Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00677
DEVELOPMENT Tigard, R 9 SERVICES 639 -4171 DATE ISSUED: 11/10/1999
SW Hall Blvd.,
PARCEL: 1S134CA-00705
SITE ADDRESS: 11915 SW SUMMER CREST DR
SUBDIVISION: BURLWOOD NO.3 ZONING: R -4.5
BLOCK: LOT : 040 JURISDICTION: TIG
Project Description: First 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:
WAGONER, WENDY J WEST SIDE ELECTRIC CO INC
11915 SW SUMMER CREST DRIVE 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Phone:
231 -1548
Reg #: LIC 13306
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 11/10/199E $37.50 99- 319713 Elect'I Final
5PCT BON 11/10/199c $3.00 99- 319713
Total $40.50 ORGNAL
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 ISSUED BY: 6. /
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
t `
SIGNATURE OF SUPR. ELEC'N: j( a Q (01 DATE:
LICENSE NO: •
Call 639 -4175 by 7:00pm for an inspection the next business day
NOV -10 -99 12:53 PM REC ELECTRIC 503 736 0677 P.01
CIT OF TIGARD Plan Check
-131 SW HALL BLVD. NOV 1 A�9t►ical Permit A Recd By
TIG , RD OR 87223 D ■leRet'd 11 - l'
Pho . (503) 639 -4171, x304 OMMUNITI( DEVELOPMENT Date to P.E.
'nap- tiler (503) 8384175 Date to DST
Print of Type Permit # j / (1 -OC 4'7 - 7
Fax 03) 598 -1960 Incomplete or illegible will not be accepted Called -
•
1. • b Address: 4. Complete Fee Schedule Below:
Name • Development w 'J f..i Number of Inspections per permit allowed
dame or name of business) MITA ttI ' R a, Service Included: Items Cost • Sum 1
gddre - : ` 1 ci 1 '1.L.) ►.' " -T 'OIL _ , 4a. Residential - per unit
Ily /S te/Zlp `t"S(v4z OA. ci-1-22:5 1000 sq. A, or leas $ 117.75 4
Each additional 500 eq. fl. or
ornm eclat 0 Residential E portion thereof $ 28,25 1
Limited Energy $ 80.00
• •
Each Manufd Home or Modular
2a. • ontractor installation only: Dwelling Service or Feeder $ 72.75 2
Prior - permit Is•usne.. applicants must provide contractor license 4b. Services or Feeders
nn ; on for COT data base). Installation, alteration, or relocation
lectri -, I Contractor i• e C - ,i4-/C,. 200 amps or less $ 64.25 2
Addres it f � 1/ � 201 amps to 400 amps $ 85.50 - 2
City j / d r► Zip �� 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone o. Over 1000 amps or volts S 383.75 2
J ob No, 7l r' - 002_ Reconnect only . $ 63.50 2
lee. Cent. Lice. No. - ;76- / 3y Exp.Date 4c. Temporary Services or Feeders
DR Sta e CCB Reg. No. l 3 3.0 6 Exp.Date • Installation, alteration, or relocation '
COT B6 ainess Tax or Metro.No. Exp.Date 200 amps or less S 63.50 2
201 amps to 400 amps $ 80,25 2
$Ignatt•e of SuDr. Elec'n 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
l icense No, ,c .3 Exp,Date ••• "b^ above,
Phone f io. 3/- 4d. Branch Circuits
New, alteration or extension per panel
a) The tee for branch circuits •
;b. For owner installations: • with purchase of service or
feeder fee.
lirint Owner's Name _ Each branch circuit $ 5.35 2
dddreS1 _ , b) The fee for branch circuits
without purchase of service
ity State Zip or feeder fee, 7 C?) p hone No. First branch circuit l $ 37.50
Each additional branch circuit S 6.35
T ie installation Is being made on property I own which is not w. Miscellaneous
intended for sale, lease or rent. • (Service or feeder not Included)
Each pump or irrigation circle S 42.76
Owner's Signature Each sign or outline lighting S 42.75
Signal circuity') or a limited energy
• Men Review section (if required):* panel, alteration or extension S 60.00
I
Minor Labels (10) ---' $ 107.00
•
Please check appropriate Item and enter fee In section 58. 41. Each additional Inspection over
�4 or more residential units In one structure the allowable In any of the above
I Service and feeder 226 amps or more Per Inspection 4 _ 5 60.00
Per hour • $ 50.00
System over 600 volts nominal in Plant $ 59.00
Classified area or structure containing special occupancy as
• described In N.E.C. Chapter 5 5. Fees:
•
• 6e, Enter total of above fees $ TD
'; SubmI) 2 seta of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ . , '
Not required for temporary construction services. Subtotal $
NOTICE lb. Enter 26% of line as for
Plan Re jf reoulred (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Sub I $
. IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR 11-51-)1000
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account #
A. ANY 'IJMEAFTER WORK IS COMMENCED. Total balance Due $ tt)
i
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