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CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELL'97--0469
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 07/17/97
PARCEL: 2S112CC-08500
317E ADDRESS. . . : 15GE5 SW 82ND AVE
SUBDIYISION. . . . :LANGTREE ESTATES ZONING: R-12
BLOCK. . . . . . . . . . : LOI.. . . . . . . . . . . . . : 17 JURISDICTION: TIG
Pt-o.ject Desct-iption : instl I branch circuit w/o feeder // job # ?
-- RESIDENTIAL. UNIT----- SRYC/FEEDERS--.-- I SCEI-LANEOUS
1000 SF OR LESS. . . . : 0 0 - 'L2.00 amp. . . . . . . : 0 PUMPIIRRIGATION. . . . : 0
MACH ADD' L 500SF. . . : 0 x.01. — 14-00 aMI-). . . . . . . : 0, SIGN/OUT LINE LTG,, . : 0
LIMITED ENERGY. . . . . : 0 401 --- 600 ramp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-100.0 volts. : 0 MINOR LABEL ( 10) . . . : 0
------SERVICE/FEEDER----- --------BRANCH CIRCUITS-------- -----ADDIL INSPECTIONS ---
it 200 Oinp. . . . . . : 0 WIGERYICE OR FEEDER: FIER INSFIECIIC)N. . . . . : 0
201 400 amp. . . . . . :* 0 1st W/O SRYC OR FDR. : 1 FIER HOUR. . . . . . . . . . . . 0
401 600 amp. . . . . . : 0 EP ALD' i.. PRNCH CIRC: 0 1 N PLANT. . . . . . . . . . . . IZI
601 1000 amp. . . . . : 0 REVIEW SECTION --
1000+ amp/Volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . r, 0 SVC/FDR 225 AMPS. . : CLASS AREA/SPEC OCC. :
OWTIOT-: FEES
TINA CLAIR PITTMAN type amol.trit by date t-ecpt
15665 SW 82DN AVE PRMT $ 35. 00 TAT 07/17/97 97-297;24,:
TIGARD OR 97223 5PCT $ 1. 75 TAT 07/17/97 97-2`97243
Phone #:
Contr,actot'..
X1_ ELECTRIC 36. 75 TOTAL.
581 LANCASTER DRIVE GE
STE 50 REQUIRED INSPc"CT IONS --
SALEM OR 97301 Elect' I Set-vice
Phone #: 503--391-9113 Under-gr-ol.ind GuviElect' 1 Final
R(-[:l it. . : 001094
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will ewpire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rule are set forth in OAR 952-00I-0010 through OA I R 952-00I-1967. You may obtain a rope
of these rules or direct questions to OUNC by calling (503)246-1987.
r-m i t t e v Sign at)it-e
115SIAPd By :
INSTALLATION
The installation is being made an property I o%-j ri which is not intended fot^
s a 1 v, lease, or rent.
OWNER' S SIGNnTLIRE- DATE:
INSTALL.nTIC"IN ONLY
STC1NnTUPE OF SHPR. ELECIN: DATE:
LICENSE NO:
+.f+++.......4-++++4-+++++-I++++-I-+-i ++++.....4,++4.++++ +++4+++ 4.+4.4.+++++++++++++4 4.
Call 639- 41775 by 6:00 P. M. for an inspection nvPdPd thp next bi-is iness (I
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. __ _"_ ..... .,.... ..-•stet-.rnt..n s.rASC.
CITY OF TIGARD Electrical Permit Application Plan Check a
13125 SW HALL BLVD. Recd By F
TIGARD OR 97223 Date Recd
Phone (503) 639-4171, x304 Date to P.E.
Inspection (503) 639.4175 Print or Type Date to DST
t
m
Incolete or illegible will not be accepted Permit a (
�-F2ut (503) 684 7297 p g p Called
1. Job Address:
4. Complete Fee Schedule Below:
Name of Development _ _ Number of Inspections per permit allowed
Name (or name of business) _ Service included: Items 170st Sum
Address_ 1 S 6 6 S SW 82nd AVE _ 4a. Residential•per until
City/State/Zip T-1GARD. OR IWO sq.ft.or Iess i 5110.00 4
Each additional 500 sq.it.or
Commercial ❑ Residential ® portion thereof $25.00 1
Limited Energy $25.00
Fair Manul'd Home or Modular
28. Contractor installation only: Dwelling Service or Feeder sAti.oO � 2
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor XL ELECTRIC, INC. Irarmllatlon,alteration,or role .Abon
Address. 200 amps or less 2
581 , ANCASTER DR SE STE tot amps to 400 amps --- $60.00
City SALEM State_Q$__-Zip 97301-- p _-- $80 00 2
401 amps to 600 amps $120 00 2
Phone No. 503_3 91 _91 1 3 801 amps to 1000 amps $121)00 -- 2
Job No.___ s_ Over 1000 amps or volts $340,00 2
Elsc.Cont. Use. No - '- Reconnect only ago '0
24-2 9c Fxp.Date_10-97 ' _ -- 2
OR State CCB Reg No 109419. Exp.Date 1 2-9 7 4c.Temporary Services or Feeders
COT Business Tax or Metro No. 4 7 0 Q _ExP-Date_ 1 _9 8-_ Installation,alteration,or relocation
�� 200 amps or less $50.00 2
Signature of Supr. Elec'n /;� , 201 amps to 400 amps $7500 2
1f 401 amps to 600 amps $10000 2
UCense No. Over 800 amps to 1000 volts,
�4 81 S Exp.Date 1 0-9 8 sea'b^above.
Phone No s n i_i g Lg 1 1 3 -
4d.Stanch Circuits
2b. For owner installations: New,alteration or extension per panel
a)The fee for branch circuits with
purchase of#@Mea or
Print Owner's Name _ ►eeder tae.
Address __ Each branch circuit $5.00 p
City Strate - - o)The tee for branch circuits �.
p------
Phone No. without purchase of
`-
service or feeder fee.
First branch circuli 1 $35.00 35.00 2
The installation Is being made on property I own which Is not Each additional branch crcuq $5.00 2
Intended for sale, lease or rent. 4e.Miscellaneous
Owner's Signature (Service or feeder not included)
_ Etch pump or Irr Marion circle $40.00 2
Each sign or culllne lighting $4000 2
3. Plan Review 8401on(if required):• Signal circun(s)or a limited energy--
panel,alteration or extension $4o n0 a
Please check Appropriate Item and enter fee In section 50. Minor Labels(10) $100.00
_ 4 or more residential units in one structure 4f.Each additional Inspection aa
Service and feeder 725 amps or more the allowable In any of the above
e.System over 600 volts nominal Per Inspection $3500
Classified tine or structure contenting special occupancy Per hour '� $5500 _
as dascnbed In N E.C.Chapter G In Plant $59.00
a r 0rnit 2 sets of plans with appliestlorn where any of the above apply. 6. Fe Los.
Not required for temporary construction services. So,E r,ter total of above fees
41-Surcharge(.05 X total taee)
N- TI cE Subtotal $
5b.Enter 25%of line ea for
PERMITS 9ECOMF VOID IF WORK OR CONSTRUCTION AUTHORIZED IS plan Review It r uirld(Sec,9) E NOT COMMFNCFD WITHIN 180 DAYS,OR Ir CONSTRUCTION OR wOf1K Subtotal $ --- --
19 SUSPENDED OR ABANDONED FOR A PFIIII Ota 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED ❑ Trust Account a 36 .75
Total balance Duo $ r -