Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
.7s. C ITY ' O F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT Pi DEVELOPMENT SERVICES PERMIT #: ELR2005 -00185 ' � I I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 6394171 DATE ISSUED: 7/12/2005 PARCEL: 25101 AD -02800 SITE ADDRESS: 12665 SW 69TH AVE 100 ZONING: MUE SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 031 JURISDICTION: TIG Project Description: Voice and data wiring. 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: CEDAR ENTERPRISES ESP TECHNOLOGIES 12665 SW 69 AVENUE 7929 SW BURNS WAY STE. F TIGARD, OR 97223 WILSONVILLE, OR 97070 Phone: 503- 636 -6657 Phone: 503- 628 -4195 Reg #: LIC 73872 ELE 34- 269CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 7/12/2005 $75.00 [TAX] 8% State Surchar€ 7/12/2005 $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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 9 - 001 -0100. You m- y obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: _ , � , Permittee Signature: �P — 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. Electrical Permit Application, . FOR OFFICE USE ONLY City of"Tigard DateBe ,: AP Permit No.` / e 06/, 13125 SW Hall Blvd., Tigard, OR 97223 / (, t, ji Plan Re ' w Phone: 503.639.4171 Fax: 503.598.1960 % i t 9 41, - ,11 DatefB : Other Permit: . Inspection Line: 503.639.4175 , :. , • , . _ , ... i Date Ready/3y: El See Page 2 for w Internet: ww.ci.tigard.or.us y Notified/Method: • Supplemental Information t Y F } � t4lifn a ; �I ? r 5 ' . Y , '' JAS • P t, j q .8; . :,. . ` . r P, � '.,,.: , , . Rnib -` n ',..;',...,:n, r ,' , - - .,nl �F,. ts r � r ., f , . 4.' . ❑ New construction ❑ Addition/alteration /replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., :..y ic pR ,^+6mitJCT,)fONv 1' .'z,:'.:0 ' 4 .. of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2-family dwelling ArCommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure OBuilding over three stories ['Feeders, 400 amps or more ❑ Multi family ❑ Master builder ❑ Other: . ['Occupant load over 99 persons ['Manufactured structures or , "ud , YO '.tiLTEt s. NIATION A1�1)d x,,- **TQisr, : ; r ` t- ❑ Egress/lighting plan RV p Job no.: I n l— ❑ Health -care facility ['Other: (� ( l (3 Job site address: oC f�I Submit 2 sets of plans with any of the above. City/State/ZIP: Qn The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: ( ( Project name j Sd rN. Cizeike Description I Qty. I Fee. I Total I •• Cross street/directions to job site: 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'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 T' ` ..x ;'.' 14SC'�JPTIQN' WORK r` ? 4 Each manufactured or modular dwelling, service and /or feeder 90.90 2 (,O� 1 Q-- �! 02-i. Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ', i 3 201 amps to 400 amps 106.85 2 RQPEIt1I Y OWNER _ _'' ._ .. • ❑: I�NANT,.'re'µ' , ' ;'' 401 amps to 600 amps 160.60 2 Name: ea .ow � e 601 amps to 1,000 amps 240.60 2 Address: J n 1 ( Ct "� S _ WO Over 1,000 amps or volts 454.65 2 °� �L 1 I _ t Reconnect only 66.85 2 City/State /Z1P: t/ b N 9CL 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel COIVTAc ,YS A. Fee for branch circuits wit h . ❑° A - r ? "F ~ ' I ` - : F ©; ER service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: Each add'l branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- ',:i\.,: d;,';,t,7,,- .COI. tkke: ; . a "• :‘,,,'.!,' 2 , . '1 5..._ 'a , ; ' energy panel, alteration, or extension. Describe: Page 2 2 Business name: Sp \ 1/�` ic< - L ' a l C t Each additional inspection over allowable in any of the above Address: 1 ct S1A) `� (J -.CV-. Per inspection 62.50 ' City/ State/ZIP: .J � ( ) `V 11 ()c L t) Q_ cc 7o Investigation per hour (1 hr min) 62.50 Phone: (1 (pq, __CU , Fax: ( 2 j O) c 0,-)0 Industrial plant per hour 73.75 ' PERMIT FECES* 1 ti CCB Lic.:13g Electrical Lic.51i - Q(4&� Suprv. Lic.:a' ( .L44 Subtotal le o d Suprv. Electrician signature, required: G -- �a_--- -G Plan review (25% of permit fee) State surcharge (8% of permit fee) 6 ,.0 (. Print name: S� F r- , a.. ,Q e,- Date: 7 _ 7 _ p s TOTAL PERMIT FEE T (c(JD Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete ,k. Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440.4615T(10 /02ICOM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: ' d �� e i uh ' F•:.. ' jISTMYd S' ° Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) • Check Type of Work Involved: ❑ Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data. Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation El Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is\ Building \Pennits\ELC- PennitApp.doc 04/03 CITY OF TIGARD , _ _ - BUILDING DIVISION + PERMIT #: ELR2005 -00105 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005 Phone: (503) 639 -4171 � Inspection Requests (24 Hrs.): (503) 639 -4175 . -_' L. INSPECTION WORKSHEET FOR DATE: 7/22!2005 TIME: 7:O9AM PAGE: 53 SITE ADDRESS: 12665 SW 69TH AVE 100 CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 031 TYPE OF USE: PROJECT NAME: CARLSON GROUP DESCRIPTION: Voice and data wiring. OWNER: CEDAR ENTERPRISES, PHONE #: 503- 636.6657 CO RACTOR: ESP TECHNOLOGIES PHONE #: r 5 - a Inspection Red -st Scheduled For: Date: 7/22/2005 Pour Time: Code # Inspe• ion Description Confirm # Contact # Message 955-01 503-454-7313 N a edo s/ - •ns: (1011-03 I • • `*1(\i\l-rtl) 0 ab ------- PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date OV Phone #: (503) 718- 2111/4