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Permit .. A ELECTRICAL PERMIT - CITYOFTIGARD RESTRICTED ENERGY v 9y; DEVELOPMENT SERVICES PERMIT #: ELR2001 -00318 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/21/01 SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100 SUBDIVISION: OREGON BUS. PARK III ZONING: I -L BLOCK: LOT: 002 JURISDICTION: TIG Project Description: Installation of alarm system. Job No. 724 -01. • 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: PACIFIC REALTY ASSOCIATES HONEYWELL INC 15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA PORTLAND, OR 97224 STE 100 PORTLAND, OR 97224 Phone: Phone: 968 -3300 Reg #: SUP 941 -JLE LIC 57824 ELE 26- 207CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 12/21/01 $75.00 2720010000 Elect'I Final 5PCT CTR 12/21/01 $6.00 2720010000 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 r • s you • • 'low rules adopted by the Oregon Utility Notification Center. Those rules are set forth ' . • AR 2- 001 -0010 thro. • h OAR 9,001 -0080. You may obtain copies of these rules or if -ct questio• : 1. OUNC at (503) 246 -1987. Issued by , !„1 al .V Permittee Signature A;,, 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 Ai.. Electrical Permit Application Date received: / A p/ Permit no.: 24 g /.. .1,1, ..ai City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: Tl'PE OF PERMIT , ❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family ❑ Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial Job address: 2 OS 5 co 7a 14 V e Bldg. no.: 3' k Suite no.: Tax map /tax lot/account no.: Lot: Block: 'Subdivision: Project name:• - J s'{.Nc 6oIF r(c.t4, 3escr ton and location of work on premises: Estimated date of completion/inspection: (- y -0 1 CONTRACTOR APPLICATION FEE SCHEDULE . Job no: 72.y -p/ Fee Max Business name: F- \vr-•� t, .� \ Description w Qty. (ea.) Total uo.iusp s \ New residential - single or muhl- family per Address: / 5'-/Q v > w Se v cl) v C 7 IL... y 1 t 0 dweling unit. Includes attached garage. City :T{ r .4 k r c\ I State: Q zI ZIP: qt7 Z z y • Service included Phone: S °3 96 8- 33001Fax:54)-1y68.334 E -mail 1' Ho .. ate cc Kt e- Isq.ft.orless 4 �� `Y Each additional 500 sq. ft. or portion thereof CCB no.: S7 fay I Elec. bus. lic. no: 26 .Z 0 7 - L -6 Limited energy, residential 2 Ci /metro lic. no.: Limited energy, non- residential 2 /Z - 7 r - C.) / . Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): (.4z_ /-( o rQlsc'..) • License no: �'9 TLC Services or feeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps -rating of 1 &2 0 Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, / 2 O System over 600 volts nominal more residential units in one structure alteration, or extension* O Building over three stories 0 Feeders, 400 amps or more *Description O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan 0 Other. Per inspection 1 Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other t, — Not all Jurisdictions accept «edit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 1 ❑ Visa MasterCard expires if a permit is not obtained Plan review (at _ %) $ . C) 00 071 State surcharge 8% credit card wrtiber: OS • ql�' yy'�l� � / /� within 180 days after it has been g ( ) •••• $ ,..c Moe .. Ex accepted as complete. TOTAL $ e, $ N of 'der as shown on credit card Cardholder signature Amount 4404615 (6/00/COM) • ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular El Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 r-, 201 amps to 400 amps $106.85 2 ` I Vacuum Systems 401 amps to 600 amps $160.60 2 ❑ 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918-260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ri see "b" above. l i Audio and Stereo Systems Branch Circuits ❑ New, alteration or extension per panel Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 � Each sign or outline lighting $53.40 I I Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension I $75.00 ) . ❑ Landscape Irrigation Control Minor Labels (10) $125.00 . Each additional inspection over ❑ Medical the allowable in any of the above - Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ) ❑ Protective Signaling / Enter total of above fees $ s n Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts \fomu \elc- fees.doc 08/30/01 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 L BUP Date Requested J — `7 AM PM BLD Location /S10,5 7;L �J�-�� Suite MEC Contact Person 640 Ph 7'9 9 c: -9 4 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR 2-60 / Od 3 Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall �! Fire Sprinkler 0 t L ' . Fire Alarm S I usp'd Ceiling �►��_��W Roof Misc: Final PASS PART FAIL PLUMBING Post & Slab - �O C rE Under Slab c.,� --ta Top Out Water Service ° ,40 Sanitary Drains Sewer 3 � 4, Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ; U ELECTRICAL `l Service 1 Rough In WaraWLYAMI UG /Slab O0 -Voltage) Fiilarm i na S) PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ) Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk D f - '/ --Q Inspector G 'j Other Ext L se Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. -CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested k 3-r) / AM PM BLD Location ) g 1 7E4 5 2? � Suite MEC Contact Person go b ,E -f a) , , C 1°7n PLM Contractor Ph SWR ____14044e44,42th______ BUILDING Tenant/Owner Retaining Wall ELR_ i:422“,r23Lc4 Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab c,� / Post & Beam — V ° SIT Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall OPP Fire Sprinkler — II I _ 41r7 -- ' i ! Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL i Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In ' UG /Slab Fir- Alarm S PART FAIL SITE Backfill /Grading :1r Sanitary Sewer ,, Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd . Catch Basin `a►,. Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date k 4.3 — �v J Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. GITY OF TIGARD BUILDING INSPECTION DIVISION c4-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested 1? ..- .— AM PM BLD Location / `� � ('s ) /4 Suite MEC Contact Person Ph PLM Contractor H Cr) F c C / Ph SWR BUILDING Penant/Owner ELC Retaining Wall ELR iZOO���i'� Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear • Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ro-ip P/1-s Susp'd Ceiling / Roof Misc: Final PASS PART FAIL 110 PLUMBING • Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains At as IN) Final PASS PART FAIL �— MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Fire Alarm Final gp , PART FAIL Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk j� A Q� Other Date / — per() "6 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.