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Permit ICAL CITY OF TIGARD RE TRCT PERMIT - NERGY ti,ty;A DEVELOPMENT SERVICES PERMIT #: ELR2005 -00013 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/12/2005 SITE ADDRESS: 15895 SW 72ND AVE BLDG B 250 PARCEL: 2S112DC -00500 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P BLOCK: LOT: 040 JURISDICTION: TIG Project Description: Voice & Data. 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: PACIFIC REALTY ASSOCIATES ALLPHIN COMMUNICATIONS INC 15350 SW SEQUOIA PKWY #300 -WMI 23220 SW BOSKY DELL LANE PORTLAND, OR 97224 WEST LINN, OR 97068 • Phone: Phone: 503- 698 -9000 Reg #: ELE 3- 406CLE LIC 107548 FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELRPermit 1/12/2005 $75.00 Elect! Final [TAX] 8% State Surcharl 1/12/2005 $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 set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct qu do s to OUNC 03) 246 -6699. ,r�� Issued by z17.(.v Permittee Signatur / kJ P/ ; V 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: CaII 639 -4175 by 7:00 P.M. for an inspection needed the next business day 01/12/2005 14:02 FAX 5035981980 CITY OF TIGARD 1Q001 E1ec1rkat Permi Apo t ED FOR OFFICE USE ONLY City of Tigard R ece i ve d Permit N o.: Date/B : — - ': r 1 0 i 01) 3 13125 SW Hell Blvd , Tigard, R 7223 [ plea • cvlew Phone. 503.639.4171 Fax: 503.598.1960 O 05 other Puma :' 1 Inspection Line: 503.639.4175 J nA • 1 f.. ,_,, Date Rtady /By: heir ® See page 2 for � Internet: www.ci.tigard or.us . Notifed/Method: 7' ) (r I Supplemenui Information t .. 1 r. ', , rill ,1 �! 1';'. ; : . t R , 'J..3 IhrrlY .., 1 ∎i f 9 ,, r,� �g7�.'ytti 1., :!!.::...:.......,...'...r.: .._ --- t. .. _ ,. r _ ..:J -�- �. .�. . . _ .-.... .... t � . fld��. C. ic_'�t�L`,CV3Sr.4Y;r ..L _.. ❑ Ncw construction rr1 d m�, , anent Please check all that apply. O Demolition B� I ❑Service over 225 amps, comm'l ❑ Hazardous location _ ,t �Yj l r 1 ❑ Service over 320 amps – rating El Buildng over 10,000 sq ft , r , p :. 1yi1, t . °y tCt - rJ t � • (,r.n, ; l 1' 4, V irygy- A . t 1� Y g L_ - ':2,..---,' rr( yf ! �({ c l a n l of 1 -and 2•famil dwellings 4 or more new residential ❑ 1- and 2- family dwelling ►`.,Commercial/indusmal ❑ Accessory building , ❑System over 600 volts norrunal units in one structure • CI Multi-family II builder ❑Other' ['Building over three stories ❑Feeders, 400 amps or more t '� J) ❑Occupant load over 99 persons O structures or i .j I c^ r /' t ., 1). r' I • t0 �IN } t :l . I lu { r )1 ark • fyc_. •, >_ a - :, _,.. - r,. :_ �.. :.• . ... ❑E p lan RV P lob no. � r d lob site address: R 95-s L ) � ✓ ❑ Health -care facility ❑Other: C . Submit i sets of pla with any of the above. City/State /ZIP' _ Gs_ ©t! ,, ( L (— � L The above are not applicable to temporary consnucnon service Project .• Q✓� •- r ;r i :! i ?,d ;;:` =i,; ?i; : „ r ;2 State bldg. /apt. no.: �T .. 9,..5- o P 7 act nalse: ,� �„ S U v Duenptl4n Qty. Pee. Tout I Cross street/directions to job site: New residential single- or multl•fnmily dwelling unit. Includes attached garage. 1,000 sq. ft. or leas 145.15 I 4 Subdivision: Lot n0•: Ea. add'l 500 eq. ft. or portion 33.40 ' I Tax map/parcel no : Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 7 ti . :..i t ,t:,; o 3 _ n } .n `t• y - i :. � . � i Ea ch manufactured or modular dwelling, service and /or feeder _ _ 90.90 _ 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 1 ir7, t i 'i 'r - ', Wes /`(t { ,::y iil I 4 .I. . , 1 -, y '.:�t 'i' !f 4 r ir',j Tt(9.t' 201 amps to 400 amps 106.85 2 - - • - .. 401 amps l0 600 sumps 160.60 ' 2 Name' 601 amps to 1,000 amps 240 60 2 Address: Ova 1,000 amps or volts 454.65 2 Reconnect only 66.85 4 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 amps to 400 amps 100.30 2 intended for sale, lease, rent, or excbange, 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 - r 7 7 , ' r • ? A. Fee for branch circuits with Cl ` LtV .! , . r � ,. ,i Y7r�v t r `�f� r j service or feeder fee, each 6.65 2 Business name: /j1,_(('' p�,,� I�� M ✓m +i ? v1 /L branch circuit r 1 B. Fee for branch circuits Contact name: e1 r ` ` without service or (ceder fcc, 46.85 2 � each branch circuit Address 3 � D SO �s "e 1 ei e . Each edd'l branch circuit C 6.65 I 3 CQ I�D _Cf 0�(J 1 J c� _ 2 Cary /State /zIP: (, jg l a [ G��N (' �Q( B Misedlaocoui (service or feeder nos Included) Phone: p ) f) Fax: 2 & J ? e, '/ D� Pump or irrigation circle I 53.40 2 Sign or outline lighting 53. 2 1 E -mail: Signal areutt(s) or limited - r - -- - , r " 1 , .l' h -. —' u+u 1 . 1 i ' 1 — ' — 1 ` extension. D ' energy panel, c . or y � L .Describe I I Page 2 12 Business name' l Address Each additional inspecion over allowable in any of the above Per inspection 1 1 62.50 City /State /ZIP. // Investigation per hour (1 hr ruin) 62.50 t Phone: ( ) Fax. ( ) -' / "Q. b Industrial plant per hour 73 75 _ I CCB Lic : 0 Electric Lic. A Suprv. Lic.: ► Subtotal W • Suprv. Electrician signature, required: . lw( l / / ° Plan review (25'/o of petmtt fee) V Stare surcharge (8% of permit fee) Priest name: Dace: TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit it not obtained wtchlo 180 days after It has been accepted as complctc Print name Date: • Fee methodology sat by 7n -County Building lndurry Service Board •• Number of inipectious per permit aUe woe. taun4,na`rennu 12/03 440.461 TT( IW7LCOM/WBn CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received o Date Requested 1 2- 7° AM PM BUP Location / 5 ` 'f 7 � ✓YI 4 Suite /3- ,7,5 MEC Contact Person €/1.4* . Ph ( ) go - / g / b PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner 0) ELC Footing ELC Foundation Ftg Drain Access: ELR ;?665-606 /✓� Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P ASS PART FAIL u MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final eca PA T FAIL EL RIC Service Rough -In UG/Slab Low Voltage Fire Alarm = Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SIT 0 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date\ - _ G Inspector \A S \A( L f fo IA 1 Ext Other: _ Final DO NOT REMOVE this Inspection record fro the Job site. PASS PART FAIL