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13500 SW 121ST AVENUE 13500 SW 121ST AVENUE _,, CITY OF TIGAR® ELECTRICAL PERM'J DEVELOPMENT SERVICES PERMIT #: ELC97-0273 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 0F./081197 PARCEL: 2s1o3CD-04500 SITE ADDPESS. . . : 1.3500 SW 121ST AVF SUBDIVISION. . . . : ZONING:R-4. 5 BLOCK. . . . . . . . . . : L ()T. . . . . . . . . . . . . JURISDICTION: TIG Project Description: IWTL 6 BRANCH CIRCUITS ----- - ------------------------ ---------------------------------------------------- ---TEMP SRVC/FEEDERS----- -RESIDENTIALUNIT----- 1,000 SF OR LESS. . . . : 0 0 200 `imp. . . ' . ' . : 0 PUMP/IRRIGATION. . . . . 0 EACH ADDIL 5009F. . . : 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LiG. - I 0 i..TMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 ----SERVICE/FEEDER----- CIRCUITS------ ---ADDIL INSPECTIONS`- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 pot - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : I PER HOUR. . . . . . . . . . . .. 0 401 - 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRC- 5 IN PLANT. . . . . . . . . . . : 0 F,01 - 1000 amp, . . . . : 0 -----------------PLAN REVIEW SECTION----------------- =4 N----------------- =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . ; Reconnect (,nly. . . . . : 0 SVC/FDR 225 AMPS. . : CLASS ARTA/SPEC-OCC-e_ FEES Owner: type amount by date recpt SHARON ULLRICH PRMT $ 60. 00 TAT 05/08/97 97-294319 t3500 SW 121ST TIGARD OR 97223 bPCT $ 3. 00 TAT 05/08/97 97-294319 Phonp #: Contractor: JARMER ELECTRIC INC $ 63. 00 TOTAL 51.05 SW 45TH REQUIRED INSPECTIONS Ceiling Cover Underground Cove PORTLAND OR 9-221 Phone #: 246-5381 Wall. Cove, Elect' l Service Req #. . : 000069 This permit is issued subject to the regulations contained in the Tigard Muniripal Code, State of are. Specialtv, Codes and all other Permi)tti Signature epolicablp laws. All work will he done in accordance with approved plans. This permit will ekpire if work is not started within 186 days of issuance, or if work is suspended for more than IN days. ------OWNER INSTALLATION ONLY----- -------------------------- The installation is being made an property I own which is not intended for sale, lease, rr rent . DATE: nWNERIS SIGNA' LIRE: CONTRACTOR INSTALLATTON ONL,Y------------------------- qTRNATURE OF SUPR. ELEC9Ns DATE: 1 TCFNSE NO: Call for inspection 639-4179 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard. OR 97223 Planck/Rec. # Permit # _ _LIZ --L 2- .� Phone (503) 639-4171 Date Issued �j 6` ` `1 7 FAX (503) 684-7297 Issued by CITE' OF TIGARD TCD No. (503) 684-21-72 Inspection (503) 639-4175 1. Job Address: '1. Complete Fee Schedule Below: Name of Development Number of Inopections per permit allowed f�/� J t Address 13�M �C� �a I Service included Items Cost(ea) Sum n h A Ciry,State/Zip tJ1 n; / 7c�� 4a Residential- per unit t000 sq It or lees $11000 _ Name or name of bu iness` -lKA/Lt-, (1 d" j Each on thereoal f agJ1 or ( � .p��►.�. portion thereol $25 0f> 3l ❑ Residential ElI Limited Energy $7S 00 Commcrcl Each Msnul'u Home or Modular 2 Dwitfling Service or Feeder woo —� 2&. Contractor installation only: 4b.Services or Feeders Installation allembon.or relocation 2 Electrical Contractor 200 amps or lase $6000 2 Address I CF5 t -'A ' 201 amps l0 400 am Ps $8000 2 401 amps to 600 amps $12000 _ 2 City State_11_ Zipqj. 601 amps to 1000 amps $18000 v 2 Phone No. Over 1000 amps or Vona $34000 Contractor's License No. - - �— RPcannedonly E5000 Contractor's Board Reg. No.:(,p_ 01, 4c.Temporary Services or Feeders Installation,alteration or relocation Signature of Su r. Elec'n 200 amps or less $5000 _ _J License No Phone o! -538i 201 amps to 400 amps $7500 401 arips to 600 amps $10000 Over 600 amps to 1000 volts 2b. For owner installations: , eve W a,rove 4d. Branch Circuits Print Owner's Name ___._ New,allerstion or extension per panel Address _ a)The Ise for branch circuits wffh City State _ Zip purchase of eervke or boder Ne. —Each branch circuit $5 00 Phone N0. b)The les lot branch circuits IrVIfhOUf_ The installation is being made on property I own which is purchase of owvke or Nader fire. r First branch c,rcwl I $3500 _ r" not intended for sale, lease or rent. Each additional branch circuit r t5 00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or 'ngalion circle $4000 ---- 2 Each sign or oulles lighting $4000 Signal cmuil(s)or a ltmded energy 2 Please check appropriale item and enter fee In section 58, panel.alteration or Prdansion $4000 4 or more residential units in one structure Minor[Abels(10) $10000 __^ Service and feeder 225 amps or more 41. Each additional in ape a ab over System over 600 volts nominal the allowable in any o _Classified area or structure containing special occupancy the above as described in N E C Chapter 5 Per inspect on $35 0o _ Par hour $55 00 In Plant 555 00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary wnslruction cervices. S. Fees: 5s. Enter total of above fees $ NOTICE 5%Surcharge(05 X total fees) $ j PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ _ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b.Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review it required(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORT: IS Subtotal E COMMENCED 11.J Trust Acccunt M $ Balance Due $ _ J .�nd,rir Wrpm 4C CITY OF TIGAR ® ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC96-0784 13125 SW Hall Blvd.,Tigard,0 97223 ('503)639.4171 DATE 1SSUED: 12/13/96 PARCEL: 2SIV13CD-04500 SITE.TE ADDRESS. 13500 SW 12,1 ST AVE G)IJBD 1.V 15 1(31\1. . . . .. Z ON I NG:R-4. 5 BLOCK. . . . . . . . . . 1. LOT. . . . . . . . . . . . . Project Description : ADD 1 SERVICE FEEDER, 6- BRANCH CIRCUITS ----RESIDENTIAL UNIT- ---- ----TEMP SRVC/FEEDERS------- I SCE'LLANEOUS---------- 1000 SF OR LESS. . . . : Qi 0 anip. . . . . . . : 111 PUMP/TRRTGATION. . . . : 0 EACH ADD' L. 500SF. . . : 0 L.,01 400 a � Mp. . . . . . . : C?1 SIGN/OUT LINE LIG. . : 0 LIMITED ENERGY. . . . . . 0 401 GOO amp. . . . . . . : 'A SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR, . : 0 601+aMps-1000 volts. c 0 MINOR LABEL ( 10) . . . : 0 .--.-.SERVICE/FE=EDER- ---- ------BRANCH ..._.._.ADD" 1_ INSPECTIONS—- 0 200 amp. . . . . . : 1 W/SERWICE OR FEEDER: 6 PER INGPE("TION. . . . . : 0 . '01. 400 0 Ist W/O SPVC OR FDR. : 0 PER HOUR. . . . . . . . . . . .. 0 401 600 amp. . . . . . : 0 En ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 (Sol. - 1.000 am p. . . . . 0 ­----------- REVIEW SEC'l ION.___..._-__.._.___._____.____ 1000+ amp/volt.....: 0 ) =4 RES UNITS ) 6011 VOLT NOMINAL— : Reconnect only. . . . . : 0 SVC/FDR > = P25 AMPS. . : CLASS AREA/SPFC OCC. Owner-: FEES lz3HARCIN ULLRICH type amount 1)y date i,-e c p t 1.3500 93W 121ST PRMT 90. 00 TAT 12/13/96, 96-2887686, 5PC 4. 50 I-PT 96-287683 TIGARD OR 97223 Phone #: Contractor: ---------------------------------------------------------------------------- CONTROCTOR NOT ON FILE $ 94. 50 TOTAL ------- REQUIRED INSPECTIONS Ceiling Cover, Undergrol.ind Cove Phone #: Wall Cover, Elect' I Service Reg This pervit is issued subs-ct to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Per Signati 11-m- applicable 13ws. fill work will be done in accordance with approved plans. This pervit will expire if work is not started within 180 days of issuance, or if work is suspended for evrp 7 �1. than 180 days. _f.r �,­e A By INSTALLATION ONLY-.- The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER' 5 S I GNATURE-c DATE: INSTALLATION IGNATURE OF SUPIR. ELEC' Ne DATE: 1 (+',ErISE NO: Call for inspection 639-4175 Community De,eelopment ELECTRICAL PERMIT APPLICATION 13125 SW 1-1311 Blvd. C Tigard, OR 97223 Permit # ,* Date Issued Phone (503) 639-4171 CITY OF TIGARD FAX (503) 684.7297 TDD No. (503) 634-2772 inspection (503; 639-4175 _ P 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Nuraber of Inspections per permit allowed Address 1 ?�5oLo��� 1�\��" Service included Items Cost(ea) Sum 1 4a. Residential -per unit City/State/Zip✓- arf�S1CJ d� —1 `^ t OUO sq ft or less $11000 NamF (or name of business),.--10�1 l� c_ l Each cddlt500 sq ft.or $25 00 portion thereof $25 00 1 Commercial C� Residential Limited Energy Each Manurd Home or Modular 2 Dwelling Service or Feeder $68.00 2a. Contractor installation only: 4b. Services or Feeders lc: Installation,wheration or relocation Electrical Contractor �." t `' 200 amps or lose $60 00 lny— 2 `-) 201 emrA to 400 amps $80 00 2 Addres _ � L— 401 ampts to 800 amps $12000 2 City Ut C�1v State Zip 'l 2 r� 601 amps to 1000 amps $18000 2 2 Phone No Q\ 1 Over 1000 amps or volts $54000 R $50 00 Job NO. Reconnect only I contractor's license NO.— 4c. Temporary Services or Feeders Contractor's Board Reg. W. Or Installation,alteration,or relocation Signature of Supr. Elec'n 200 amps or less _ r _U(O 201 amps to 400 amps $50 Oo License No.t_?s��_ Phone Nq-"� 401 amps to 600 amps $7500 Over 600 amps to 1000 volts $10000 2b. For owner installations: see°b°above 4d. Branch Circuits Print Owners Name Now,alteration or extension per pane Address _ __�____ a)The fee for branch circuits with purchase of service or feeder lee y State_ Zi _ Cit _ — p--- Each branch circuit (In $5.00 t� Phone No. b)The tee for branch circuits without The installation is being made on property I own which is purchase of service or feeder/ea. 2e rv1 First brienct circuit not intended for sale, lease or rent. Each additional briii circuft $500 Owner's Signature— _ 4e. Miscellaneous (Service or feeder not included) 2 Each pump or Irrigation circle $4000 2 .3. Plan Review section (if required): Each sign or outline lighting _ $4000 2 Signal clrcull(s)or a limited energy Please check appropriate Item and enter fes In section 58 panel,alteration or extension _._ $417 ai 4 or more residential units In one structure Minor Labels(10) S10000 Service and feeder 225 amps or more 41. Each additional Inspection over System over 600 volts nominal the allowable In any of the above Classified area or structure containing special occupancy Pet inspection $3500 as described In N E C Chapter 5 Per hour _ $5500 --_ In Plant _ $55 00 _ Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services 5. Fees: 5a. Enter total of above fees _ NOTICE 5% Surcharge 105 X total fees) 9 '�kJ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal g 5b. Enter 25%of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if required (Sec 3) y CONSTRUCTION CR WORK IS SUSPENDED OR ABANDONED FOR Subtotal f, A PERIOD OF 180 JAYS AT ANY T,ME. AFTER WORK IS COMMENCED Trust Account # $ $ Ralanre nue ti�• >�