Permit CITY OF TIGARD
�-� DEVELOPMENT SERVICES ELECTRICAL PERMIT
1 1 1 PERMIT #: ELC97 -0035
!+� '� �.. 13125 SW HaII Blvd.,ligard, OR 97223 (503)639-4171 639 -4171 DATE ISSUED: 01/17/97
PARCEL: 251O2BA -00501
SITE ADDRESS...: 09740 SW TIGARD ST #2
SUBDIVISION....: NO.TIGARDVILLE ADDITION AMEND. ZONING :I —P
BLOCK LOT .60
Project Description: instl 14 branch circuits
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 — 200 amp ...... °: 0 PUMP /IRRIGATION 0
EACH ADD'L 5O0SF...: 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: 13 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
DANNEL SNYDER type amount by date recpt
9740 SW TIGARD PRMT $ 100.00 TAT 01/17/97 97- 289084
5PCT $ 5.00 TAT 01/17/97 97- 289084
TIGARD OR 97223
Phone #:
Contractor:
WILLAMETTE ELECTRIC INC $ 105.00 TOTAL
PO BOX 230547
REQUIRED INSPECTIONS
TIGARD OR 97281 Ceiling Cover Underground Cove
Phone #: 503- 624 -3631 Wall Cover Elect'l Service
Reg #k..: 000750
This peroit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permit e Signatu
applicable laws. All work will be done in accordance with
#kid
approved plans. This peroit will expire if work is not started _ within MD days of issuance, or if work is suspended for .ore
than 183 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
Community Development ELECTRICAL PERMIT APPLICATION
./ 13125 SW Hall Blvd.
Tigard, OR 97223 Permit # �C97-� �?
� Date Issued 07`/ 3 97
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 D ail „ e l C vie A_ Number of Inspections per permit allowed
Address 9 7 7 `f 0 Sc,J i 1 ch.a p 1,1 Z Service included: Items Cost(ea) Sum
City /State /Zip i i ' i4 n� fJ A C ! 1- - Z Z 4a. Residential - per unit
S 1000 sq. ft or less $110 00 4
Name (or name of business) Each additional 500 sq ft. or
portion thereof $25.00
Commercial Residential ❑ Limited Energy $25 00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68 00 2
2a. Contractor installation only:
4b. Services or Feeders
J { Installation, alteration, or relocation
Electrical Contractor . /t AN( { IR. ` bcc 1 ►q C /," t 200 amps or less $60.00 2
Address Po �a o ;. 230 ''' '. $80 00 2
�- 201 amps to 400 amps $120 00 2
4 01 amps to 600 amps
City Tl► n n State Lit Zip y 2 U $180.00 2
601 amps to 1000 amps
Phone No) %-, Z t.{ - 3 L 3 / Over 1000 amps or volts $340.00 2
Job NO. C, y 9 4. Reconnect only $50.00 2
contractor's license NO. 3 4 - ZS( 3 C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Z9 i Installation, alteration, or relocation
Signature of Supr. Elec'n IPMED:r _ 200 amps or less 2
-
License No. (SG S — S Phone No. 1 - -rbc i 201 amps to 400 amps $50 00 2
G Y 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
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5 00
Phone No. b) The fee for branch circuits withou
2
The installation is being made on property I own which is purchase of service or feeder fee.
First / $3500 2
not intended for sale, lease or rent. circuit
Each h addiionddch n al branch circuit I ? $5 00 ( j
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 circud(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 $3500
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:
G
5a. Enter total of above fees $ /eiiJ
NOTICE 5% Surcharge (05 X total fees) $
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. xordlcomdeNeieo- ❑ Trust Account #
$
prm aYP /) -
Balance Due $ S
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
Plbg.Und /Flr /Slab Plbg. Top Out Insulation 41g12,
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: l
Date: ' 2-( ( " A.M. P.M. Entry:
Address: C I - 7 1 46 `.. 51 1
Tenant: / J Ste: Z MST:
�" /J-�� C�,� MU
Con /Own: L(.(� O MEC :
PLM
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
7c 77
C '
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li r -e ÷ n / c . /5- c t c
Inspector: /,
— A Date:. ''-'7
APPROVED _ DISAPPROVED /CALL FOR REINSP. CO
' CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service 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: ‘-{9- A.M. P.M. Entry.
Address: / 7 q D 1 -St
Tenant: _ �.., 2- MST:
Con /Own: (JUL J- �vyl_JC.r SL MEC:
PLM:
ELC.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: Of C 4,..v._6. �, R e( Date: 2 "a• 7
_APPROVED DISAPPROVED /C . FOR REIN P. CO