feeders
(Prior to permit Issuance, applicants must provide contractor license
Informadon for COT data E 6L i CA-i. CoNSTR.�+�eTIO Installation. alteration, or relocation
Electrical • ntractor _ • g [i • , l . 200 amps or less $80.30 2
Addre- - .. ' % r ' , :" 201 a to 400 amps $108.85 2
401 amps to 600 amps $160.60 2
City Or. State 0,' Zip-. '044 601 amps to 1000 amps $240.60 2
Phone No. + - 55oe Over 1000 amps or volts $454.65 _ 2
Job No. . T7 . I Reconnect only 566.85 2 ,
Elec. Cont. Lice. No. D/ -46c- _ Exp.Date 0 of O/ 4c. Temporary Services or Feeders
OR State CCB Reg. No. 44707 Exp.Date 1 /6 04 Installation. alteration. or relocation
COT Business Tax or M= .• No. Exp. = 200 amps or less $66.85 2
� 201 amps to 400 amps
5100.30 2
Signature of Supr. Elec'ni., .4......_.. - , de, I, _ 401 amps to 600 amps _ $133.75 2
Over 600 amps to 1 000 volts,
License No. 3 i 0 sea ' b" above.
Exp.Date O + .
Phone No, , d& Branch Circuits
• New, alteration or extension per panel
a) The fee for branch EXPIRED
2b. For owner installations: rrb purchase purcchhase o /spry /pm or
M derfbe.
Print Owners Name Each branch circuit _ _ $6.65 , 2
Address b) The fee for branch circuits
City State wflnout pw/efaae of service 1
Zip. Phone No. Fe st branch circuit 1 $46.85 .4S
Each additional branch circuit $6.65
The installation is being made on property I own which Is not 4e. Mtacattaneous
intended for sale, lease or rent. (Senate or feeder not included)
Each pump or irrigation circle $53.40
Owners Signature Each sign or outline lighting $53.40
Signal clrcult(s) or a Milted energy
3. Plan Review section (if required):* - panel, alteration or extension $75.00
Minor Labels (10) 5125,00
Please check appropriate item and enter fee In section 5B. 4r. Each additional Inspection over
4 or more residential unite In one structure the allowable In any of the above
Service and feeder 225 amps or more Per btepecdon $62.50
System over 600 votis nominal Per ho ur $62.50 .
In Plant $73.75
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
* 6a. Enter total of above fees 5 ' ,, - . Se)
Submit 2 sets of plane '*111, eppikutlon where any of fife above 8% Surcharge (.08 X total fees) $ '�
a pp l y Subroal $ 50 - (ae
Not required for temporary conebuceon services. 5b. Enter 25% of tine 5e for
NOTICE • Plan Review)f reaulreq (Sec, 3) $
Subtotal $
PERMrTS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS
NOT COMMENCED WfTHIN 180 DAYS, OR IF CONSTRUCTION OR ❑ Trust Account # ,
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Tote/ balance Due $ *�
AT ANY TIME AFTER WORK IS COMMENCED.
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