Permit CITY OF TIGARD
4.„
` ��; DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC97 - 0100
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/19/97
PARCEL: 25102BA -00501
SITE ADDRESS...: 09744 SW TIGARD ST #
SUBDIVISION • NO.TIGARDVILLE ADDITION AMEND. ZONING:I —P
BLOCK LOT .60
Project Description: 1 SERVICE /FEEDER, 3 BRANCH CIRCUITS
J155
•
- -- 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: 3 PER INSPECTION - 0
201 - 400 amp : 0 1st W/O 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 - - --
DANIEL SNYDER type amount by date recpt
9740 SW TIGARD ST PRMT $ 75.00 TAT 02/1.9/97 97- 290540
5PCT $ 3.75 TAT 02/19/97 97- 290540
TIGARD OR 97223
Phone #: 639 -3908
Contractor:
WILLAMETTE ELECTRIC INC $ 78.75 TOTAL
PO BOX 230547
REQUIRED INSPECTIONS
TIGARD OR 97281 Ceiling Cover Underground Cove
Phone #: 503 -624 -3631 Wall Cover Elect' 1 Service
Reg #..: 000750
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ire. Specialty Codes and all other Perm tie Si gnat ' r
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started �/
within 188 days of issuance, or if work is suspended for sore ,ii(_a v
than 188 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
l Community Development ELECTRICAL PERMIT APPLICATION
A 13125 SW Hall Blvd. n -7 f,
Tigard, OR 97223 Permit # r � /-U1�Q
rsa
,, Date Issued a-119111
�i�I Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address q}u1h1 S co 11 ` f,# 4 n S'r $ Service included: Items Cost(ea) Sum
City /State /Zip l z to 40 n, Q}ZZ 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) � ha oZt ( S' . ' .. Each additional 500 sq. ft. or
+�' portion thereof $25.00 1
Commercial V Residential Limited Energy $25.00
Each Manul'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
T f I Installation, alteration, or relocation �+ O d`
Electrical Contractor w t 11 it .n.., t'� 0 t 1 e el- al , I h--( 200 amps or less ( $60.00 f0 '- 2
Address P () R l) . 2:36.3.4--.3- 201 amps to 400 amps $80.00 2
amps
m
600 to ap 2
City ii- vtsty� State On Zip R�Zhr f 401 a mps $180.00 2
601 amps to 1000 amps $120.00
Phone N . G 24 - 36 3 r Over 1000 amps or volts $340.00 2
Job NO. /SS Reconnect only $50.00 2
contractor's license NO. 34 - 2S L 4c. Temporary Services or Feeders
Contractor's Board Reg. No. rt si Sc( Installation, alteration, or relocation , 2
Signature of Supr. Elec' Avi„-- 200 amps or less _i___ 2
License No. ict s' S Pho No. Gal-1-.74Z I 201 amps to 400 amps $50.00 2
401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
Cit State Zi purchase of service or feeder fee. �/ c 2
`7 p Each branch circuit $5.00 /3
Phone No. 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
First additional circuit $35.00
not intended for sale, lease or rent.
Each additional branch circuit $5.00
Owner's Signature 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 inspection $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:
Of
5a. Enter total of above fees
NOTICE 5% Surcharge (.05 X total fees) $ r...1.
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
Sb. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
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. wo,dkwmdeAeIee. ❑ Trust Account #
prm.epp S
Balance Due $
VICINITY MAP
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Covercial FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: [ �
Date: ` ? S I - 17A.M. P.M. ntry: el'
Address: 1 l JT
Tenant: Ste36 MST
BUP:
Con /Own: MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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L/-e e lei r . / - re}/ f
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Inspector: WIC-Z1' Gy -P A Le Date: 7
APPROVED DISAPPROVED /CALL FOR REINSP. CF CO
/4. •