Permit T im
C ITY OF T I GARD ELECTRICAL PERMIT
PERMIT #: ELC96 -0608
DATE ISSUED: 09/25/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 1 S 134BC -00101
SITE ADDRESS...: 12160 SW SCHOLLS FERRY RD
SUBDIVISION ZONING:C -G
BLOCK LOT °
Project Description: Installing five branch circuits for a ATM.
- -- 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 : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp ° 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 - 600 amp : 0 EA ADD'L BRNCH CIRC: 4 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 --
FIRST INTERSTATE type amount by date recpt
12160 SW SCHOLLS FERRY RD PRMT $ 55.00 CJS 09 /25/96 96- 284342
SPCT $ 2.75 CJS 09/25/96 96- 284342
TIGARD OR 97223
Phone #:
Contractor: --
ELECTRICAL CONTRUCTION CO $ 57.75 TOTAL
PO BOX 10286
REQUIRED INSPECTIONS
PORTLAND OR 97296 Wall Cover Elect' 1 Final
Phone #: 503 -244 -3511 Elect'1 Service
Reg #.. : 49737
This peroit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with /�
approved plans. This permit will expire if work is not started ��� u���T
within 180 days of issuance, or if work is suspended for more /���
than 180 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 : Iy1Q i I ec(' DATE: c(— oD5 5
LICENSE NO:
Call for inspection - 639 -4175
07.'05.96 11:53 $'5(I3 684 7297 i 1T1 OF TIGARD 0002 /002
Job# 77082 -86 Greenway ATM #1
,, : Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # •LC 96 - 0608
�� 1 , � Date Issued q - a.5 - �l6
� . .,� �I Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development A'jy tvl i n _ Number of Inspections per permit allowed
Address 12160 SW Schalls Ferry Road Service included. Items Cost(ea) Sum
City /State /Zip Tigard. Orggon 97223 4a. Residential - per unit
1000 sq. ft. or less 3110 00 4
Name (or name of business) First Interstate Bank Each additional 500 aq n. or
portion thereof 325.00
Commercial Residential ❑
Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $88.00 2
-
2a. Contractor installation only: 9 -14 -96
4b. Services or Feeders
Installation. enereUann. er relocation
Electrical Contractor El ectrical Construction CO. 200 amps or less 380.00 2
_
Address P.O. Box 10286 201 amps lo 400 amps 350.00 2
City Portland _ State OR Zip 97296 401 amps to 600 amps 3120.00 2
601 amps to 1000 amps 31 60 00
Phone No. 224 -3511 3340,00 2
Ov er 1000 amps or voAs
Job NO. 77082 -66 Reconnect only 3550.00 2
contractor's license NO. 26-45C z"\,
/ �, 4c. Temporary Services or Feeders
Contractor's Board Ra�nn No
tea• Installation, etiolation, or relocation
Signature of Supr. Elec'n �� 200 amps or tesa 2
-
License No. 2986S Phone No. 224 -3511 201 antes to 400 amps 350.00 2
401 amps to 600 amps 375 00
Over 600 amps to 1 000 vorta $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
City State Zip purerlase of MIMICS or feeder see 2
Phone No. Each branch circuit 55.00
O) The lee for branch disuse without 2
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent First branch circuit ass 00 I LL
Each additional branch circuit 35 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or Irrigation circle 340 C3 _
2
Each sign or outline aghting 340 00
-
Signal circuit(s) or a lim;.ed energy - 2
Please check appropriate item and enter fee in section 5B panel, alteration or extension 340 00
___ 4 or more residential units in one structure Minor Labels (10) 3100.00
Service and feeder 225 amps or more 4f. Each additional inspection over
System over 600 volts nominal
Classed area or structure containing special occupancy the allowable in arty of the above
as described in N.E.C. Chapter 5 Per Inspection $35
Per hour 355.00
in Plant 555 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 $ 55.00
5% Surcharge (.05 X total fees) $ 2. /5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 57_75
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 - .,a,.e.,e. ❑ Trust Account # S
o" nr r
Balance Due $ 57.75
SP 231996
COMMUNITY DEVELOPMENT