Permit /\11 CITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00411
DEVELOPMENT SERVICES DATE ISSUED: 7/12/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113AB -01201
SITE ADDRESS: 16290 SW UPPER BOONES FERRYRD
SUBDIVISION: BANfffD CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of 9 branch circuits. Job No. 7843
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: 8 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:
PACIFIC REALTY BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY 55 SE MAIN
SUITE 300 PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Phone: 233 -2006
Reg #: LIC 00044569
SUP 2808S
ELE 26 -451C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 7/12/99 $80.30 99- 316759 Elect'I Final
5PCT DEB 7/12/99 $5.62 99- 316759
Total $85.92
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: - _ 3 / /// Issu d 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: 00 _ , Ce-f /6'v DATE:
LICENSE NO: ---)90g
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD l P Application Plan
-13128 SW HALL BLVD. RE CEl!/ E Recd
TIGARD OR 97223 Date Recd 7- %9
JUL 0 71999 Date to P.E -
Phone (503) 639 -4171, x304 �Date to DST �-
Inspection (503) 639- 417 COMMUNITY DEVELOPMENT Print of Type --5(A.19 9 ��
� Permit# g • e I gQCf - Q7 4 ///
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Flir Systems
Number of Inspections per permit allowed
Name (or name of business) /J, ��QQ,�, ®yam Service included: Items Cost Sum
Address /6‘ n 0 .w l.UPL tpi Ode- f ") 4a. Residential - per unit
1000 sq. ft or less $ 117 75 4
City/State /Zip -176 6t a-o o /, 7A 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 Bachofner Electric 200 amps or less $ 6425 2
201 amps to 400 amps $ 85.50 2
Address 5 5 SF. Ma 401 amps to 600 amps $ 128.50 2
City Porl-1 and State Og Zip 9771 4 601 amps to 1000 amps $ 192.50 2
Phone No. 2 3 3 - 2 0 0 f Over 1000 amps or volts $ 363.75 2
Job No. 7 8 4 3 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 2 6 - 4 51 C Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. 4 4 5 6 9 Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Ele ' -_% 401 amps to 600 amps $ 107 00 2
Over 600 amps to 1000 volts,
see "b" above.
License No. 2 8 0 8 5 Exp.Date
Phone No. 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
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit 1 $ 37.50 3 7. 5 0
Each additional branch circuit 8 $ 5.35 42.80
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
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (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
Service and feeder 225 amps or more Per inspection $ 50.00
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 t f above fees ����'// $ 8 0, 3 0
* Submit 2 sets of plans with application where any of the above apply. 5° urcharge ( 05 X total fees) 1 $ 5 . 6 2
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a 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 balance Due $ 8 5.9 2
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