13250 SW FALCON RISE DRIVE w
N
Cn
0
cf)C
D
r
C7
O
z
X
rn
rn
1
13250 SCJ FALCON RISE DRIVE
ICY OF TIGARD ._�:T' f: LCRMIT
{'"'E'RMIT #k: CC'3G 01611 1
COMMUNITY DEVELOPMENT DE' RTMENT DI-ITE I05UE'D. 03/18/96 j
13125 SW Hall Blvd.Tgard,Orrgon 07223.5190 (503)830.4171
TE PDD RC^_,0. . . : 1.:su_C0 `'�' *"ALCON I,1.'C.. DR i
DDI1:1SION, . . : MOkNING HILL NO. 1 ZONING: R--4. S
0C+!, . . . . . . . . LOT. . . . . . . . . . ., . . ..27
o.ject Desc-v—iption: IT 5ta` 11 a,-:e nnc:!}
RESIDENTIAL UNIT - - --... ..TEMP ORVC/FEEDERS- --_. ___. _.. ._MI;:%CXLLANEO!J0
;QrIZ' C.1.: OR I..CrSS. . . . : 17+ 0 200 �am(J. . . . . . . : I ('LIh1F'/Il2RIC1ATILON. . . . 10
01 ADD' L 5000F. . . : 41 201 _ WO ramp. . . . . . . : 171 SIGN/OUT LING LTG— 0
'M177D C.r:ERGY. . . . . . 0 401 00 atlrp. . . . . . . . 0 SIGNAL/PANCL. . . . . . . . 0
',hlr-. HM/ SVC/FDR. . : 0 volts. : 0 MINOR LALIEL { 10) . . . fi
DERVIt,C/F['CArR _ DRANCI I CIRCUITC .. ..ADD' L INSPECTION'.j
- 2100 amp. . . . . . : Il' W/SERVICE C]R FEEDER, i F'ER INSPECTION. . . . . .. 0
711 I+00 emp. . . . . . . 1 r>t, W/0 "PVC )R f'DR. . 0 C'CR I IOUR. . . . . . . . . . . . 0
,1 C,o�O a mp. . . . . . .. Q, EA TODD' L SRNCH CIRC: 0 IN PLANT. . . . . . . . . . . 0
1 10177 ke ;R m p. , . . . : 0 r,LAINI REV I CW GrCT I 0N._. . ._ .._
'100 amp/volt. . . . . : 0 ) =4 RES UNITE;. . . . . . . . . ) 600 VOLT NOMINAL., .
'canneut only. . . . . : 0 '...UC/1-Ep. i L�wC CLf1C8 AREA13REC: OCC
4neY" : ..-_.._.—_...---- .-....__.__..._._., - _. .. -...... ... - __.._.�_ FEES _..__._...»..... _.....
`DGrWO0D typC• amalant by date r-ecpt
'250 OW FALCON RISC DR rT.MT I. 35—Oz CJ'S 03/10/96 96-27710C
e'-. r-7 ?- el• "�" �'I:;/1 /'?�, ')6.. ,1-77 t KI
" (1 R LI OR 07'17'7.--
..
-E' C CLECTR T C 1 TOTAL
OE SE CLINTON
ZE-".0U I RCD I Nr,7,[ r'T I PNS
)r7TJ_ iND OR 1?7202 f 1 <.^ . t," 7er•Vir-e
,one #: L'��s-6467 L.1 ;r o. ' ' ) i irla1
s pervit is issued subject to the reg-+lations contained in the �—
aard Municipal Code, 'tate of Ore. Specialty Codes and all othrr r'er--mittee rir�nat ..+re
;1icable laws. All world will be done in accordance with
;.rovsd plans. this persit will expire if work is not starte,
thin IU days of issuance, or V work is suspendp: fer sore el
r; I38 days, T s W . E'cJ Dy
_
OW-11-R 1 NS' ''ILLAT I ON nM! -
cr IT,,.,"Allcation is t3etrU made on pi-ol evty T own wh.ict; is not intencted fo,
l ray 1 er.so, a1" rent.
'NCJ.• Ci SIGNATURE: DAT 1-:
t:LONTPnCTOC INCTAi_l_rt'IOhJ C111..Y
_.
I ' URE 131- SUr"f' . r Lrt' '."' N; Q12_._Q�//cQfI,�GL_ �_._ DATC: �.4r /*I' �6�
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 P lanck,Rec. #
Permit # jL<_1,6 6V
)4 Phone (503) 639-4171 mate Issued ? - /h' - 96
CITY OF TIOARDFAX (503) 684-7297 Issued by Lha ie,
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: A. Complete Fee Schedule Below:
Name of Development Number of Inspections mfr permit allowed
Address ,5/ / ,.� 1�1Sf' Service included Items Cost(ea) Sum
City/State/Zip� 4a. Residential-per unit 4
1000 sq It or less $11000
Name (or name of business) Each additional 500 eq 1t or —`
pnrtton thereof _ $2S00 1
Commercial ❑ R@Slit@ntlal Limited Energy V11 00
Each Manul'd Homs or Modular 2
Dwelling Service or Feeder 188 00
2a. Contractor installation only:
4b.servir•4+a or Feeders
Installation,alteration,or relocation 2
Electrical Contractor IE' > " 7--, 200 amps or leer __ s80 00 2
Address ; 201 amps to 400 cmpe $80 00 V�_ 2
401 amps to 8rju amps $12000 2
cityate Zip Z L 601 amps to 1000 amps :16000 2
Phone No. --2-11•—67 6e h 2 Over 1000 amps or volts � S.14000
Contractor's License 1 Z e--- Reconnect only $5000 —^
Contractor's Board Reg. NO. _. 4c. Temporary Services or Foeders
Installation,alteration,or relocation 2
Signature of Supr. Eler. I r7200 amps or less $5000
License No. 1-J5 5'S Phone 201 amps to 400 amps s75 00 ?
•�— 401 amps to 600 amps $100 00
Over 600 amps to low volts
2b. For owner installations: sea W above
4d. Branch Circuits
Print Owner's Name New,alteration or extension per panel
Address_ I a)The fee for branch circuits wfrh
City State Zip I purchase of Nrvke or feeder Ase. 2
Each branch circuit f.S 00 _
Phone No. b)The fee for branch circuits without
The installation is being made on property I own which is- purchase of service or finder fee. 2
not intended for sale, lease or rent. First branch circuit _L 8?5 00 ? 2
Each additional branch arcu0 $1,00
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or irrigation recle $4000
Each sign or outlirw.lighting $40 00 _
Signal cirou4(s)or a limiter!enerpy
Please check appropriate item and enter fee in section 5B. panel,alteration or—1armon $40 110
4 or more residential units in one structure Minor Labels(10) _--- $100)0
Service and leader 225 amps or more --
System over 600 volts nominal 41. Fitch additional inspection ovw
Classified area or structure containing special occupancy the allowable in any of the above
��
as described in N.E. �.,..chapter 5 !"
V15 00
-'
Submit 2 sets of plans with application where any of the above 166 00
l
epp!v. Not reau)►ed for temporary construction services. 5 Fees: pJ
NOTICE 5a. Enter total of above fees $ �s '
5%Surcharge(.05 X total fees) _ _�J
PEFiMITS 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 if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTFR WORK IS subfofal $ _
COMMENCED ® Trust Account M $
Balance Due $ , S
e �sap