Permit ELECTRICAL PERMIT
CITY OF T I CARD PERM I ISSUED: 09 / 24 2
COMMUNITY DEVELOPMENT DEPARTMENT
PARCEL: 15114PC- 00101
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
SITE ADDRESS...: 1 160 SW SCHOLLS FERRY RD
SUBDIVISION....: ZONING:C - -G
BLOCV...... ° .... LOT
Project Description: Installing five branch circuits for a ATM.
- -- RESIDENTIAL UNIT - - - -- -- -TEMP SRVC/FEEDERS---- --°----- MISCELLANEOUS• - - - - --
100_0 SF OR LESS e 0 0 -- 200 amp° ...... a 0 PUMP/IRRIGATION....: 0
EACH 'ADD' L 500SF... a 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: IZr
LIMITED ENERGY.....: 0 401 -- 60IZI amp........ 0 S1GNAL /P'ANEi_ ..... . ° . 0
MANF. HM/ SVC /FUR.. : 0 601+amps - 11ZIO0 volts.: QI MINOR LABEL (10) ... e 0
----SERVICE/FEEDER---- _- -- .- BRANCH CIRCUITS - - - - -- - -- -ADD' L_ INSPECTIONS--
0 -- 200 amp......: 0 W/SERV10E OR FEEDER: 0 PER INSPECTION.....: 0
201 - 400 amp....... 0 1st W/0 SRVC OR FOR.. 1 PER HOUR...........: 0
401 - 600 amp......: IZ► EA AWL BRNCH CIRLo 4 IN PLANT ° 0
601 - 1000 amp.....: 0 ----------------PLAN REVIEW SECTION----------------
1012112,+ amp/volt.....: 0 > =4 RES UNITS > 60121 VOLT NOMINAL..:
Reconnect only ° 0 SVC /FDR' > = 225 AMPS..: CLASS AREA /SPEC OCC,, °
Owner: - - - -- ----- •----------- -• - - -• -- - -- _ - •-- • - -• -- FEES -- - •------ -• - - --
FIRST INTERSTATE type amount by date recpt
12160 SW SCHOLLS FERRY RD PRMT $ 55.00 CJS 09/24/96 96- 284315
UPCT $ 2.75 CJS 09/24/96 96-284335
TIGARD OR 97221
Phone #a
Contractor: -• - •--- •- - - - -•- ---- - - - - -• - - --
ELECTRICAL CONTRUCTION CO $ 37.75 TOTAL
PO BOX 11286
---- - - - -•- REQUIRED INSPECTIONS ---- --- - --
PORTLAND OR 97296 Wall Cover •Elect'1 Final
Phone #a 503- 244 - -3:1.1 Elect' 1 Service
Re r. 49737
This peroit is issued subject to the regulations contained in the ___ ___ _•__�__ — _ — _�_ — ___
T ioard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e Signature
applicable laws. Ail work will be done in accordance with
approved plans. This peroit will expire if work is not started -
within 180 days of issuance, or if work is suspended for pore - --
than !89 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 :
IINSTALLATION ONLY-_-___._--__.--__._--____-_-.-
SIGNATURE OF SUPR. ELEC' N a _,cr- Lecr __ __.__- __.... DG-1TE
LICENSE NO e
Call for inspection -- 639 -4175
07:115..96 11:53 '5113 684 7297 ( ITl OF TIGARD 0)01121002
Job# 37082 -87 Greenway ATM #2
A- Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # F ctr -O 157 ...____
Alit• : Date Issued G.- Ali- 46 J,1. ,. JI • Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ATM Machine Number of Inspections per permit allowed
Address 12160 SW Scholls Ferry Road Service included. Items Cost(ea) Sum
City/State /Zip Tigard, OR 97223 48. Residential - per unit -
1000 sq. ft. or lees $110.00 4
Name (or name of business) First Interstate Bank Each additional 500 sq. il. or
preen thereof 325.00 1
Commercial ® Residential ❑ umned Energy 00
Each Manufd Home or Modular
Meeting Service or Feeder 388.00 2
2a. Contractor installation only: 9 -14 -96
4b. Services or Feeders
r fes
Electncal Contractor El ectrical Construction Co. Installation. lon, on, or relocation 200 en+ps o err ess 340.00 . 2
Address P.O_ Box 10286 201 Saps l0 400 amps nom 2
City Portland State OR Zip 97296 401 amps to 500 amps $12 0.00 2
601 amps to 1000 amps 3190.00 2
Phone No. 224 -3511 over loon amps or volts 3340,00 2
Job NO._ 77082_82 _ Reconnect only S50.00 2
contractors license NO. 26 -4 • 4c. Temporary Services or Feeders
/
Contractor's Board Reg. No .' 97 •7 Installation. alteration, or relocation
Signature of Supr Elec'n ��:::: 200 ampe er less 2
License No. 2986S Phone No. 224 -3511 201 amps to 400 amps 360.00 2
401 amps to 600 amps 375 00
-
Over 600 amps to 1000 voila $100.00
2b. For owner installations: see 'le above. .
4d. Branch Circuits
Pnnt Owner's Name New, alteration or extension per pane
Address a) The fee for branch =irks with
2
City State Zip purchase aleervuee or feeder fee
Phone No. Each branch ckwa $5.00
b) The fee ter branch comas without 2
The installation is being made on property I own which is purchase ofserviceor feeder lea. 2
Rai branch circus $35 00 35 _ 00
not intended for sale, lease or rent.
Each additional trance eireun 35 00 "yrSS7Lr.57lTS1Lr
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not Included) 2
3. Plan Review section (if required): Each pump or Intgatlon circle $40.00 - 2
Each algn or artiste blaming 340 00
- Signal cuzvrt(s) or a limrao energy
2
Please check appropriate item and enter fee in section 58. panel. alteration or extension 340 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 355 00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE Sa. Enter total of above fees $ 55.00
5% Surcharge (.05 X total fees) $ 2 15
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 57_75
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter ev i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) y
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. - ..a..e.,e... ❑ Trust Account f/ S
on• .PP _
Balance Due $ 57.75
RECEIVED
SEP 2 31996
COP.^,; 1Up!ITY DEVELOPMENT
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/t° C SGN95 -0002 FIRST INTERSTAT MCDONALD, STEVE 12160 SW SCROLLS FER "II
if° C SGN95- 0003✓tIRST INTERSTAT MCDONALD, STEVE 12160 SW SCROLLS FER ofl
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/I° F ELC96- 0457 INTERSTAT FIRST INTERSTAT 12160 SW SCROLLS FER °ltlt
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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
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -B .g.
San. Sewerr Gas Line Appr /Sdwlk Reins.
Other: 5. " 0 '/�
Date: /Q - z- - / b A.M. - c cki P. P.M. /, ntry: �/J
Address: �/ (00 5
Scew T s
Tenant: Ste: MST:
BUP:
(/ C ( -
Con /Own: 1 / 1 '" MEC:
7 i 7 - 0 - 3 yC ELC: O 7
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
7/ 30 e.-c.. -060C
Ca-/1/ C.)
Inspector Date:71— 7�
4 . APPROVED _ DISAPPROVED /CALL FOR REINSP CO