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ELECTRICAL PERMIT
CITY OF TIGARD DATEIISSUED:C96-0227 04/115/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tlgard,Oregon 97220*8199 (503)839-4171 PARCEL : 1 S 135AB-01004
i I L. 1.aD1)I'<LOb. . . . 1.1r_'ic_Ll1i W GItL_ENL•{UItU 1"r.1) #345
,UBDIVISION. . . . : ZONING:C-P
'LOCK. . . . . . . . . . . Lo"r. . . . . . . . . . . . . .
1,10.ject Descriptiovi: install two branch circuits.
---RESIDENTIAL UNIT---- --TEMP' SRVC/r-EEDE:.RS---- -----MISCELLANEOUS-----
100Q1 5F OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTC. . : 0
LIMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : ILI
IyIANf=. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
CIRCUITS----- ___ADD' L INSPECTIONS—
0 - 2oo amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . : 0
201. -- 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : t PER HOUR. . . . . . . . . . . : 0
401 -• 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC- 1 1N PLANT. . . . . . . . . . . : 0
1601 -- 1000 amp. . . . . . 0 -- - ------------ - FLAN REVIEW SECTION-__.-___.________._.__
101210+ amp/volt. . . . . : 0 ) s4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > _ 225 AMP'S. . : CLWSS AREA/SPEC OCC. :
Owner: ---__.____.___.____.._.__.____._____ _____. _-._...______._..____... FETES
ME.LVIN MARIA. type amoI.int by date recpt
101120 SW GREENDURG PRMT $ 40. 00 CJS 04/15/96 96-278182
3PCT f 2. 00 CJS 04/ 15/96 :?C-;"-7 8 18 E
11GARD OR 97223
Phone #:
Cunt Tact or s
CHRISTE:NSON ELECTRIC INC E 42. 00 TOTAL
10250 SW GREENBURG ROAD
- --- -- REQUIRED INSPECTIONS
---- ---
iIGARD OR 97223 Wall CovL-r Elect' ]. Finr•1
Phone #: 503-241-4812 Elect' 1 Service
Reg #. . : 548 -
This permit is issued subject to the regulations crntained in the —_—
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Fislnatcire
applicable laws. All work will be done in accordance kith
approved plans. This permit will expire if work is not startea
within 18@ days of issuance, or if work is susperaed far more
than 18@ days, I s s Lied By
_. ..._OWNER INSTALI A r ION 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
SIGNATURE OF SUF'R. ELEC' N: DATE:
I_.I CENSL NO:
Call for inspection - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd
Tigard, OR 97223 Permit # LCL.C96- L?;j7_ _
Date Issued
Phone (503) 639-4171
CITY OF TIrARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. .fob Address: 4. Comp!ete Fee Schedule Below:
Name of Development LINCOLN CENTER Number of Inspections per permit showed
Address 10220 SW GREENBURG ROAD SUITE345 - ( Service included Items Cost(ea) Sun
City/State/Zip— PORTLAND -- 4a. Residential -per unit
1000 3q. ft or less $110.00
Name (or name of business)_MELVIN MARK -_ Each additional 500sq it or - �-
f portion thereof $25.0
Commercial "X Residential Limned Energy $25,00
Each Manu"d Home or Modular
Dwelling Service nr Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
ROSS CROSBY
1 Electrical ContractorCHRISTENSON ELECTRIC, INC. Inslallatn,or relocation
200 ammpspsor less $6000 2
Address 111 SW COLUMBIA,SUITE 480 201 amps to 400 amps seoon — 2
City PORTLAND State OR Zip97201-588( 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 7
Phone No. 503 241-•4812 over 1000 amps or volts _ $340.00 — z
Job NO. 222-4400 Reconnectonly $5000
contractor's license No.26-34C
4c. Temporary Services or Feeders
Contractor's31AArtinstallation,allocation,or relocation
Signature o-Supr.. �R;L- �--No, nitsR
Q,,,1 = ?00 amps or less201 amps to 400 amps $5000
License No._ x G � Tshone NO 241—481 2 _ 401 amps to 600 amps $75.00 1
Over 600 amps to 1000 voll s $10000 —-- -
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owners Nm)(,. New,alteration or extension per pane
Address a)The fee for branch circuits with
City —__ _ State Zip _ purchase of service or feeder foe
Each branch circuit _ $5.00
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 fee.Firs ) 35. 7
not intended for sale, lease or rent. Each
branch cal br $$500 _
Each addltlanal broneh circuit $5.00
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not Included)
3. Plan Review section (if required): Each pump or Irrigation circle $4000 �—
Each sign or outline lighting $4000 �-
Signal clrcult(s)or a limited energy
Please check appropriate Item and enter fee in section 68. panni,alteration or extension $40 CO
4 or more residential units In one structure Minor Labels(10) 510000 —
Service and feeder 225 amps or mon
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 descr?ed in N.E C Chapter 5 Per Inspection -- $3500
Per hour $55.00
In Plant $5500
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. I=nter total of above fees y 40,
NOTICE 5%Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK Or?CONSTRUCTION subtotal $
AUTHORIZED IS NCT COMMENCED W11 HIN 180 DAYS, OR IF 6b. Enter 25°x6 of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sea 3) $
A 11FRIOC, OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal s �+Z
COMMENCED. Trust ti-count e
S _—
M—Apr
Balance Due S 42. ..