Permit (174) CITY OFTIGARD
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is rep g � = DEVELOPMENT SERVICES 7 , � rTRIC,�, PERM I -
'-4- Alt . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 RESTRICTED . , R \
PERMIT ; ELR3 - •'7_:32
DATE ISSUED; 11/12/97
G I 11alt61 PARCEL; 2S T. 15DA ---001 Q 1
IT1-' ADDRESS. G . r' 2 S!.:.! P r "
SUBDIVISION..... ZONING; C --G
BLOCK. — „....,.; LOT. — .s.,. „„....; viURISDICTN; TIC
Pr c,.,sect De set- 7.p1 ion; Installing data telecon unications systes •
A. RESIDENT I € L - -_ ----- B. COMMERCIAL .
AUDI O & STEREO„ ..: i: UD I O & STEREO.. ; INTERCOM & PAGING.. ;
BURGLAR ALARM— . . BOILER... „ ... , ... LANDSCAPE/ I RR I GAT. . .
GARAGE OPENER.... _ CLOCK............ ; NEDICAL ............ .
HV C ............. . DA A/? ELE COMM. , ; X NURSE CALLS— ., ... .
VACUUM SYSTEM..... EIRE ALARM. . - .... • OUTDOOR LPNDSC L I TE
OTHER; .: HVAC ............. PROTECTIVE SIGNAL...
INSTRUMENTATION.; OTHER... . _
TOTAL # OF r N 1
Owner .,. ___._...._...__. EEC __..... .._.... - .._._.
CAPITAL/BIT HOLDINGS TWELVE IN type amourgt<, by dates rcpt
0/0 FORUM PROPERTIES PRMT $ 40.00 B 11/12/97 97- ,:S00871
&l705 SW NIMBUS SPOT $ 2.00 B 11./12/97 97-300871
BEAVERTON OR 9700
Phone Vi': 626.- .227' +
CATE..S ELECTRONICS & SECURITY $ 42.00 TOTAL
PETER N GATES
6318 SW CAPITOL HWY --- • -• - -- REDU I RED INSPECTIONS _... - - -- .- - - --
PORTLAND OR 77219 • Ceiling Cover Low Voltage Inspv
Phone to a. 246-- -9551 Wall Cover Fl. ect;' 1 Final
Re q ' . . . 1781.687
i
This perait is issued subject to the regulations contained in the Tigard Municipal Cede, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This perait will eHpire if work is not started within, 18-;
days of issuance, or if work is _suspended for xore than 180 days. ATTE T1CN: Oregon law requires you to follo4 rule adopted by th'
Oregon Utility Notification Center. Those rules are set forth in OAR 952-3 1 -i2ii3 through OAR S52 -2.01-3083. You may obtain co ' s of
these rules or dim . questions to OUNC at (523)845 -1987.
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<<_J�' /�/ P' "ek'fl1l.Lt C?e CiL�ilcli :�R2`
_.___.......__.._....__...._ ._...,__._.._ __..,_.__...OWNER INSTALLATION O NL_ Y _..._._._...__.._..._.._._...__ .-. �____._ _.__...--- _......_.__.._
The installation is being made on .property I own which is not intended •fear
sale, lease„ or rent. . • OWNER'S SIGNATURE; _ _ __ _ DATE;
C- . y^ ___ . -__ __-
-_..__._----------------------------- CONTR "tC?O !.! \I �1r,__L ('ION CN L.. Y-----.-_.._.-....._.-..--.-_---....._ _- _.- .___- .._- .- .._._.
S I C�NI'1 r' L!F E OF SUP fin EL EC' 0\! .._ !s _.. A -' °SC / /7.___________
LICENSE NOe 1 Lj)
a .. f .. + . a . + - f - -1-i`-g -4- .;..q....- F- I--1 -q- F _S i- -i...F4- :- -1 -A-q -+4.4.-¢•-r9--¢-.¢.-t+-4-..g_... ;.. -s ti-';- 4.1-.8 -¢.-,'..-i -1--. - ,-J-- ¢- ±.'e......;--f + ¢ ,...;.. ---
Call 639-4175 by 7;0Z P. M. 'For srg 1.fspect:t on needed . th-e next bus i. -leas day
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CITY OF TIGARD Electrical Permit Application Plan Chec I
13125 SW HALL BLVD. Rec'd B I DASU .-
TIGARD OR 97223
Date Rec'd 11 I Z. -1-7
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # elR' - b 321
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: �,����� / 4. Complete Fee Schedule Below:
Name of Development i ��%�r"5'.Tit/ Number of Inspections per permit allowed
Name (or name of business) y , �?/jr� Tl /� S Service included: Items Cost Sum
7 1:„,017 1 Address ,�/r! /J�.0 / 4a. Residential - per unit
1 '~� r Each additional 500 sq. ft. or $110.00 4
City/State/Zip �GP � � / / � �
CommerciallA Residential El Limited thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current lice s ) - 4b. Services or Feeders
Electrical Contractor _�� .� ifs 4e(4. Installation, alteration, or relocation
��� 200 amps or less $60.00 2
AddreJ ; =� /T 201 amps to 400 amps $80.00 2
Ci O r, r -- 0 ip / /_PLr 401 amps to 600 amps $120.00 2
Phone No. - y 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. `- Exp.Date .0" - Reconnect only $50.00 2
OR State CCB Reg. No. Exp.Date d- -'I' 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Ex .Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n iW / /.� 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No _` f . Exp.Date h // see "b" above.
Phone No -' 5
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circ $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui
$5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited e :rgy � ga., -
panel, alteration or ext si.) $40.00 y 2
Minor Labels (10) 0 $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspe , tion over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ' I2
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $
I: \DSTS\ELC96.APP Rev 9/96
6/30/99 Activities for Case #: ELR97 -00325
4:43:20 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 11/12/97 B RECD DST 11/12/97
ELRC003 Permit Created 11/12/97 B DONE • DST 11/12/97
ELRC700 Ceiling Cover 11/18/97 MJR PASS MJR 11/18/97
• ELRC720 Wall Cover 11/5/97 MJR PASS MJR 11/18/97
ELRC725 Low Voltage Inspection 11/18/97 MJR PASS - MJR 11/18/97
ELRC799 Elecfi Final 11/18/97 MJR PASS MJR 11/18/97
ELRC500 (F) Issue permit 11/12/97. B PASS DST 11/12/97
ELRC800 Case finaled 11/18/97 MJR PASS MJR 11/18/97
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