Permit CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00249
�I4c DEVELOPMENT SERVICES DATE ISSUED: 4/26/99
r� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 DB -00705
SITE ADDRESS: 07475 SW VARNS ST
SUBDIVISION: ROLLING HILLS ZONING: R -3.5
BLOCK: LOT : 005 JURISDICTION: TIG
Project Description: Add two (2) branch circuits to an existing dwelling.
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:
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
MILLER, BOB & DOROTHY PHOENIX ELECTRIC CO
7474 SW VARNS 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
Phone: • Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'! Service
PRMT GEO 4/26/99 $40.00 99- 314835
•
5PCT GEO 4/26/99 $2.00 99- 314835
Total $42.00
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 copies of these rules or direct questions to OUNC at (503)
246 -1987. //
Permit Signature: 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: ' J DATE: ` / r
� - -9-9 9
/
LICENSE NO: `� / y0 ' 3
Call 639 -4175 by 7:00pm for an inspection the next business day
Y .A2 26 -99 MON 09:32 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02/02
CITY OF TIGARD RECEIVE
Electrical Permit Application Plan Check 4
13125 SW HALL BLVD APR 2 6 1999 Rec'd By
TIGARD OR 97223 Date Rec'd
Phone (503) 639- 4171, GeltVUNITY DEVELOPMENT 7 / _ Date to P.E.
Inspection (503) 639-4175 Print or Type 7-i l � Date to DST
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Ref"' "G y a`/7
Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of busines k V\4\,.∎ \\, �+ _"( Service Included: Items Cost Sum
Address ]L1 ) U'
C�bvc; ,k- ^ 40. Residential -per unit
City /State/Zip 4 4.. •c1 i‘r- _ 1000 sq. ft. or less X110.00
Each additional 500 sq. ft. or 4
Commercial ❑ Residential portion thereof $25.00 1
i A1 • - { f I r Limited Energy $
� -'\ 1 Each Manufd Homo or Modular
2a. Contractor installation only: �\�� u rx Dwelling Service or Feeder $68.00
Y• o �K5 iG Q 2
(Attach copy II current b. Services or Feeders
Electrical Co tracto �yLv��, •p t, Installation, alteration, or relocation
Adr ss � � e ))) -C _ E _ 200 amps or less $60.00
201 amps to 2
City L .c ......c. . State C) ( Zi p / 1 � - 3 401 amps to 6 600 amps $80.00 2
Phone N (p,4{( p $120.00 _ 2
601 amps to 1000 amps $180.00
Job No. _')01.1) - I / es Over 1000 amps or volts $ 340. 2
Elec. Cont. Lice. No. :: - eXf'7 Exp.Date Reconnect only $50.0 2
2
OR State CCB Reg.- No. - -1 =" -- - Ex P: Date - 4c. Temporary Services or Feeders
COT Business Tax or Metro No._ E . . . : ; Installation, alteration, or relocation
/� 1 200 a or loss $50.00 2
Signature of Supr. Eleen r *5 ee------�� - 201 amps to 400 amp $75.00 2
/ ' 401 amps to 600 amps $100.00 2
License No. f 410 Over 600 amps to 1000 volts,
Exp.Date _ Bee "b above.
Phone No._ Psi - :. ( e/N2)
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations:
a) The fee for branch circuits With
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
City State_ b) Tho fee for branch circuits
Phone No. � without purchase of
service or feeder fee.
First branch circuit \ $35.00 3 M 2
The installation is being made on property I own which is not Each additional branch circuit l $5.00 - 4 2 2
intended for sale, lease or rent.
4o. Miscellaneous
•
Owner's Signature (Service or feeder not Included)
Each pump or Irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Please check appropriate item and enter fee In section 5B. Minor Labels (10) $100.00
4 or more residential units in one structure 4f, Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as descnbed In N.E.G. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application whore any of the above apply. 5. Fees;
Not required for temporary construction servlcos. 5a. Enter total of above fees $ I. .r ) 0
NOTICE 5% Surcharge (.05 X total fees) 1{ /J
Subtotal $ ��NA
5b. Enter of line for I _
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Reviow w rpoui uired (Soc.3) $ r /
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK ubtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY �f�
TIME AFTER WORK IS COMMENCED. Trust Account q 0 /1 /1
Total balance Due $ U (✓
i 91,v 9,9fi