Permit ELECTRICAL PERMIT �~
OF TIG
CITY DATE ISSUED 07/23/96
COMMUNITY DEVELOPMENT DEPARTMENT
131nmSm He ll Blvd. Nerd, Oregon 97223°819* (503) 639-4171 PARCEL : 1S134DB-06900
SI ADDRESS.. . : :,1102 SW TORLAND ST
SUBDIVISION,. TORLAND ESTATES ZONING:R-4.5
LCT. . . . . . . . . . . . . '
Project Description: Installing one branch circuit.
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS
100Z 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 - 6Q0 SIGNAL/PAkEL...... . : 0
MANE. HM/ SVC/FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (10)...: W
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS--
0 — 200 amp ^ 0 W/SERVICE OR FEEDER: 0 PER INSPECTION ^ 0
2Ql — 400 amp...... : 0 1st W/O SRVC OR FDR. : 1 PER HOU�.... ....... : 0
401 — 600 amp......: 0 EA ADD'L BRNCH CI RC: 0 IN PLANT...... 0
L.01 — 100 amp.....: 0 ----- ---PLAN REVIEW SECTION--- ---
12100+ amp/volt..... : 0 >=4 RES UNITS.. . .. ... : > 600 VOLT NOMINAL.. :
Reconnect only... SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.
Owner: -- — — FEES -----
DAN DOVER type asoLint by date recpt
11102 SW TORLAND PRMT 35'00 CJS 07/23/96 96-281792
5PC� 1.'75 CJS 0//22/96 96-2G1792
TlGARD OR 97223
Phone .t:r
Contractor: — -----
TICE ELECTRIC s" 36.75 TOTAL
PO BOX 15009
REQUIRED INSPECTIONS
PORTLAND OR 97215 Wall Cover Elect Final
Phone 503-233-8801 Elpct'l Service
Reg *1 166
This peroit is issued subject to the replatio:s contained in the
Tioard lumicipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be dune in accordance with
approved plans. This 'emit will expire if work is not started
within 18B days of issuance, or if work is suspended for nore
then 182 days. I ssued By
OWNER INSTALLATION OKLY------------- --------- --
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNERS E: _____ DATE:
------ CONTRACTOR INSTALLATION ONLY—
SIGNATURE OF SUPR. ELEC' N: _Matted DATE :
:_ICENSE NO2 ____________—______________________________ _
Call for inspection — 639-4175
8754 Community Development ELECTRICAL PERMIT APPLICATION
A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # SIG- 018(79' a
Yh .i Permit # FIE 9,s- o y>U
i1 ;) �I P hone (503) 639 -4171 Date Issued lR / 96
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by Chc,r IPC �ch.n�dt
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address 11102 SW Torland Service included: Items Cost(ea) Sum
City/State/Zip Tigard OR 97223 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) Dan Dover Each additional 500 sq. N . or 1
portion thereof $25.00
Commercial ❑ Residential ® Limited Energy $25.00 -
Each Manufd 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 Tice Electric Co. 200 a2
mps or less $60.00 2
-
Address PO Box 15009 201 amps to 400 amps $60.00
Portland 401 amps to 600 amps $120.00 2 -
City State OR Zip 97293 -500 3 601 amps to 1000 amps $180.00 2
Phone No. 233 -8801 FAX 231 -3372 Over 1000 amps or volts $340.00 2
- Contractor's License No. 26 -126C Reconnect only $50.00
Contractor's Board Reg. No. 166 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n & 200 amps or less $50.00 2
License No. 71 Phone No. 201 amps to 400 amps $75.00 2
lS 233 8801 401 amps to 600 amps $100.00
-
• Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
Each branch circuit $5.00
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. 35.00 2
not intended for sale, lease or rent. First branch circuit 1 $35.00
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
$35.00
as described in N.E.C. Chapter 5 Per inspection
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 $ 4 35.00
5% Surcharge (.05 X total fees) $ _L-25
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 36.75
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for 0.00
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 $ 36.75
COMMENCED. ❑ Trust Account # $ 0.00
Balance Due $ 36.75
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