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Permit ELECTRICAL PERMIT j'fy' OF TIGARD DATE I ISSUED: 05/1 5/96 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 151 34BC -00200 SITE ADDRESS...: 12160 SW SCHOLLS FERRY RD SUBDIVISION ZONING :C —G BLOCK ° LOT ° Project Description: SUBWAY - -- 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..: 2 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 ° 0 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0 201 — 400 amp 0 1st W/0 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 BLAZE SIGNS type amount by date recpt PO BOX 3529 PRMT $ 80.00 JSD 05/15/96 96- 279454 5PCT $ 4.00 JSD 05/15/96 96- 279454 PORTLAND OR 97298 Phone #: Contractor: BLAZE SIGNS OF OREGON $ 84.00 TOTAL PO BOX 25357 REQUIRED INSPECTIONS PORTLAND OR 97225 Ceiling Cover Elect'1 Final Phone #: 503 - 639 -3262 Wall Cov Reg #... 64325 i This peroit 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 e e Signature applicable laws. All work will be done in accordance with approved plans. This peroit will expire if work is not started �G within 180 days of issuance, or if work is suspended for ©ore than 180 days. I sued B 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 .- Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. 11 G Q / 0.--3 Tigard, OR 97223 Permit # L� l0 / ( , �� ..� Date Issued 05 I C , �� 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 Greenway Shopping Cnt= . Number of Inspections per permit allowed Address 12160 SW SCholls Ferry Rd. Service included' Items Cost(ea) Sum City /State /Zip IIMNXRE Tigard, Or 97223 4a. Residential - per unit 1000 sq. ft. or less $110 00 4 Name (or name of business) SUBWAY Each additional 500 sq ft or portion thereof $25 00 1 Commercial © Residential ❑ Limited Energy $25 00 Each Manut'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders Electrical Contractor BLAZE SIGNS Installation, alteration or relocation $60 00 200 amps or less 2 Address p. 0. BOX 2 5 3 5 7 201 amps to 400 amps $80 00 2 401 amps to 600 amps $120.00 2 City Port a n, State n r Zip 9 7 7 9 8 601 amps to 1000 amps $180.00 2 Phone No. 6.1q-3262 Over 1000 amps or volts $ 3 4 0 00 2 Job NO. Reconnect only contractor's license NO. , ■ 4c. Temporary Services or Feeders Contractor's Board Reg. No. / 64 47 Installation, alteration, or relocation Signature of Supr Ele 'n /��'r 200 amps or less 2 License No. S' r !f hone No. 6 3 9-3 2 h 2 201 amps to 400 amps $50 00 401 amps to 600 amps $75.00 2 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 purchase of service or feeder fee. 2 City State Zip Each branch circuit $5.00 Phone No. b) The fee for branch circuits withou The installation is being made on property I own which is purchase of service or feeder fee. 2 First branch 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 7 $40.00 R n _ n f) 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 Chapter 5 Per inspection $35 00 as described in N.E C. Cha p 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: 5a. Enter total of above fees $ 80.00 NOTICE 5% Surcharge (.05 X total fees) $ 4_00 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% 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. wordecomdevlelec- ❑ Trust Account # $ pan app Balance Due $ 4 _ n n