13040 SW FALCON RISE DRIVE I ~
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13040 SW FALCON RISE DRIVE
CITY OF T I GARD ELECTRICAL PERMIT
COMMUN.ITY DEVELOPMENT DEPARTMENT PERMIT #: ELC96--0583
13125 SW Hall 31vd.Tigard,Oregon 97223.8199 (503)839-4171 DATE ISSUED: 09/06/96
PARCEL: IS133DC.--0060LA
)ITE ADDRESS. . . : 13040 SW FALCON RISE DR
SUBDIVISION— . : ASH VALLEY TRACT ZONING: R--4. 5
BLOC;',. Lur. . . . . . . . . . . . . :8
Project Description- PATH I
-------------------------------------------------------------------------- -------------
—-RESIDENTIAL UNIT---- SRVC/Fw:EDERS---- --------M1SCELLANLCUS----
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5012ISF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
..IMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 0 601 *amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : ILI
------SERVICE/FEEDER------ -----BRANCH CIRCUITS------ ---_ADD' L. INSPECTTONS---
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 1 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : I PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA AEDIL BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -------------------PLiN REVIEW SECT I
1000+ amp/volt. . . . . . 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > 225 AMPS. . : CLASS AREA/SPEC OCC. :
i)wner: FEES -----------------
(,OLLETTE SIKORSF%I type amount by date recpt
t3040 SW FALCON RISE DRIVE PRMT $ 40. 00 JMH 09/06/96 96-28368 ,
5PCT $ 2. 00 JMH 09/06/96 96-263685
I IGARD OR 9717-,---'3
whose #:
"'ontractors'
OLL CITY ELECTRIC f 42. 00 TOTAL
`.j422 POR7LAND RD NE #123
REQUIRED INSPECTIONS
,iALEM CR 91305 Ceiling Cover Elect9l Service
Phone #: 503-223-059e Wall Cover Elect' 1 Final
Rey #. 087014
This pervit is issued subject to ;he regulations contained in the
-lzei
Tigard Municipal Code, State of Cre. Specialt,; Codes and all other Permittee S ' nature
,-ipplic&bl,, laws. All work will 1@ done in accordance with
loproyee Plans. This "reit will xpire if work is not started
within IN days of issuance, or if worm is suspended for sort ........
than HO days. ssued By
I NSTALLAT?1s,14 s ONLY-__._._._-_---____.__._-___-----------
rhe installation is being made on pr-werty I own which is riot iTttended for
sale, lease, or rent.
IWNERIS SIGNATURE: DATE:
INSTALLATION ONLY---________.___.____._.__.__._-_--
SIGNATURE UP SUPR. ELECIN: DATEi
LICENSE NO: ...................... ---------
Call for inspection - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd
Tigard, OR 97223 Permit # _ j L _—
Date Issued T-L:
T' Phone (503) 639-4171
FAX (503) 684-7297
CITY OF TIGARD I UD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address. fid. Complete Fee Schedule Below:
( ( ;
Name of Development Number of Inspections per permit allowed
Address '�' /1 -C: �� I Service Included Items Cost(ea) Sum
City/State/Zip r,%� / L1:2 - _ . 4a. Residential -per unit
$ �r
1000 sq ft or less 110.00
r —--
��� //�rY/ � i1r I"C� .r Each addition.1500 aq ft or $2500
Name (or name of business C /�V( � portion thereof _ _
Limited Energy $25.00
Commercial ❑ Residential Each ManuCd Home or Modular
Dwelling Service or Feeder $69,00 _
2a. Contractor installation only: 4b. services or Feeders
J . /`� Installation,alteration,or relocation 2
Electrical Contractor _ 200 amps or leas $BO 00
r ,'('' 401 amps to 900 amps 201 amps to 400 amps $90.00 2
Address �,7/7 / / -- _ $120.00
601 amps to 1000 amps slew w
/ .� ✓ State( _ Ip_ i_
City _
'� ? over 1000 amps or volts $34000
Phone No. -- $5000
Job NO Reconnect only
contractor's license NO. 4c. Temporary Services or Feeders
Contractor's Board Reg O
Phone No 401 amps to 600 amps $75 00
installation,aneration,or relocation 2
200 amps or leap 2
Signature of Supr. Elec'n 201 amps to 400 amps —� $5000
License No._ — 2
;,� S-
over Soo amps to 1000 volts $10000
2b. For owner iristallations: see'b"above
4d. Branch Circuits
Print Owner's Name _ New,alteration or eytension per pane
Address a)The fee for branch circuits with
_- purchase or service or feeder fee,
City State Zip_ Each branch circuli _ 15.00
Phone NO. b)The fee for branch circuits wirhow
purchase or service or leader fee
The installation is being made on property I own which is First branch circuit 136.00
not intended for sale, lease or rent Each addltlonal branch rarcult _= 19.00
Owner's Signature_ _ __ 4e. Miscellaneous
(Service or feeder not included)
Each puinn or Irrigation circle $4000
3. Plan Review section (if required): Each sign or outline lighting $4000 2
Signal circult(s)or a limned energy
Please check appropriate Item and enter fee in section 58 Minor panel,afterbels(1o) or extension $
$400
_ 4 or more residential units in one structure
Service and feeder 225 amps or more 4f. Each additional inspection over
System over 600 volts nominal the allowable in any of the above
Classified area or structure containing special occuP,111c 4 Per inspection 53500
as described in N E C. Chapter 5 Per hour $5500
In Plant $5500
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: A
5a. Enter total of above fees S
NOTICE 5% F rcharge (05 X total fees) $ =_
Subtotal E
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review If required (Sec 3) $ Lr—
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal S 1--
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED rw.aKom�.n, _ Trusl Account # $
Balance Due $ Zaw=_