12348 SW GRANT AVENUE � 1
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ELLC'TRIC:AL PERMIT �
CITY OF TIGARD DAME T ISSUED: 08/23/96
COMMUNITY DEVELOPMENT DEPA TMENT
13125 SW Hall Blvd.Tigard,Orac.:n 07223.8190 (50:i)639.4171 PARCEL:: 2511112BA-01:512 0
J,E3UIV151ON. . . . : NO. TIGARDVILLE ADDITION AMEND. ZONINGtR--12
.... . . . . . . . . . . I_i.1 T. . . . . . . . . . . . . . 13
Oject Desc.r^i,ption: One elec-trical inspection.
---RE.aIDE:hJ"TIAL UNI"I"---...--- ----TEMP SRVC:/FEE.DEHS-------- -- -•--1v1I5CELLANEOUS--.--•--
V100 SF OR LESS. . . . 0 1'11 - .='00 -AMP. . . . . . . : Ia POW-,/ 1 RR T GA","I ON. . . . . 0
4CH ADD' L 500SF'. . . : 0 _:01 — 400 amp. . . . . . . : 0 SIGN/OUT t_INE. LTG. . : 0
i.A.111TED ENERGY. . . . . : IZI 41111. (~ITIVI amp. . . . . . . : VI SIGNAL/PONEL. . . . . . . . Ib
MANF. HM/ Civ'.""./FDR, . : Its 6 11+amps -10IZ0 volae;. : IlI MINOR LABEL ( 10) . . . : 0
RV ICE./Ft.EDER-__.___ _.___.....-DRANCN 1.:I RCU I1 S--------_. --ADD' L- I NSIDEC:T IONS •_.._
200 amp. . . . . . .. 0 W/SERVICE OR FEEDER: 0 PER INSPF_C"TION. . . . . .. 1
SII -4Ir1111 amp. . . . . . . 0 I st W/O SVC OR FDR. : 111 PIER HOUR. . . . . . . . . . . . VI
,,hi _ 600 amp. . . . . . : 0 EA ADD' L PEtNC:H CIRC: 0 IN PLANT. . . . . . , . . . . 0
-01 10,110 .-imp. . . . . : 111 __..____.... .._._ ._._.___._.PLAN REV II_W SEC TI.OIV--.__.._..______._..__.._._ _....._
iVAIZ1 r+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
i>;ar_onner_t on 1 y . . . . . : 0 SVC/FDR 1 225 AMPS. . : CLASS AREWSPEC UCC. :
Iwner; ___..__.________.....________._.__._.._..__.____.._.._____________.___ FEES ______.___.__..._......._._...
I-PAD BERNARD t ype am0Unt I•Dy d at e i,ecpt
! ,::,348 SW GRANT ST PRMT $ 35. 00 . JS 08/23/96
5PCT $ 1. 75 Lis 0(3/17113/96 9S-128.*•1 ':sl
I IGARD (al's 97213
I'!1one #: 590--0123
ontratctor-.
WI�II= R $ 3,6. 75 TOTAL.
--_-- — REQUIRED INSPECTIONS
_.._._._.._
E:1eat' 1 E= ina1
lune if: SLE ABOVE.
This perut is issued subject to the regulations contained in the
iigaru Municipal Code, State of Ore. Specialty Codes and all other rmittee ��ignat .ire
applicable laws. All work will be done in accordance with
approved plan;. This permit will expire if ;pork is not started
oithin 160 days o,` issuance, or if work is suspended for more
Char. 160 days. I s s t(ed By
IPI,` I(ALLATION
he installation is tieing macie on property i own which is not intenr+od f!r-
al L- , lease, or- rent._
WNE_R' S S 1 GNAJ IJRf :� . DO E: 1--
_.... - CON1 RACTOR INSTAI._LA1 ION
6NAIURL OF SUPR. E_LLA..' N: ---� ___.___._..._.._._._._...._.___._...__ DATE:
LGE:NSk: NU: __.__...._.......___._.._.._........_ _._ .._. _W.__.,_. ,.______....___.._.._..___
Call for inspection _. 63`x--4175
Community Development (ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
I igard, OR 97223 Permit # EtCk-7 CJ-5 5�-,
()ate Issued U- ;C - c "-
Phone (503) 639-4171
CITY OF TIt3ARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: .,R, C ,�,
ornulete Fee Schedf f Below:
Name of Development Number of Inslxctions per permit alloteed
Address ,,�34js- Service Included: Ifc'
-- _ ;r1S Cost(ea) Sum
City/State/Zip /_1 C, n �� � _ 4a. Residential -per unit
1000 sq R. tx kis $11000
Name (or name of busine9e)4, V Ewh addAW&'500 sq.n.or
portion thereof 32500 1
Commerc!al ❑ Residential Lsnead Energy $2500 _
Each Manurd Hoar or Modular
2.a. Contractor installation only: D""Servfu or Feeder 380.00 2—� -
4b. Services or Feeders
Electrical Contractor Installatlon,alteration,or relocaron
Address -- 200 arra or Was Silo 00 — 2
s_ 201 amps to 400 ameo amps S 00 _ 7
City_ State Zip 401 amps to e00 snipe _— 312000 2
Phone No. —- - 601 arnps to 1000 amps _-- $18000 2
over 1000 amps or voea S34000 2
.lob NO. _ _--_—_– _ J' Reconnect only __— t50 00 2
contractor's license NO. —
--- 4c. Temporary Services or Feeders
Contractor's Board 9eg. No` — __ �_� Installation.alteration,or relocation
Signature of Supra Eia-i'n 2mp
00 as or less 7
l_icerlst: No. Phone No. —� 201 amps to 400"a -�"' S5000 ---- 2
- -- --�-- 401 amps to 600 amps $7500 — 2
Over 600 amps to 1000 volts -- 3100 00
2b. For owner installations: see V above.
4d. Branch Circuits
Print Owner's Name 7�_�:_ � .�:� � C.Y New altererlon or extension per pane
Address �,,t 3 a The fee for bnmh ci cuaa Witty
City_ - f 'r" c t. , ; Slates TZip__ %_) wit sr ee of ce or feeder fee. 2
is LX)
Phone No <. �� _ b)The lee fix branch c.rmka wjd"t
The installation is being made on property I own which is purchas.of service or foodiar fr.. 2
not intended for sale, tease or rent. Flat branch caGie W 00 2Foch additional bra ich cirmo S500
Owrer's Signature ___ _ / ` J __ 4a. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pwv or irrigation rir>s —_ $4000 2
Each sign or moline fighting ;40 00
Signal crwe(s)or a WrWed energy
Please check appropriate I; m and enter fee in section 513. pant,alteration or extension y40 0t,I
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 ahova
as described in N.E.C. Chapter 5 Per'specnon 13500
Per hour V"on
_---
Submit 2 sets of plans with application where arty of the above In Plant SSS 00-- --
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter tot.•tl of above fees
5% Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal S
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WIDRK IS SUSPENDED OR ABANDONED FOR I Plan Review if required (Sec 3) S _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS I Subtotal
COMMENCED. ❑ Trust Account >x
P1-*M 4I _
Balance Due 3