Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00380
4221 DEVELOPMENT SERVICES DATE ISSUED: 6/25/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104BA -02300
SITE ADDRESS: 12061 SW WILTON AVE
SUBDIVISION: COTSWALD MEADOWS NO.3 ZONING: R -25
BLOCK: LOT : 104 , JURISDICTION: TIG
Project Description: First branch circuit
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: 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:
RICKARD, DAVID A/MARGARET S GRF ELECTRIC
12061 SW WILTON AVE 15460 SE PARADISE LN
TIGARD, OR 97224 MULINO, OR 97042
Phone: Phone: 503- 829 -4146
Reg #: LIC 001015
SUP 3003S
ELE 26 -878C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
•
PRMT BON 6/25/99 $37.50 99- 316402 Elect'I Final
5PCT BON 6/25/99 $1.88 99- 316402
Total $39.38 ORIGINAL
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.
5
Permit Signature: (91(k 11)(Z41(07A
— ���� 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: Ort V � � DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
06/24/1999 10:25 5038295747 GRF ELECTRIC PAGE 01
•
,
Y` RECEIVED
CITY OF TIGARD Electrical Permit A Ph
13125 SW HALL eLVP 2 "z — Redd by Pi
TIGARD OR 97223 osh !u - �`f - ?i
Date cnM �Dp�TY DEVELOPMENT to RE,
Phone (603) IN104177; Print or T Dame to oar
!nape:Bon (503) 839.4176 Incomplete or Illegible wit not be accepted Pow* . __ Cad - S ",�
Fax (503) 884.7207 u:allad
1. Job Address: 4. Complete Fee Schedule Below:
Name of DsysbpmenL_ Nuraea of bupoalons per welt eooerew
Name (or nouns of bums) Dr v P, R c 1, a.eri,/ Santos included: Awns Cost Sum
Addams i z W" s IA 0171 +0.7 Ihre , ■ 4 .. • par hmR
City/Mate/Zip T l�n---A____ 4'7 1aao el. n.or Imo
s�toao a
Each aeadand 600 eve a a
Commercial ❑ Rssidendd9/ Mao thane
Untied gooey
. —
Each Mean Meow co Moeuar `�'
2.a. Contractor Installation only: 011011119 aloft or Fee* sae MAO .
• passe espy �. e l of all Younr awnless er Pe
EeCOicaI Contractor 7 �. ..C� ihmo on, or rolocaecri
Address 102 wee sr < /s . f �G "I . . amps ac � amps $10A 2
City , t 5 $Eels -4.20....1= 9 O eo SOO amps $110.0 — 2
2 /
Phone No,_ 4 'Y' l %y 01 WO
amps to loos anps $1$0.00 , a
Job No, Ow 1000 amps or vdes SUMO , 2
Be& Cent U. No. 1 r - g'? v c. , Exp,Datil �'+"� co/ $150.00 2
OR State CCB Res. No 0150 as. Taniporsrr Smokes or Powers
COT Business Tax or Metro Date am.rmaon, or nlooreon
200 amps cress $FOOD _ 2
Signature of Supr. Elsc'A soh amps m ace — 401 m aao ro 0000 2
l.tar nn S• o_ m °i aa. �: o 1062was.
Phans No, 7 r 444 W ~
ad. Smart Circuits
2b. For owner Installation.: he he boo eanaro psr PW+d
a) The a. aer.rhdh doles WO
Dunham o I oonif s or
Print Owners Name body Ma.
Address Each grand deeds $6.00 �_ 2
• e)Ito hs for bmndh about.
P ho ne No, +» wear 3 7. S° 3
Furs tow* WWI ' - M -- 2
The insoWadon Is being made on property I own which Is not Each aeewoew branch ohoue UM 2
intended for sale, lease or rent
(oyes or lesser not mstide3 .
Amer's Signature
a Each p Dud a 556000
a
3. Plan Review section (If r :" : a0 oroloded anew
pond, 4e4e0e40 ar actatelon WAD - 2
Mho Lame (to) $10.0
Please cheek appropriate Item and enter tee In motion SD.
a or may realOrresl who In ow aster s 41. faolh odetIo ol Impowlon owe
System ever 800 wife nominal S. l p a"b hi any of In doom $35.00
Cl odllsw was or Moeas
u doseeew hi N.E.C. °wo 5 � 1ep► In Root — $50.0 ,
— Submit ono of plans with opt u. whom wry or Os Cho apply 6. Fees: y
No r.vhelws r 0r1
for nporsry e0v00wi s.vAoss. 80. Erse toll of slavae how $ 3 ? .
5% Surdmga (.am x IoW Iwo) . $ = b
• Odom $
5b. &kw 116% at tins War
PERMITS DECOR NOT COMMENCED Wrtw i 8 c � �uCTION OR WORK (�` $
18 SUSPENDED OA ABANDONED FOR WE WORK CO D. A PERIOD OF ISO DAYS AT ANY
T l *owe r, • R , 2 g
otal T balance Dim