Permit •
-A CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
*1 i;� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00346
-- '�I I a 13125 SW Hall Blvd., T igard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/13/2005
PARCEL: 2S101 DA -00104
SITE ADDRESS: 13333 SW 68TH PKWY ZONING: MUE
SUBDIVISION: FARMERS INSURANCE LOT: JURISDICTION: TIG
Project Description: Fire alarm low voltage.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
F I G HOLDING COMPANY E C COMPANY
REAL ESTATE ACCTG PO BOX 10286
4680 WILSHIRE BLVD PORTLAND, OR 97296
LOS ANGELES, CA 90010
Phone: Phone: 503 220 - 5377
Reg #: ELE 26 -45C
LIC 49737
FEES SUP 4040S
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/13/200: $75.00
[TAX] 8% State Surcharl 10/13/200E $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 503-246-6699.
Issued By: r , J 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 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.
10/12/2005 23:50 5032205347 PAGE 01
'
a 'trical Permit A 1 • c I.O i( ( ) 1 I, t f I . [ 5 I : (» l . 1 .
..t..Ty of Tigard Cj Received
1 23 may: 0 3 05 ; 1.1 Pertoit No, CID 3
• 13125 SW Hall Blvd., Ti gard 1%\\S Dace
Phone: 503.639.4171 Fax: 3.598.140 � � , • i , ' DatdB • Odor Permit
Inspection Line: 503.639.4175 \ P LO ..i4. •h ' '' Date Ready/Ely; 1°. ®See page 2 for
Internet: www.ci.tigard•or.us \G QN NoGIIed/M metal Information
OF \ \ Bawd I Supple n
lki "! ti I':'1''7':'' r ` ' ' '' % “I'',1,'''''' ^ -'))::,-1,,'''' . l 5 / '- 2' ,.,,,
1.1 . � � � . }.:. � ) ( '( '),.'': > h t - � , 11,1�)•�l ���I�',�!r .r,t�}%. `!. . ::,: ^r ,
❑ New ognstruction ❑ •.•::' on/alteration/replacement lacement Please eh : a that app y.
❑Demolition er: ❑Service over 225 amps, comm'I 0 Hazardous location
, ' w ❑Service over 320 amps ratan
-.. : 'rl`ec; i' f i e r n n r ti mp g ❑Bulking over 10,0 sq. ,
'a: " :1re.di _I , '4r ' `s '' '• v •� }' of 1- and 2-family dwellings 4 or more new residential
❑ I - and 2 - family dwelling apeozrunerciallindustrial 0 Accessory building ❑System over 600 volts nominal units in one structure
DBnildiatg o three stories ❑Feeders, 400 amps or more
❑ trlulti fhmily O Master builder ❑ Other
r ;! ['Occupant load over 99 persons Manufactured structures or
lN , y ,r , i.. is e ` i i ' . r \ r . petsott ❑
;�.. y St ..._ ! .. , 1 1 ...: ^N '' ?• ... n' K , r , Y • I.. r I l DF.gressJlight rig plan RV park •
Job no.: a o a U Job site address: 133 ❑Heatth� are facility ❑Other:
ts • A"' v" Vi‘ Submit 2 sets of plans with any of the above.
City /State/ZIP: Th e above are not
1 � OR. a a � applicable to temporary construction Service.
Suite/bldg. /apt. rto.: Project name: ...i ' .:'`t ,' - , , , TI�li�llli�' .',!n,: "�:�tri,i.l_
�Y f`lvi �) S q ,. ( Doscriptba Q4• Pee Total ..
Cross street/directions to job site: New residential single- or multi- amity dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ba• add') 500 sq. ft. or portion 33.40 l
Tax map/parcel no.: Limited energy, residential 75.00 2
,: : J�_g c 't � '� ,. Limited energy, non-residential 75.00 2
..... �x'. '1''''
�l �15� •rr �..: Lr �
���{u::f L., � ) , � ) ,, e . r f v � r 1 '
F
:�, } :,, :.. : . a� . . . ... . ... ... . .. ch n�rufhhc or alai
l t ' dwelling, service and /or feeder 90.90 2
h0 v G • lr d , 1 S ervices or feeders installation, aiteradon, and/or relocatlo
200 amps or less 80.30 2
._:: ••. :: J .>F'-; � 201 a I 400 amps � mPs 106.85 2
1 amps amt 160.60 2
Name: \R . . is) S ‘"," p es 601 amps to 1,000 amps 240.60 2
Address: 1 3 3-1 s i„..) _ S. pp,/ _ v • Over 1 ,000 amps or voila 454.65 2
J t Reconnect only 66.85 2
City/State/ZIP: -T. % x' 1 0 9. a \ -- 1 as Temporary services or feeders Installation, alteration, and/or
Phone: ( Sol) L.\43. G oa e, Fax: (S03 ) C 11 r
`i`I � - S D 200 amps or less 1 66,85 1 I
Owner installation: This installation is being m • e on property that 1 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 1 33.75 2 t__
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
t : } . r .. ; , ,. , ! .. , . 1 r `.; , ,, s • „ ..... ., ■ A. Fee for branch circuits with
_
service or feeder fee. each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) Fax: ; ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
,niil'i'. v i i i ", p. lv'�` i j- Fi g ! } ,; } i , i r ; i , / } ✓ �7 1 ' ;:, energy el, alteration, Or
fv..i lr t r -,r : ..'..' t . rr .. 'f, �) i , Y':> } .� .i: , -:`
extension. Describe: ` Page 2 . co 2
i _
Address: P 0 C b., 0 a ` Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: p 1 G, (L q'1 .)-C 1 Investigation per hour (i hr min) 62.50
Phone: (So ) 0 S rj'11 Pax: ( S') ) a q S - ',1D% Z Industrial plant per hour `` 73.75
CCB Lic.: ■kGcl 3) Electrical Lic.: DG. Lisp Subtotal NI „
`1S o0
Suprv. Electrician signature, r Plan review (25% of permit fee) El
t State surcharge (8% of permit fee) G ,011
Date: /�
0 — ' -e - f TOTAL. PERMIT FEE
signature: � `
Authorized si
$ This permit application expires K a permit is noe within IBC
days after ft has been accepted as compkte
Print name: Date: • Fee methodology set by Tri County Building Industry Service Board
"• Number of inspections per permit allowed.
i:\ Building 'ermitA2LC- PamitApp.doc 12/05 44046t5T(ION2/CCM/wea
CITY OF TIGARD :. -.
BUILDING DIVISION PERMIT #: ELR2005 00346
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10113/2005
Phone: (503) 639 -4171 .. � 11 ° 1 f49
Inspection Requests (24 Hrs.): (503) 639 -4175 - `- —
INSPECTION WORKSHEET FOR DATE: 12/5/2005 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 13333 SW 6BTIi PKWY CLASS OF WORK:
SUBDIVISION: FARMERS INSUR :NCE LOT #: TYPE OF USE: '
PROJECT NAME: FARMER INSURAN ►
DESCRIPTION: Fire alarm low voltage.
OWNER: F I G HOLDING COMPAN , • PHONE #:
CONTRACTOR: E C COMPANY PHONE #: 503 220 - 5377
Inspection Request Scheduled For: Dat. • 12/5/2005 Pour Time:
Code # Ins ection Description Confir # Contact # Message
199 Electrical final 022831 -0 503-415-9691 N
Corrections /Comments/ Instructions:
•
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cm- ■e421 L.. Date: /12
1 - Q Phone #: (503) 718 - 2414 -