Permit ELECTRICAL PERMIT
GIN OF TIGARD DATE /01/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 131 30AD -IZI 1801
SITE ADDRESS...: 08340 SW SPRUCE ST
SUBDIVISION • GRAHAM ACRES ZONING:R -4.5
BLOCK - LOT -3 •
Project Description: Re: MST95 -0209
- -- 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 LTC..: 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: 4 PER INSPECTION 0
201 - 400 amp - 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 - 600 amp : 0 `A ADD'L BRNCH CIRC: 0 IN PLANT 0
601 - 1000 amp - 0 -- - -PLAN REVIEW SECTION - - - --
10004 amp /volt • 0 > -4 RES UNITS - > 600 VOLT NOMINAL..:
Reconnect only : 0 SVC /FDR )= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: - - - - -- - - - - -- - -- _ _ _ _ FEES -- - - --
TOD KINSLEY type amount by date recpt
8840 SW SPRUCE ST PRMT $ 80.00 JSD 03/01/96 96- 276522
SPCT $ 4.00 JSD 03/01/96 96- 276522
TIGARD OR 97223
Phone #: 503- 977 -0327
Contractor:
OWNER $ 84.00 TOTAL
REQUIRED INSPECTIONS
Ceiling Cover Elect'1 Final
Phone i#: Wall Cover
Reg #..:
This perait is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other P •m i t t n a u'
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started ' i
within 180 days of issuance, or if work is suspended for more _
than 180 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
i Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. 6 --e)
Tigard, OR 97223 Planck/Rec. # :� � G
Permit # p i ` - a/ :
•
i ll�1u Phone (503) 639 -4171 Date Issued Or3o) `i (o
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175 /'1ST q'. s - (:),C) 9
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development _ Number of Inspections p er permit allowed
Address g g 9 0 S -Ll! . Sp'rtr e.e_ S 1 ,/. Service included: Items Cost(ea) Sum
City /State/Zip 'Di ,‘ rd O re_ 1 ,, tj 9 7 2 23 4a. Residential - per unit 4
I� 1000 sq. ft. or less $110.00
Name (or name of business) 1 r) K i N S f-et/ Each additional therel thereof sq. ft. or 1
portion thereol $25.00
-
Commercial ❑ Residential K. Limited Energy $25.00
Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor 200 amps or less l� $60.00 gd -Oa 2
Address 201 amps to 400 amps $80.00 2 - 401 amps to 600 amps $120.00 2
City State Zip 601 amps to 1000 amps $180.00 2 - Phone No. Over 1000 amps or volts $340.00 2
Contractor's License No. Reconnect only $50.00 -
Contractor's Board Reg. No. 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less $50.00 2
License No. Phone No. 201 amps to 400 am $75.00 -
401 amps to 600 amps $100.00
Over 600 amps to 1 000 volts
2b. For owner installations: see 'b' above.
� � f� 1 NS j 4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address R g 4io S -,,v - S) ry c e S r? e . f - a) The fee for branch circuits with 2
City State 0 he Zip p 23 purchase of service or feeder lee.
ty �[ J q � p ! 7 3 Each branch circuit $5.00 aU. Ci
Phone No. 777 -0 12 7 b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sal , lease or rent. First branch circuit $35.00
Each additional branch circuit $5.00
Owner's Signature A-. 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:
NOTICE 5a. Enter total of above fees $ �. 0 O
5% Surcharge (.05 X total fees) $ -0 0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ S' - 0
o o
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i 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 $ t7 yr
woecandwW.eym.app
•
5/16/99 Activities for Case #: ELC96 -00128
9:09:05 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 3/1/96 3/1/96 JSD PASS JD 3/1/96
ELCA003 Permit created 3/1/96 3/1/96 JSD PASS JD 3/1/96
ELCA700 Ceiling Cover 3/1/96 1/27/97 TLP PASS • JT 4/7/97 check space connectors. okay
to insulate
ELCA720 Wall Cover 3/1/96 JD 3/1/96 •
ELCA799 Elect'I Final 3/1/96 11/5/97 TLP PASS _ JT 11/23/97
ELCA500 (F) Issue permit 3/1/96 JSD PASS JD 3/1/96
ELCA800 Case finaled 11/23/97 JT 11/23/97
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