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Permit (27) CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY pp DEVELOPMENT SERVICES PERMIT #: ELR2004 -00296 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/7/2004 SITE ADDRESS: 07358 SW DURHAM RD BLDG G PARCEL: 2S113AB -01400 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P BLOCK: LOT: JURISDICTION: TIG Project Description: T- stats. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES PROTEMP ASSOCIATES INC 15350 SW SEQUOIA PKWY #300 -WMI 9788 SE 17TH AVE. PORTLAND, OR 97224 PORTLAND, OR 97222 Phone: Phone: 503 233 - 6911 Reg #: EIiO3- 23826063CRE LIC 38868 SUP 2613LEP FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 10/7/2004 $75.00 Elea! Final [TAX] 8% State Surcharl 10/7/2004 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (5 246 -6699. Issued by Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit A 1' fi` ,FOR OFFIICE,USE ONLY CI`tly Of Tigard Received Date/By: I / 5 / J� .+� (; d,/ PemutNo.: S f/, � 13125 SW Hall Blvd., Tigard, OR 97223 I /, Plan Review { C_. {{// Phone: 503.639.4171 Fax: 503.598.1960 SEP 15 20:t:,�-;. �,, a I +k Date/By: Other Permit: Inspection Line: 503.639.4175 { � PV'e / Date Ready /By Y • Muir% El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIG — Notified/Method: J (,), Supplemental Information {� �r: - Pv- �UtLQlNG D.lVlSIO.N .:�... :•„ . -..�. t? . � Y*'.� ", Y ice. . d k <�" ",, , ?-`,�' .k�, .+ .'awe• `� :ka .k - ,. r `�.�. TPE�OE•�V4RK. ���;.; `7�...2.. - k'��:�5 -�,�a: :t�.�,<.>,�:.�•;� 'S�:•` + >�rtz: ....n`, ..� .�.� „ ,..,., ,.,.. '.S`',, - _ ..,. 1 - ,. ., u. -r �- .. ,.r., >�, '�,. A.a-;-.�:�n �a..���m�x �...., ..��F`. ^<.:.:- <_.�.::�.:. =� ^:.: =,.a,- A <....�. �s:_, _.:�', ❑ New construction ❑ Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑Other: []Service over 225 amps, comm'l ❑Hazardous location �„n .: , >,- Service over 320 amps - rating EBuildng over 10,000 sq. ft., �,� � , .'CATEGORY�•�OF- ,CONSTRUCTION:? . � ='” . ><<`� of 1 -and 2 -famil dwellings 4 or more new residential ❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure • ❑ Multi - family ❑ Master builder ❑ Other: ❑Buildin over three stories EFeeders, 400 amps or more Occupant load over 99 persons EManufactured structures or .�; -_' _ fir, ; ::t >,s,.�t; =� - <.. i` RV park ��•. '''J B`'SITE:' =11V)? Rn4AlTI 1�Nv 4 ., D:`' =:�, -� _ �x,v ":a., O � O O �,. N ,tiOGATION�: E ess /li htin P .......<.�__,.�. ............ ..... r , ,.... ,., � _. ,...� , i.. >... � -a ..,_„ ❑ b'I' g g lan P Job no.: Job site address: 7 Q- EHealth-care facility ❑Other: 7V �U 9/t 4' 4i i2,4_7 Submit 2 sets of plans with any of the above. City /State /ZIP: - 715 A - A49 7,E- Q -1 2y The above are not applicable to temporary construction service. Suite/bldg./apt. no.: P roject name: , 4w4i' . . .'.:.cii ,, ,. :. :: :: .. . ' � -' _ ,,. : � , : + C .f �� Description Qty. Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 3 1 Limited energy, residential 75.00 2 Tax map /parcel no.: ".�,° k,a * = c<..: : ;c . ,: ;:' energy, 75.00 2 m ,k.;' e , ESCRII'T'ION ;t.OF : V1!OltK : ,; ' :, e g ,, , h ,' ( , ;t4 , : , 't ,,> .:. . ` .i ` Limited nergy ,,��- -- �H_�H,x.�z�� ..�a.::.�.- - <.r. a4T'x � }�_,,:.- -. <.- ,a��.,<.'� ^ ^.e- �'t� ,,.� ",. �: a �... � �E� ' �a�;u.����;t�,�..�... - ...� �� Each manufactured or mod r dwelling, service and /or feeder 90.90 2 PO i. ti 1 4) - F... Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 . , , ., -, r' ., : tF ' ',; 1, oxe „ . . +, 201 amps to 4 amps 106.85 2 �; ��;yv� � �,. ,. �, P,ROPERTI:OWIVEI2'p, ` t. -...,� ( � P r ` s ;..... � T >NA■N T � ,?� ':: ..,. 'v < 401 amps to 600 amps 1 60.60 2 Name: l 02ip -m A c5 r, P P 601 amps to 1,000 amps '240.60 2 Address: 7,1 rt .- c A, L\ Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: / ,t - tt 1 ©A_ j ` > 22-V Temporary services or feeders installation, alteration, and /or relocation • Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits- new, alteration, or extension, per panel ` , . -.�... ' "t =� > >€�� i " �.��� :_' A. Fee for branch circuit with ea rte: m ` PE!I.I GA ,:,W4I;K.:. , "ef. K ,' tl , ]v .A re �' ,. ' :.�, e o s .:��:i,�i,. _ � „ . � ".�'` I:�?�� °' � C0 .31 C Ir:PERSOIV�'��h < ;�; , z ._ �:�, ' .., .,.,5_ -� ,,� �.;, -, „ „, �, -�, -� . service or feeder fee, each Business name: Ro 1- 4S - branch circuit 6.65 2 Contact name: B. Fee for branch circuits f?, t f j„�i , 7 j without service or feeder fee, Address: C; , S ' �� il � each branch circuit 46.85 2 !! ® ' - Each add'1 branch circuit 6.65 2 City /State /ZIP: / OA, (414.4 04.- Miscellaneous (service or feeder not included) Phone: (6;eu ) 2 z...-6 # / Fax: : (� ) 2,-p �- Pump or irrigation circle 53.40 2 t / Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - t. .- r. `a M `' °+ 1 energy P anel ' alteration °r ,s�v :r�ix �, .COI�•TRAC - �Rr . z °�,:,: °i " =;:.;;s;'s�r: � = ='” energy ..:= :�....,>;zz -� .._. r: Si:�..,k`'.awa;.".�''�.:M, , . ,_..,.:t:�'�u'�,t'°r: °e .. ,. �.,- ,. <..,,,. ,,,,,T�Y -" ate, � "� ➢�Czi�aS'�'°<,• ":; ^.'ssi ''�l,.ua :as�tE;,'.Zex:4EfeEc.:o;;vc'$. 4_444 -., Business name: extension. Describe: Page 2 2 Address: Each additional inspection over allowable in any of the above Per inspection 62.50 . City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour • 73.75 I vl"t' "',`° tEEEESTFPI AE:DERA 1 TES WPRI x CCB Lic Electrical Lic.2C Jo‘c Suprv. Lic. 3 '3 %G /Q Subtotal Suprv. Electrician signature, required: '/ Plan review (25% of permit fee) S Print name: /0.4c...AJ— .• P /4've-. nr Date: \ State surcharge (8% of permit fee) ` TOTAL PERMIT FEE - E Authorized • . si nature g i - i This permit application expires if a permit is not obtained within 180 1 • - days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits \ELC- PermirApp doe 12/03 440- 4615T( 10/02/CO M/WEB CITY OF TIGARD 24 -Hour BUILDING Inspectiot .ineQ- (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date 3 atte Requested / - 2- d AM PM BUP Location — 7 .3 5 b 7)/-! Suite D G MEC Contact Person f ,J.,,f�� Ph ( ) /I — 6 / 9 9 PLM Contractor �� � Ph � ( ) SWR BUILDING Tenant/Owner L_-' ELC Footing Foundation ELC , ` /1 0� Ftg Drain Access: it/L ELR �D�7 �ua Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING )/a, Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In C1 , a"5G� Cam_ UG /Slab Low Voltage kQL — arm '�" PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 4�� SI E ❑ Please cal for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date / �� �� Inspector Ext Other: Final DO O T REMOVE this inspection record from the job ite. PASS PART FAIL