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ELECTRICAL PERMIT
PERMIT *1:: ELC95-0618
CITY OF TIGAR® DATE ISSUED% 12/11/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tlgard,Oregon IZ223o8199 .(503)639-4171
SITE ADDRESS. . . :Q?1±2j.�bW 66i'H AVE
SUBDIVISION. . . . : WEST PORTLAND HEIGHT'-, ZONJNG:C-P
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :7
Project Description:
_-_.-RESIDENTIAL. UNIT---- GRVC/FEEDERS-----
1000 SF OR LESS. . . . 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L '500SF. . . 0 201 401A amp. . . . . . . : 0 3.3IGN/OUT LINE LTG. . : I
LIMITED ENERGY. . . . . 0 401 600 amo. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601yamps-1000 volts. : 0 MINOR LABEL 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS----- ----AUDI L INSPECTJONS----
IZI - 200 amp. . . . . . : 0 W/SCRVICE OR FEEDER: ID PER INSPECTION. . . . . . 0
201 - 400 amp. . . . . . : 0 Ist W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 - 600 vamp. . . . . . : 0 FA ADDIL BRNCH CIRC;- 0 IN PLANT. . . .. . . . . . . . : 0
601 - 1000 amp. . . . . : 0 --_._._._-_-_.-___-.----PLAN REVIEW SECTION ----------------
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL— :
Recon"ect only. . . . . : 0 SVC`/FDR ) = 225 AMPS— : CLASS AREA/SPEC OCC. :
Owner: -------------------------------- ------------------ FEES -----------_
CRAFT ELECTRIC type aMOUnt by date recpt
PO BOX 16177 PRMT t 40. 00 CJS 12/11/95 95-273/61
5PCT $ 2. 00 CJS 12/11 /95 95-273761
PORTLAND OR 97216
#. 503-255-19E5
Lontractor: ------------------------- ------------------------------------------- -----
CRAFT ELECTRIC INC a 4`. 00 TOTAL
PO BOX 16177
------ REQUIRED INSPECTIONS ------
PORTLAND OR 972116 Coiling Coyer Elect' l Service
Phone Wall Cover Elect' l Final
Reg #.
This permit is issued subject to the regulations contained in the
figard Municipal Code, State of Ore. Specialty Codrs and all other FWi4_ii+ ee Sipnoj
applicable laws. All work will be dcne in accvrda. with
approved clans, This permit will PxDirp if work is not started
within 160 days of issuance, or if work is susrionded for morp (ICr -SC/7
than 188 days. ly5ued By
_--_._.__.____._...__._._...._._-_._._.._-----.___OWNE=R INSTALLATION
The installation is being made an property I own which iv not intended for
Sale. lease. or rent.
IWNFRIS SIGNATURE: DATE:
TNSrALLATION ONL4------------------------- -
71 GNATURE OF SUPR. ELECI N: DATE:
LICENSE NO:
Call for inspection 639-4175
.'.,
Community Development ELECTRICAL PERMIT APPLICATION
13',25 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # '9s-OLY"A2
Phone (5uj) 639-4171 Date Issued /,Q_ - 9s-
FAX (503) 684-72S7 Issued by
CITY OF TIGARD TDD No. (503) (384-2772
Inspection (503) 639-4175
9. Job Address: n 4. Complete Fee Schedule Below:
Name of Development R k o A,)4fl LQ(&-QNumber of Inspection$ per permit allowed
Address_ 15 S w �\ A�'� Service included Items Cost(ea) Sum
City/State/Zip 49. Residential- per unit 4
1000 sq II or lean $11000
Name (or name of business)
Each portion
additionalel � n or 1
rtion thereof $2500
Commercial ED Residential❑ I Limited Energy $2500
Each Manurd Home or Modular 2
Dwelling Service or Feadnr woo
2a. Contractor, installation only:
4b.Services or Feeders
Irr.lallnlion,Alteration,or relocation 2
Electrical Contractor t2. 1e C Iyt<- TAC 200 amps or lose $6000 2
Address
201 amps to 400 amps $8000 2
x b 17'7 ---
401 amps 1c 600 amps $12000 2
City__ ��fr I6"NC-1 Stated t� Zip 1 601 empe l0 1000 amps — $10000 2
Phone No. .'?5 5` n)_I 3_S Over 1000 amps or vons $34000 2
Contractor's License No. ,1 11, - 5 C1 Reconnect only $5000
Contractor's Board Reg. No. L,80`/5 i 4c. Temporary Services or Feeders
Installation,alteration,or relocation
Signature of Supr. Elec'n C; = _ .JO amps or less $5000 7
License No. 3,/0 S Ph6ne No. ,7 SS' I C r3 S :101 amps I�400 nmpo _- $7500
401 amps to 600 amps $10000 _
Over 60C amps 10 1000 volt:
2b. For owner installations: see W above
4d. Branch Circuits
r,rint Owner's Name` — ?`o" alteration or extension par panel
Address n)The tee for branch circuits with
Cit State Zi purcheee of semke or heder he.
y� p Each branch circutl $F 00
Phone No. b)The fee for branch circuits without
The installation is being made on property I own which is purchase of serywe or h«»r he.
riot intendeu for sale lease or rent. First branch circuit $3500
2
r Each additional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or leader not included)
3. Flan Review section (if required): Fach pump or irrigation circle $4000
Each sign or outline fighting = $40 n0 _
Signal ctmurt(s)or a limited energy
Please check appropriate item and enter fr+e in section 5B. panel,aBeration or extension $4000
4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additionsl 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 $3500
[t Per hour $5500
1- In Plant S5500
Submit 2 sets of plans with application where any of the above
1—
apply. Not required for temporary construction services. Jr. Fees:
~ NOTICE 5a. Enter total of abotie fees $ y0,QD
22° 5%Surcharge(.05 X total fees) $ t O
:
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Eubfornl $
5b. Enter z:%of line A for
LL AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABINDONEO FOR Plan Review if required(Sec 3) $Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. ❑ TrUSi Account 0 $
Balance Due $ t a
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