Permit w
o CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00319
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/21/2007
PARCEL: 2 S 112AB - 01100
SITE ADDRESS: 07235 SW BONITA RD ZONING: I -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HORIZON RESTORATION
Project Description: Install new low voltage phone and data system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HORIZON RESTORATION CLACKAMAS ELECTRIC INC.
7235 SW BONITA RD. PO BOX 51
TIGARD, OR 97223 BEAVERCREEK, OR 97004
Phone: Contact #: PRI 503- 969 -5684
FAX 503- 632 -2421
Reg #: ELE 3 -606C
FEES LIC 161932
Description Date Amount SUP 5041S
[ELPRMT] ELR Permit 8/21/2007 $75.00
[TAX] 8% State Surcha 8/21/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 . -stions to OUNC at 503.246 .699 or 1.800.332.2344.
Issued = //,/4� L // Permittee Signature: Ll C
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
AUG -2O -2007 02:40P FROM:CLACKAMAS ELECTRIC 5036322421 TO:5035981960 P.1'3
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Electrical Permit ,� �lication n , ( y
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Received
CIty of Tigard ° : W �� DateB : 0 I� Permit No.:' .: , I - • ` `1
, • 13125 SW Hall Blvd., Tigard, ' a R ' 7223 Plan Review
j. I . 1 , Phone: 503.639.4171 Fax: 503.�J (361 0 lUU Date/By: Other Permit:
~� " i Inspection Line: 503.639.4175 Date Ready /By: lures SI See Page 2 for
1aR.tt crawl Internet: www.tigard - or.gov ary g GP D Notified/Method; Supplemental Information
TYPE laced' 't>a D16�lSl °Rt PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please cheek all that apply (submit a sots of plans w/items checked below).
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
Tess to ground, or exceeds 14,000 ❑ Commercial -use agricultural
- and 2- family dwelling 3if Commercial /industrial ❑ Accessary building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑mergen system. larger separately c derivedsystem.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: 7235 SW Bonita Rd. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR. 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt- no.: Project name: ❑ Servico or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 72" Ave. Description 1 Qty. 1 Pcc. I Total 1 •
New residential single- or multi- fancily dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential
DESCRIPTION OF WORK (with above sq. 6.) 75.00 2
Limited energy, multi - family 75.00 2
Install new phone and data lines residential (with above sq. 6.)
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Horizon Restoration 401 amps to 600 amps 160.60 2
' l _J 601 amps to 1,000 amps 240.60 2
Address: --i-2,3 5 S (�l 6(in Over 1,000 amps or voles 454.65 2
City /State /ZIP: 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 599 amps _ 133.75 _ 2
Branch circuits- new, alteration, or ex tension, per panel
Owner signature: Date: A. Fee for branch circuits wish
® APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Clackamas Electric Inc. B. Fee for branch circuits
Contact name: Scott Johnston
without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (503) 969 -5684 I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal panel, or limited -
Business name: Clackamas Electric Inc.
energy panel, alteration, or
Address: PO Box 51 extension. Describe: i Page 2 5W 2
City/State/ZIP: Beavercreek, OR. 97004 Each additional inspection over allowable In any of the above
Pcr inspection 62.50
Phone: (503) 632 -2420 Fax: (503) 632 -2421 Investigation per hour (1 hr thin) 62.50
CCB Lic.: 161923 I Electrical Lic 3 -606 I Suprv. Lic.: 5041S Industrial plant per hour 73.75
ELECTRICAL - PERMIT FEFS
Suprv. Electrician signature, required: r ■•'' Subtotal: 75.00
Print name: Scott Johnston d l Date: 08/20/07 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 6.00
Authorized signature: TOTAL PERMIT FEE: 81.00
This permit application espirm If a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I \ Bultdina \PermuslELC- PenaitApp.doc 05/23/06 440 -4615T(1 I/a5/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E�t_R2007 -0( 10
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: (3!:? j /2(t()7
1
Phone: (503) 639 - 417 0��„I "'I � , ��
+lr
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 8 /29/2007 TIME: 7:00AM PAGE: 25
SITE ADDRESS: 07235 SW BONITA PD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HORIZON RESTORATION
DESCRIPTION: Install new low voltage phone and data Eystern.
OWNER: HORIZON RESTORATION, PHONE #:
CONTRACTOR: CL At"CKAMAS ELECTRIC INC. PHONE #: 503
Inspection Request Scheduled For: Date: 8/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 051822 -0 ► 503.679.2335 Y
Corrections /Comment /Instructions: 43
P' ..,
4 A4DASS n PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
Inspector:C t Date: ? ? (2 Phone #: (503) 718-