14375 SW FANNO CREEK LOOP-1 I
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14375 4W FANNO CREEK LP
_ ELECTRICAL PERMIT
CITYOF TI` ARD - PERMITM ELC1999-00404
CE`JEL�JPMENT SERVICES DATE ISSUED: 7/8199
13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 PARCEL: 2S112BB-09800
SITE ADDP.ESS: 14375 SW FANNO GREEK LP 3 ORIGINAL ZONING: R-7
SUBDIVig1r)N: COLONY CREEK ESTATES NO JURISDICTION: '�
BLOCK: LOT : 08U
Project Description: Installation of one branch circuit. Job No 630-012 -
- TEMP SRVCIFEEDERS MISCELLANEOUS -
_ RESIDENTIAL UNIT _, - ---- PUMP/IRRIGAI ION
1000 SF OR LESS: �0 - 200 amn:
201 - 400 amp: SIGNIOUT LINE LTG:
EACH ADD'L 500SF: 401 - 600 amp: SIGNAL./PANEL:
LIMITED ENERGY: MINOR LABEL (10):
MANF FIM/ SVC/ FDR: 601+amps - 1000 volts:
_ SERVICE/FEEDER _ B_RANCH CIRCUITS- _ _ADD'(_ INSPECTIONS -_-
- W/SERVICE OR FEEDER: PER INSPECTION:
0 200 amp: PER HOUR:
201 - 400 amp: 1st WIO SRVC OR FDR: 1 IN PLANT:
401 - 600 amp: kA ADD'L BRNCH CIRC:
601 - 1000 amp: _��__-_ __PLAN REVIEW SECTION
— > 600 VCyI_.T NOMINAL:
>=4 RES UNITS:1000+ arriolvolt: CLASS AREA/Spec OCC:
n
Reconect only: SVCIFDR>= 225 AMP -
Contractor:
Owner: WEST SIDE ELECTRIC CO INC
HACKETT• SILVIA C TR 1834 SE STH AVE
14375 SW FANNO CREEK LP PORTLAND, OR 97214
TiGARD, OR 97224
Phone:
Phone: 231-1548
Reg#: LIC 13306
SUP 1556s
ELE 26-135c
-- ------- -
FEES _ Required Inspections
Type gy Date Amount Receipt Elect'I Service
PRMT DEB 7/8199 $37.5099316709 Elect'I Final
5PCT DEB 718/99 $2.62 99-316709 EXPIRE)nt
Total $40.12
alty
and a
This Permit is issued subject to the regulationspapproved plans This permit in the rd M expire if work is nunicipal Code, ot started wiitthiinn 180 days sof issulance,or ifworkis l�
All work will be done ire accordant ppby the
suspended for more than 180 days. 0th throN Oreaugh OAR 9�'t 001 0080law �You may os you to lbtainucopies ofadopted
t ase rules Oregon direct sUons to OUNCtat(503)sn
rules are set forth In OAR 952-001-0010 9 �-
246.1987
ISSUP,d y:
Permit signature: i _
OWNER INSTALLATION (-NLY _ .--• -
The installation is being made on property I own which is not intended for sale, Rase, or rent.
OWNFR'S SIGNATURE: -
DATE: -
_ CONTRACTOR INSTALLATION ONLY
- -- ----- 1 t- DATE: Z- L S!`'
SIGNATURE OF St1PR. ELEC'N:
LICENSENO:
Call 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Apb%1*tbn Plan CK( #
13125 SW HALL BLVD. Recd
TIGARD OR 97223 JUT_ Date Redd 7 7
Date to P E.
Phone(503)639-4171, x304 COMMUNITY Divi Date to DST_
Inspection (503)639-0175 Print Of Type Ili j Permit# f4�/yw�-til
Fax (503) 59H-1960 Incomplete or illegible will not be, Called
1. Job Address: 4. Complete Fee Schedule Below:
Name o Number o!Ins Development. _ _ pecuons per permit allowed
Name(or name�of business) Lut ze Service included: Items Cost Sum
Address 4a. Residential-per unit
T 1000 sq fl or less $ 117.75 4
City/,,tate/Zip �� Each additional 500 sri it or —
r�y� portion thereof _ S 2625 1
Commercial❑ Residential IYJ Limited Energy _ $ 60.00
Each Manurd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder _ $ 12.75 _ 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
Information for CO1. data base). Installation,alteration,or relocation
Electrical Contractor1 / F' �1 �( 200 amps or less S 64.25 2
Address y [rP 201 amps to 400 amps _ $ 85.50 2
City_!r i/ 4/1 State Zip �����/ 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. 31- / S Over 1000 amps or volts S 363.75 2
Job No. •- _ Reconnect only S 53.50 2
Elec. Cont Lice. No. A'& 3 Exp.Date 4r„Temporary Services or Feeders
OR State CCB Reg. No. Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. Exp.Date — 200 amps or less _ $ 53.50 2
201 amps to 400 amps $ 8025 2
Signature of Supr. Elec'n 401 amps to 600 amps --- $ 10700 _ 2
-- Over 600 amps to 1000 volts,
License No.1,�-i�t/l_3 Exp.Date see"b"above.
Phone No. — 4d.Branch Circuits
,Z3/ -'� -- ---- New.alteration or extension per panel
a) The Ne for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name_ Fach branch circuit S 535 2
Address b) I lie lee for branch circuits
without purchase of service
City State Zip M or feeder fim.
Phone No — _ First branch circuit $ 37 50 315a
Each additional branch circuit $ 5 35 _
The installation Is being made on property I own which Is not 4e.Miscellaneous
intended for sale, lease or rent. (Service or feeder n,1 included)
Each p,mp or Irrigation circle $ 42 75
Owner's Signature _ Each sign or outline lighting $ 42 75
��------- Signal circuits)or a limited energy
panel,alteration or extension $ 6000
3. Plan Review section (if required): Minor Labels(10) _ _ $ 10700 --
Please check appropriatR Item and,enter fee In section 5B. 4f.Each additional Inspection over
4 or more residential units in one structure the allowable In any of the above
`Service and feeder 225 amF.s or more Per Inspection $ 50 0'J
Per hour CAP' $ 59 00
System over 600 volts nomir�.vl In Plant � $ 59.00
Classified area or structure co staining special occupancy as
described in N E .Chapter 5 5. Fees: `����
Be.Enter total of above fees $
Submit 2 sets of plans with application where any of the above apply. 7A416-Surcharge(P'Sx total lees) $ �
Not required for tomporary construction services. Subtotal 1:57
6b.Enter 25%of line 6a for
NOTICE Plan Review if ie wired(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtof $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account# _
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due Y $
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