Loading...
Permit ' " ELECTRICAL PERMIT - C ITY OF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT #: ELR2004 -00063 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 3/12/04 SITE ADDRESS: 13535 SW 72ND AVE 130 PARCEL: 2S101 DC -00200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P BLOCK: LOT: JURISDICTION: TIG Proiect Description: Low voltage (2) systems: Data tele, security. 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: SECURITY`. X TOTAL # OF SYSTEMS: 2 Owner: Contractor: PACIFIC NW PROPERTIES LTD PTNSHP FIRE PROTECTION SERVICES 9665 SW ALLEN BLVD STE 115 15100 SW 139TH AVE BEAVERTON, OR 97005 TIGARD, OR 97224 Phone: Phone: 503 - 590 - 3732 Reg #: ELE 34- 488CLE LIC 154333 FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 3/12/04 $150.00 Low Voltage Inspection Elect'I Final [TAX] 8% State Surcharl 3/12/04 $12.00 Total $162.00 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 tea. � Permittee Signatur• ���,4 , ► se 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 Electrical Permit Application FOR OFFICE USE ONLY �g - ��� , City of Tigard R eceived Permit No. b - ODD 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: #.2.-/Q y � � LU � Phone: 503.639.4171 Fax: 503.598.1960 �4 ", sP1i4 (''- Date/By: Other Permit: Inspection Line: 503.639.4175 e 'I I Date Ready/By: fug: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction . AAddition /alteration/replacement Please check all that apply: ❑ Demolition ❑Other: 0 Service over 225 amps, corning ❑Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling .- a Commercial/industrial ❑ Accessory building El System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION RV park ❑Egress lighting plan P Job no.: Job site address: 3 5 3S 5W 42 "--°` A/6- A/ ❑Health care facility ['Other: Submit 2 sets of plans with any of the above. City/State /ZIP: 77 0 0/Z q77-1, 3 The above are not applicable to temporary construction service. C Suite dg. /apt. no.: / 3 0 Project name: SC- FEE* SCHEDULE 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'I 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 dwelling, service and /or feeder 90.90 2 vD (L - — C CA4LI'L Services or feeders installation, alteration, and/or relocation - 56 - Y ,S YST6 1 200 amps or less 80.30 2 . ❑ PROPERTY OWNER ❑ TENANT • 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 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 arnps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 arnps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel V APPLICANT . 1 fir CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: � without service or feeder fee, v171/� ` n"'J C j ht-- / L each branch circuit 46.85 2 Address: Each add'I 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- CONTRACTOR energy panel, alteration, or Business . — extension. Desc ibe: Page 2 7 .C' 2 usiness name: F R C P z rc -c- - c S G-2v 1 S f LA, rip i( 117r /4 .ai4 \ Q Each additio((b�,al inspection /over allowable in any of the above Address: °� 5� /�ok� t N � E ` 44 Per inspection 62.50 City/State /ZIP: S ( G�LJ 0 Q D t OQ q 7- AO Investigation per hour (1 hr min) 62.50 Phone: ( ) s —37 32 Fax: (j1 ) (p z g - �0 a / 1 Industrial plant per hour 73.75 11 ELECTRICAL PERMIT FEES* . CCB Lic.: /.S — i S 33 Electrical L .:, j ly _q C Suprv. ic.: ? yi-t Subtotal �� , Suprv. Electrician signature, required Plan review (25% of permit fee) State surcharge (8% of permit fee) /, Print name: { [7� '` ✓ D • ) j, l Q wl" D e: 3 _/2_,..05 > � / TOTAL PERMIT FEE I lo 2 - Authorized signature: / �1�� n ) - This permit application expires if a permit is not obtained within 180 C I��ir da after it has been accepted as complete Print name: p' Y D , 1 Date:5 — 12.— 0 Y • Fee methodology set by Tri- County Building industry Service Board Number of inspections per permit allowed. i:\ Building \Pemtits\ELC- PennitApp.doc 12./03 440- 4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard - - - Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: .. RESIDENTIAL WORK ONLY: . 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: COMMERCIAL WORK ONLY::: • Fee for each commercial system $75.00 (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 ❑ Outdoor Landscape Lighting* Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Pemuu\ELC- PermitApp.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 7 ' () AM PM BUP Location / . vs 7 d 414 Suite /3d MEC Contact Person DZ[h _ Ph ( ) . j v -3 7.32- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: / ELR - do o 6 3 Crawl Drain Slab Inspection Notes: v SIT Post & Beam Shear Anchors Ext Sheath/Shear P Int Sheath/Shear Framing Insulation Drywall Nailing Firewall f i bL Pb� NY‘ ' , 1 Fire Sprinkler �r�t . _ , S (� \4 14-D Fire Alarm `,,�L p 1 . Susp'd Ceiling CA w Roof L� LL,j ∎,J \asaa- t■■ - ys( E Other: Final N 7 0..RE) - PASS PART FAIL PLUMBING Post & Beam © V( V ® - �'O L/4 SO V R,L'as Z "'Z Q, Under Slab [� 'j Rough -In c (� �" �1`� G � � m V 1 ( Water Service Sanitary Sewer U L `� , Rain Drains 1 Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm ,,,,' Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 1. PART FAIL SIT ❑ Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA � } �� A, (� Ext Approach/Sidewalk Date - In spector , vOv Other: Final DO NOT REMOVE thls Inspection record from the job site. PASS PART FAIL