Permit •
CITY! ® F TI G AR D . E:L._ECTRICAL •PERMIT
DEVELOPMENT SERVICES . E 4 � E:LC' m7 ,�,5
.: -. 13125 SW Hall Blvd., Tigard, 01317223 (503): -4171 " . •
•
• . PARCEL:. . ' � . _;. 2S i. 02BD- -OO7r 1r. . .
• SITE ADDRESS.. • ., 12785 €3W PACIFIC .I -IWY
SUBDIVISION ... :NO. TTGARD'VIL.I. £. ADDITION AMEND. 1.ONINGsn - -0 •• •. •
LOT. . ........,., . . ; r71Z18 • • : JURISDICT ION- TIG•:•' • • '
. Pr e et De s pi- i pt i on ; Instal iation,, alterat ion ors: re ccation Of a 2.Z0 AV .service .
or feeder and six (6) branch circuits to an existing cooertial tenant occpy: . , .
---'—RES I DENT I AL. UNIT - - -- . ---..TEMP SRVC; /FEEDE'R r - --. -- • • - - - - - -M I SCELL _A NEOUS•- = - - - --
1000 SF OR LESS... •. ;; 0 0 . — 200 a III r3. ; , . r: 0 PUMP/ IRRIGATION. F, 0 . .
EACH ADD' L SOOSF... 0 • 201 — 400 amp,..... ,': -!ZI • SIGN /OUT LINE LTG.. . ; .0 _
LIMITED ENNIFRG'r..:. - . 0 .. 1 . 4 — 6i210 • atop. _ . „ .. - 0: - SIGNAL /PANEL. , n IC 0 . -
MANF.• HM .SVC /FDR. , 0 r,0i-1 "amps 10L .vo1 0 MINOR LABEL. (10) .:, ._ e 0
----SERVICE/FEEDER----'- - -- ORANGE•~ C - =.- . • - - -- :.ADD' L INSPECTIONS- • -
•0 • 200.' amp...... 1 .' •W /SERVICE OR FEEDER 6 PER .INSPECTION... . 0
:201 -- 400 amt ° ..0 1st W /O SRVC OR FIR, ; 0 PER HOUR • ... .. ; 0
401 ' — 600 ari p.. ; 0 • EP ADDS L BRNCH CI RC., . 0 I N • PLAN .. . > . ...: 0
6.01 .._ 1000 amp. . . o .: 0 . w.. - - -- ------ , ..— .- . - - .- - - - -.- -PLAN REVIEW SECT IOlaf -•---------- -----•-------
:1000I4- . -imp /volt, . ' 0 . > -4 RES UNI "iS.. , ., , o ..: > 600 VOLT NOMINAL... • ,
Reconnect on 1. y..... i 0 . . SVC /FDR = 225 AIM'S. CLASS AREA/SPEC • OCC.
Own e r ; -- . -- __.... —.- - - -- -- - - -..- - — - -- FEES
Sp`ADA FRED & JOSEPHINE type amount . . by date r
= '",i7; CI.I nfINN MAV PT PRMT - s?!;1 . mi71 (=Fnl 1 1 /t7i7 /C)7 c .0 7.A 2 .
PORTLAND OR 97201 • • 5PCT $ .4.50 0E0 f1/07/97
Phone 4$o . , '
• Cont.ract.or :'
BROADWAY E1..ECTRIC- COCHRAN INC` .. $ 94e 50. , ;TOTAL ,
' PO BOX 33524 • .
• . • - • . • -. REI; U I RED INSPECTIONS -- , _.
•• SEATTLE WA 93133 -05`4 . Cell in j Cover = U.nder gr.ouncl Co•��e.
Phone ; 234-6564 . • 'Wall Cover , ' .E,le.i.7.t• Service •
ReC1 I1 .- : ' +007'9 '
This peroit is issued subject. to the regulations contained. in the Tigard Municipal Code State of ;Oregon .Specialty . Codes 'arid all. other
applicable .laws. Ail work will be done in 'accordance with approved plans.. This .perait -will .expire if'work is not started within 1.'& ' '
,days of 'issuance, •or if •;pork is suspended for aore than 18r days. . ATTENTION: Oregon law requires you: pules to follow the' adopted. by ,
the Oregon litility Notification Center. Those rules are' set forth in OnR 952131-Ma through OAR .352-��3L -1337.' You nay •obtain a.copv •
of these rules or ::::i: -197, , • em t te ' '.I s s.ded . •B v - = -- - -''
._.. ... •;----- -•--•-- .•----- - - - -, --- _ ._.. -- - -- - - GWNE.1? :'I'NCs 1 ON c44.Y' - - - -• — . -- - •_.- - -... ---• -- -- .
The i:nstar]:1ation is bei:nn•' mad e`' • orr.,, I ow •;.t-,hichr _i.,s• r7 , intende.d .for •
sal. e,,' 'lease or ren:C.
OWNER' S SI CNA "fUtE: _ DATE:: _ . •
--- _----- . —.�_. - ...._— • — CONTRPC"fOP INSTALL PT'Il:3N Cf�•.L:Y- . - - - -- w.._- ..... . -- • ,I+
SIGNATURE.. OF. ELEC" N ' � ! DATE; i
• L I°CENSE: NO : r : . __ _
3 •
1-++..p 4.F..1:...F•i-•-h•?--I-.4- 1 ..-. - 1- .a...r,.-I..4..;. +.}.;.R. ,,,, ,-...F, y..+ i.:-F-i t i.:{ *-4 -42.1 i-, ::+: F=1-- ... _ : ;. g.: i_... ., ::f.,.�.:,, +.:+•f-i--F•:F•;.. , . •
C:6I .1:•.637• - -4175 by 7..:00: rip m. for afr .inspecbi.onwne'eded the ne'xt. .b■..i:iness• day .
• . -1 . { �L ..r J.J.. 1.J"J:J ±.:!.. x o- 1.: :. 4 . - - .L.. 1 � . 4. :
' -+ 1- -i 1'^
r. I- •4--4-•4-- t••-i"-_i•••i• .. ••� . -F- F•�i•-I - -l- : - -F• ; 9- . �.. 'N'- F .. S :•. ; •r•i- -1-•f-' -!-''. a= ,' -a- Y-F•-i--1-••� . ;4 .. F .. 1 . • :....F._;.- c- ;rte' -r ,. .
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
jii■ Tigard, OR 97223 Planck/Rec. #
Permit # eGC°q.7 -4 35 -
tM1l'�,!I Phone (503) 639 -4171 Date Issued
°`'` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: t 142_T-19- 5155 4. Complete Fee Schedule Below:
Name of Development VelliA ` Number of Inspections per permit allowed
Address 1 218 5 SW PG ' ' \I Service included: Items Cost(ea) Sum
City/State/Zip - viQ t/1. ok 't 3 4a. Residential - per unit 4
J n' _ 1000 sq ft or less $110 00
Name (or name of business) VJ- rdyis Each additional 500 sq ft or
portion thereof $25.00 1
Commercial M Residential ❑ Limited Energy $2500
- Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68 00
2a. Contractor installation only:
4b. Services or Feeders
u fr�� Installation, alteration, or relocation e® 2
Electrical Contractor ec 200 amps or less 1 $60 00 LA.) e 2
Address (0 ip (.56 140,t,0 201 amps to 400 amps $80.00 2
City State ('jam Zip \ laP't4_ 401 amps to 600 amps $120.00 2 -
rr `� p 601 amps to 1000 amps $180.00 2
Phone No. 03 l� 5 (v4 Over 1000 amps or volts $340 00 2 -
Contractor's License No. 3'7 - SA-ln Reconnect only $50.00
Contractor's Board Reg. No. '12_1 Li-a. 4c. Temporary Services or Feeders
* Installation, alteration, or relocation 2
Signature of Su r. Elec'n -e-../ 200 amps or less $50 00 2
$75 00 2
License No. 3) R4-S Phone No. 23d- I� 201 amps to 400 amps
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see - b• above
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The tee for branch circuits with
City State Zip purchase of service or feeder. lee. $5 00 2
Each branch Circuit
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder lee. 2
First branch circuit $35 00 2
not intended for sale, lease or rent. Each additional branch circuit $5.00
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 cucuit(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 $35.00 -
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:
NOTICE 5a. Enter total of above fees $ An
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. ❑ Trust Account #
$
Balance Due $ 9 tf o
racr°rndnANse-pm epp
•
•
RECEIVED .
NOV 071997
0L- vEuJNIviti,f
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0735
SPADA, FRED & JOSEPHINE
12785 SW PACIFIC HWY
02/21/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
ELCC001 Application received / / / / 11/07/97 RECD GEO 11/07/97 GEO
ELCC003 Permit created / / / / 11/07/97 PASS GEO 11/07/97 GEO
ELCC500 (F)Issue permit / / / / 11/07/97 PASS GEO 11/07/97 GEO
ELCC725 Underground Cover 11/07/97 / / 11/13/97 PASS MJR 11/13/97 MJR
ELCC799 Elect'l Final 11/07/97 / / 12/22/97 PASS BRP 12/22/97 B *P
ELCC800 Case Finaled / / / / 12/23/97 12/23/97 JT