Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00139
IL 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2005
PARCEL: 25101 AB -01606
SITE ADDRESS: 07357 SW BEVELAND RD 100 ZONING: MUE
SUBDIVISION: HERMOSO PARK LOT: 017 JURISDICTION: TIG
Project Description: Installation of limited energy for central vacuum system. Job No. 70364
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: VACUUM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TOM CLARKE GARY'S VACUFLO INC
7355 SW BEVELAND ST 9015 SE FLAVEL
TIGARD, OR 97223 PORTLAND, OR 97266
Phone: Phone: 503 775 - 2042
Reg #: LIC 69047
ELE 26- 728CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 6/2/2005 $75.00
[TAX] 8% State Surcharl 6/2/2005 $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 fol sdopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throu OAR 952 -00 I 00 •• may obtain copies of these rules or direct • = -lions to • - C a 0q -24: -6699.
Issu d By: A, Permittee Sigrt: ure: ;`
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.
Jun 01 05 02:14p Alicia Molina 5037725446 p.1
Electr Permit Application IVE .
FOR OFFICE USE ONLY
' City of Tigard JUN I� o 1 oOL Dal / : pint � Pe rmit No.:
13125 SW Hall Blvd., Tigard, OR 97223 .r v Y 1 `j � i l� 7 �i / It"
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
+t.! i '" DateiB Other Permit:
CITY _ l� y.
Inspection C
ton Line: 503.639.4175 ��� . !! Dale R ®
Ready/By: Jun • See Page 2 for
Internet: www.ci.tigard.or.us �F r ��' Notified /tvteihod:
7� } � T 4 .. Suppterocntal Information
ITT T
TYPE OF L DI V G DIVISION
PLAN REVIEW
® New construction ❑ Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l CI location
❑ Demolition ❑ Other:
❑Service over 320 amps— rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Building over three stories 0 400 amps or more
❑ Multi family 0 Master builder [] Other:
❑ Ocxupantload over 99 persons ❑ Manufactured structures or
JOB SITE INFORNLATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: 70364 Job site address: 7357 sw Beveland Rd. 0 Health-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 t A .1f CO _ The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: /00 Project name: u1 mg l FEE" SCHEDULE
Description I Qty. I Fee. I Total I t.
Cross street/directions to job site: 72' St. 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'1 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75,00 2
DESCRIPTION OF WORK Each manufactured or modular
Central vacuum installation dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Diversified Construction 601 amps to 1,000 amps 240.60 2
Address: 12448 SW Orchard Hill Rd Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Lake Oswego, OR Temporary services or feeders installation, alteration, and /or
Phone: (503)793 -2621` I Fax: (503)293 -1536 relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on properly 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
® APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Gary's Vacullo branch circuit
Contact name:jty1 B. Fee for branch circuits
1�l1tt-`o without service or feeder fee, 46.85 2
Address: 9015 Se Flavel each branch circuit
Each add'l branch circuit 6.65 2
City/State /ZIP: Portland, OR 97266 Miscellaneous (service or feeder not included)
Phone: (503) 772 -5430 , Fax: : (503) 772 -5446 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: amolina@garysvaculio.com Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
Business name: Same as above
extension. Describe: I Page 2 2
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: I Investigation per hour (I hr min) 62.50
' Phone: ( ) F ax: ( ) '. Industrial plant per hour , 73.75
ELECTRICAL PERMIT FEES°
CCB Lie.: 69047 Electrical Lie.: 26928CL4.. SSuprv. Lie.: 309LEA Subtotal -- 75
Suprv. Electrician signature, required: \ 66 � Plan review (25% of permit fec) .
fee) of (8% State surcharge name: i arge ( o permit ee) �/
Po \� ,, \ Date: 6/1/05 �� 1 �l[
Authorized signature: ? /J / {��`j``,� TOTAL PERMIT FEE FI s ( 1
�1 / //1 .. This permit application expires if a permit is not obtained within I80
vi days after it has been accepted as complete
Print name: f • c. (� nn ) " i t � � / ( I (
� I ► ! �� Date: ( Fee methodolcw set by Tri- County Building Industry Service Board
• • Number of inspections Per permit allowed.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00139
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/212005
Phone: (503) 639 -4171 i i
Inspection Requests (24 Hrs.): (503) 639 -4175 :. ',W :film _a.
INSPECTION WORKSHEET FOR DATE: 1 1/2/2006 TIME: 7:04AM PAGE: 79
SITE ADDRESS: 07357 SW BEVELAND RD 100 CLASS OF WORK:
SUBDIVISION: CLARKE BUILDING LOT #: 017 TYPE OF USE:
PROJECT NAME: BEVELAND STREET COFFEE SHOP
DESCRIPTION: Installation of limited energy for central vacuum system. Job No. 70364
OWNER: TOM CLARKE, PHONE #:
CONTRACTOR: GARY'S VACUFLO INC PHONE #: 503-7T5-2042
Inspection Request Scheduled For: Date: 11/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 020058-01 503 -793 -2621 N
Corrections /Comments /.Instructions:
44 G ba ,d
SS I 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: •1 _ 2 Date: /( ---s #: (503) 718-
COY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200E. -00139
13125 SW Hall Blvd., Tigard, OR 9722:3' " DATE ISSUED: 6/2/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/3/2005 TIME: 7:09AM PAGE: 50
SITE ADDRESS: 07357 SW BEVELAND RD 100 CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 017 TYPE OF USE:
PROJECT NAME: BEVELAND STREET COFFEE SHOP
DESCRIPTION: Installation of limited energy for centralwacuumsystem Job No. 70364
OWNER: TOM CLARKE, PHONE #:
CONTRACTOR: GARY'S VACt INC PHONE #: 503 - 776-2042
Inspection Request Scheduled For: Date: 6/3 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Low voltage 008327 -01 503 - 351 -1290 N
Correctidns /C o mments/ Instructions:
CI -�
%1.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: a Phil. /A/4 Date: ' / Phone #: (503) 718-