Permit l'� 4 c r rr f' f,l "' ELECTRICAL RESTRICTED ENERGY PERMIT
., CITY I i
4P1 COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00394
TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/22/2007
�' ° "'' , PARCEL: 1 S136DB -00201
SITE ADDRESS: 11565 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: FRED MEYER LOT: JURISDICTION: TIG
PROJECT: WASHINGTON MUTUAL
Project Description: Sound system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WILMINGTON TRUST CO, TRUSTEE MUZAK LLC
BY FRED MEYER, INC 12449 NE MARX ST BLDG 10
3800 SE 22ND AVE PORTLAND, OR 97230
PORTLAND, OR 97242
Phone: Contact #: PRI 503- 889 -3848
FAX 503- 889 -3883
FEES Reg #: ELE 26- 1055CLE
LIC 142760
Description Date Amount
[ELPRMT] ELR Permit 10/22/2007 $75.00
[TAX] 8% State Surcha 10/22/2007 $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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: � / Permittee Signature: X Li)
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.
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J� • Cl Date/By: n - P
`J Of Tigard g DateBy: /(/ o� Q 7 / 3 / ..,..40 ! 'ce.73
a 13125 SW Hall Blvd., Tigard, OR 97223 OCT Plan Review
17 Phone: 503.639.4171 Fax: 503.598.1960 o 2 2' 2007 Date/By: Other Permit:
I T I '' A 1i I��, Inspection Line: 503.639.4175 I - a ,.. - R /B inns :, ® See Page 2 for
Internet: www.tigard- or.gov Cif 1 ur b IUA : ' .t, ied/Method: / Supplemental Information
TYPE ?RIMING Dd V 1ST pYV PLAN REVIEW
❑ New construction[ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
7� ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
- C ATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
'JOB, SITE INFORMATION AND LOCATION ' ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ",
I00HP or more. occupancy.
Job no.: Job site address: (` 6 ( SW 1 o pcutc.- 4., 4 \ / ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 1 b /_ f 4,b ' T 1 - 7 \ ' LZ R • , ' ❑ Health -care facilities. ❑ Supply voltage for more than
lJ V J ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: W Ask 5 4 / Vl ,41.E ❑ Service or feeder 600 amps or more.
FEE 'SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential wt^— s 75.00 2
15
DESCRIPTION OF WORK (with above sq. ft)
df L imited energy, multi -family 75.00 2
S I residential (with above sq. ft.)
I 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: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 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 extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ - APPLICANT ❑ CONTACT I PERSON, above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: 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
• dwellin:, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
(V\ (.42., A �. energy panel, alteration, or
Address: 1 L ( t,�c� N E �P�� extension. Describe: Page 2 ' 2
City/State /ZIP: Q p - � ., J. c q-1- Each additional inspection over allowable in any of the above
1 Per inspection 62.50
Phone: (5 ) 2 4 ' Fax: ( So,3) - - .3 Investigation per hour (l hr min) 62.50
CCB Lic.: VI 4Z"1 b0 Electrical Lic.:_ l c, uprv. Lic.: cZoi b L Industrial plant per hour 73.75
� � �
ELECTRICAL PERMIT FEES;
Suprv. Electrician signature, required: ( ,L ) .c . � (d Subtotal:
Print name: t i ii t I' j �Z Date: to L b Plan review (25% of permit fee):
A..04 rrH ' 7 State surcharge (8% of permit fee):
Authorized signature: (I�J�Jt! TOTAL PERMIT FEE:
This permit application expires 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 :\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 I /05 /COM /WEB
Electrical Permit Application - City of Tigard F` • •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
1 RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n O utdoor Landscape Lighting*
n P • rotective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 : 1BuildingWermitslELC- PermitApp. 03/23/06
,,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ; }007.003,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/270 007
Phone: (503) 639- 4171
_'
Inspection Requests (24 Hrs.): (503) 639 -4175 ++i _ ,
INSPECTION WORKSHEET FOR DATE: - 10/30/2007 TIME: 7 :(PAM PAGE: 62
SITE ADDRESS: 1156E, SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PIED IvMEYER LOT #: TYPE OF USE:
PROJECT NAME: WASHING TON MUTUAL
DESCRIPTION: Sound system.
OWNER: WILMINGTON TRUST CO, TRUSTEE, PHONE #:
CONTRACTOR: MUZAK LLC PHONE #: 503- (3(39 - 3(r i
Inspection Request Scheduled For: Date: 10/30/2007 Pour Time:
Code # Inspection Description - # Contact # Message
( \ ,,.
135 Low voltage 058386 -01 503 - 889-3848 Y
Corrections /Comments /Instructions:
AN\ Any29
i
I PASS n PARTIAL APPROVAL ( 1 CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector:. 1 V (Sd L.c Date: 1611 0 Phone #: (503) 718- 1-4
•
[4.M ,
CITY ZF TIGARD
.t 1
BUILDING DIVISION PERMIT #: ELR2007 00394
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 101220007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/24/2007 TIME: 7:00AM PAGE: 69
SITE ADDRESS: 1156 SW PACIFIC HVWY CLASS OF WORK:
SUBDIVISION: FRED MEYER LOT #: TYPE OF USE:
PROJECT NAME: WASHINGTON MUTUAL
DESCRIPTION: Sound system.
OWNER: WILMINGTON TRUST CO, TRUSTEE, PHONE #:
CONTRACTOR: MUZAK LLC PHONE #: 503-889-3848
Inspection Request Scheduled For: Date: 10124/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 058212 -01 503- 889 -3848 Y
Corrections /Comments/ Instructions:
WO
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. TAO \) LokbbtA. f- T&NNEc/.4._.
v awl b e S`r' 1 N 1 L6.261- F
1: : _ • . •, _ • l • :
on this report shall be corrected and
an inspection request IMAM within 90
calendar days per OAR 918 - 271 -0030
n PASS n PARTIAL APPROVAL n CANCEL 1 1 NO ACCESS
jA FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: CT (W) Le Date: 10 I 0/ Phone #: (503) 718 - I `O