Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
ELECTRICAL PERMIT - C ITY OF T 1 G A R D RESTRICTED ENERGY L �i�4 DEVELOPMENT SERVICES PERMIT #: ELR2003 -00317 13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/13/03 SITE ADDRESS: 11308 SW 68TH PKWY PARCEL: 1S136DA -00100 SUBDIVISION: ZONING: MUE BLOCK: LOT: JURISDICTION: TIG • Project Description: Tenant Improvement - HVAC 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: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: BENSON CAPITAL ENVIRONMENTAL CONTROL CORP. 1708 3RD AVENUE 7606 SW BRIDGEPORT ROAD NEW YORK, NY 10017 PORTLAND, OR 97224 Phone: Phone: 620 - 4228 Reg #: LIC 64673 ELE 3 -434C SUP 4425S FEES Required Inspections Description Date Amount Ceiling Cover [ELPRMT] ELR Permit 10/13/03 $75.00 Wall Cover Elect'I Final [TAX] 8% State Tax 10/13/03 $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 throuc Issued by -- Tia-rn,pec.._ Permittee Signature ,/ / G �� _ 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 8706/2003 16:33 FAX 5035981960 CITY OF TIGARD 1721002 .r- FOR OFFICE USE ONLY Electrical Permit •,,, ,1I ' r'• A ;on Receive Electrical Ii‘ Date/B Permit No- , L.ov 3 - av 3 / 7 c w � Planning yy pproval Sign City of Tigard p © °..,, Date/ y: Permit No,: 13125 SW Hall Bled. 31,,�`i Plan Review Other Tigard, Oregon 97223 Gp l Date/B : Permit No.: mope: 503-. 639 13 -4171 Fax' \S C Post-Review Land Use \� Date/B : Case No.: Internet twww.cl.tlgard.or.t1S O \ % � j - g� a rt -:• ) Contact Juris.: 7 See Page 2 for 24 -hour Inspection Request: 5( -639 -4175 --"' Name/Method: Supplemental Information. :... -:.. . LiANiRE�!IEW:(PlisseCLOeitai thatalapk): a;! ;':' "' =5 a 7 •:•••,!;• , •:....• ° '•'t�;,: '•� . �-:; �;" rYP` EOF�WOItK :';= '.. ': • :: , : � :, • r:: . : .: ._..., ! ?';i: . :'... !4 4: .. P N • onstruction Demolition Service over 225 amps- in Health-care facility commercial ❑ Hazardous location Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, 4 ;.: . :: -: CiVF.EGORIrOVICONSLRIIC EION; ,F.; : ':'' ' c.`•r ...':: 1 & '2 family dwellings four or more residential units in 0 I 1. & 2- Family dwelling_ V'Commercial/Industrial ❑ system over 600 volts nominal one structure Multi-Family ❑ Building over three stories ❑ Feeders, 400 amps or more El Accessory Building al Y ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder Other: ❑ Egress/lighting plan ❑ Other. '-`' :., : , ;.'. 70$ SiiTE�INFOR1VIAXIOPtand :L.O:CA• > ON ''` ••, Submit sets of plans with any of the above. The above are not applicable to temporary construction service. Job site address: ' j 3O S —3 (� e r'A-et�z ✓j - . -. , ::1 . = FE E* SCW.;2 ' " ...V.;..1.;;” =.. , . ,;, � . ,: :• _ Suite #: 1 Bldg./Apt#: Number of inspections per permit allowed Project Name: ?Po ut1Ai.1G r It'o A-I?.A Description - Qty Pee (ea.) Total New residential- single or multi -family per 1 Cross street/Directions to job site: dwelling unit. Includos attached garage. Service Included: 1000 sq. f. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 . Subdivision: Lot #: Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling .. .....:DESCRII'TION_OF . ",.. . •, ' :: :.. service and/or feeder 90.90 2 Services or feeders - installa 'or, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 maps 106.85 2 401 amps to 600 amps 160.60 2 PRopER_ ..NER :•:. �, , -. `Q;TENONJI. ,' .. ; ? 601 amps to 1000 amps ' 240.60 2 Over 1000 amps or volts 454.65 2 Name: Reconnect only 66.85 • 2 Address: • Temporary services or feeders - installation, alteration, or relocadon: City /State /Zip: zoo amps or toss 66.25 _ 1 201 amps to 400 amps 100.30 2 Phone: Fax: 401 to 600 amps 133.75 2 ir3rAPPLIrCANrr i '! .. :', : ', ''•CONTAG3+;.PERSOPI-:'`..; " B ranch circuits - new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee. each branch circuit 6.65 ' 2 City /State/Zlpi 9- Fee for branch circuits without purchase of service or feeder fee, Ern branch circuit 46.85 2 Phone: ------ . Fax: Each additional branch circuit 6.65 2 E -mail: Misc.(Service or feeder not included): ;• ;:: Each pump or irrigation circle 53.40 2_ «:; CONTRACTOR:= . • Each sign or outline lighting 53.40 2 Job No: /4,0 [ (QQ Signal circuit(s) or a limited energy panel, Business Name: / r L, ,\ /1� f,L7 (p,,�r, t ehp.,J . alteration. or extension Page 2 2 A i fj61 Description: Address: 1--6.o (o s(..0 Ti' A I.1161-ii/Cr Rd- . — Each additional inspection over the allowable in any of the above: City /.State[Zi i,A L/tr4 CO Q Gl 2 2-T _ Fer inspection per hour (min. 1 hour) 62.50 Phone: 5_0_3_6 `f 2. t 0 F o 3 1(e S le 2 investigation fee: CCB Lic. #: Lic. #: Other. 7 � ..... � .... < - . . ° Electi��iri ];PeriouilFt:'es .; :.: ....... . . .. : i ., ... s.: _, _ Supervising electrician Subtotal $ signature required: Plan Review (25% of Permit Fec) $ Pont Name: M(}K_ Ti nl Meat WetLie. #: ¥Y26 .S State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ 8/ " _ Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after It has been accepted as complete. 'Fee methodology set by TO- County Building Industry Service Board. (Please print name) is \Dsts \Permit Forms \E 1cPermitApp.doc 01/03