Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00501
DEVELOPMENT SERVICES DATE ISSUED: 8/13/99
13125 SW Hall Blvd., Tigard, OR 97223 (5 rain I PARCEL: 2S101 DC -03900
SITE ADDRESS: 07150 SW SANDBURG ST A t
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: C -P
BLOCK: LOT : 004 JURISDICTION: TIG
Project Description: Installation of protective signaling.
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: 1
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: 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:
PROGRESSIVE CASUALTY INS CO ESP COMMUNICATIONS INC
6300 WILSON MILLS RD 28170 SW BOBERG RD
MAYFIELD VILLAGE, OH 44143 WILSONVILLE, OR 97070
Phone: Phone: 682 -4195
Reg #: LIC 00073872
SUP 2281JLE
ELE 34269CLE
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 8/13/99 $60.00 99- 317648 Elect'I Final
5PCT DEB 8/13/99 $4.20 99- 317648 •
Total $64.20
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 copjes'bt t - ules or direct questions to OUNC at (503)
246 - 1987. • Permit Signature: , 1 4 % Issue B y: , I A JAL
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 NSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: .AD 1 4 va -- DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
fill
CITY TIGARD II Plan C
13125 S4 V HALL BLVD. RE C % 1 FtrICal Permit Application Reed Ma/
TICARD OR 97223 Date Recd -/9--9 `I
Phone (503) 639 -4171, x304 AUG 1 2 1999 Date to P E. _
-
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # EGCtg99 - Do 5
Fax (503) 598 -1960 COMMUNITY ip_, Called
Incomplete or illegible will not be accepted
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Pg('Yr , (Service included: Items Cost Sum C
Address TAP 5 ` )- ■ $ ' �� • 4a. Residential - per unit
City/State /Zip • ' ► ` 1000 sq ft or less $ 117 75 4
Each additional 500 sq ft. or
portion thereof $ 26 25 1
Commercial Residential ❑ Limited Energy $ 60 00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72 75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base) Installation, alteration, or relocation
Electrical Contractor • 0... - _ • 200 amps or less $ 64.25 2
Address c `c C. r ESF 201 amps to 400 amps $ 85.50 2
City I .. I.,:ltJVl11 State Zip __ / p 401 amps to 600 amps $ 128.50 2
��� 601 amps to 1000 amps $ 192.50 2
Phone No. ,5r)3- (.O ' - d1 ,5' Over 1000 amps or volts $ 363.75 2
Job No. / • i Reconnect only $ 53 50 2
Elec. Cont. Lice. No. s = . ___ xp.Date 0 4c. Temporary Services or Feeders
OR State CCB Reg. No. :; . - Ex•.Date I Installation, alteration, or relocation
COT Business Tax or Met. o. G., r 200 amps or less $ 53.50 2 I amps $ 80.25 2
Signature of Supr. Elec'n a 401 amps to 600 amps $ 1 07.00 2
ri �� Over 600 amps to 1000 volts,
�.- ) D) c1q see "b" above.
License No. �� • /,:� ,. rate I
Phone No. , 'I f D 7 e 2-0 1 � ,1- 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5 35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or imgation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42 75
Signal circuit(s) or a limited energy // -� ��
* panel, alteration or extension 1 $ 60.00 I..DCJ,
3. Plan Review section (if required): Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable In any of the above
Per inspection $ 50 00
Service and feeder 225 amps or more 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:
5a. Enter total of above fees $ i GO ,
* Submit 2 sets of plans with application where any of the above apply. e regurcharge (p 1( total fees) $ q.
Not required for temporary construction services. Subtotal . $
5b. Enter 25% of line 6a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total ba lance Due $ I ' 2D
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