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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY it DEVELOPMENT SERVICES PERMIT #: ELR2001 -00223 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/7/01 SITE ADDRESS: 15957 SW 72ND AVE BLDG -A PARCEL: 2S112DC -00701 SUBDIVISION: OREGON BUS. PARK III ZONING: I -P BLOCK: LOT: 038 JURISDICTION: TIG Project Description: Data Telecommunication Installation. 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: NETWORK CONNECTORS INC P.O. BOX 1718 OREGON CITY, OR 97045 Phone: Phone: Reg #: 6@3 ELE 3- 313CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 9/7/01 $75.00 2720010000 Elect'l Final 5PCT CTR 9/7/01 $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 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Issued by 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. ELECN: DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day Sent By: NETWORK CONNECTORS INC; 5036504810; Sep -5 -01 9:44AM; Page 2/3 ‘.„ 1 " Electrical PermitAp . 'i _cat bate re eived: 9 ff p 1 Permit no.: a ' .� — �i 3 !1` 4 : City of Tigard P ro v t/ �. no.: - - J pP Expir�edate.: CirynfTigard Address: 13125 SW Half Blvd, Tig: 0 97223 Date issued: �� Receiptno,: Phone: (503) 639 -4171 • Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: l J(......... U 1 & 2 family dwelling or accessory ' Commercial/industrial O Multi- family 0 Tenant improvement 0 New construction : 0 Addition/alteration/replacement 0 Other: ❑ Partial .1011 SIR; 1Nl ORA1,AT10N Job address: y ,_ YI& Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: , it)( . A • Project name: l , 4 Description and location of work on premises: p, . q , ~ , r. . Estimated date of coin' lotion/ s .. - lion: • . • ... : -_. _ .. k •t. + •• (:(1i\ A P11.1 (:A 1 ON . . rEE S('11! 1)14 . Job no: Q l ^ a % Fee Max Business name: A jr tw tic nays hr t fs t _ ve:eni�Oa Qh• 0. Total no. lase Address: i 8 � 111 dwelling mit. includes . per New residential -single or 'maid-family Cit lik ,x.41 4 State: Z - ZIP: � a Scn;ceinchsded: Phone: , .tiO ���1 ��;11 -mail: 1000 sq. ft. orless • 4 CCB f r. fro ■ ' Ora : Elec. bus. lic. no: i - ' )j{ Each additiona1500 sq. ft. or ponion thereof _ Limited energy, residential 2 Lily . • Ii Limited energy. non-residential 2 • ra 1. Each manufactured home or modular dwelling Si . 7 e of su i • i • . -` • � ' r clan (required) Service and/or feeder 2 Sup. elect flume (pnno; Llcenac no . / ,---. Services or feeders — installation, alteration orrebcatfon: 700 amps or less 2 Name (Puny: 201 amps to 400 amps . 2 401 amp to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: [ State: [ZIP: Over 1000 amps or volts 2 Phone: • , Fax: [E -mail: Reconnect only 1 Owner installation: The installation is being made on property 1 own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to tI1ation. alteration. artrcltkalioa: 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 . 2 F G I N 1111 Branch clrcaits - sew, alteration. • or extension per panel: • Name: . A. Pee for branch circuits with purchase of Address: service or feeder fee, each brunch circuit _ 2 City: I State: 1 ZIP: B. Pee for branch circuits without purchase of scrvic a or feeder fee first branch circuit: 2 )?hone: Fax. E-mail. Each additional branch circuit: PLAN 1 EVII W (Please check all that apply) 1 Ilse . (Service or feeder mot Included): —~ 12 Service over225 amps - commercial • Q Health-care facility Each pump or irrigation circle 2 0 Service over 320 a/ups• rating of l &2 ❑ Hazardous location Each signor outline lighting 2 family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 0 System over 600 volts nominal more residential units in one structure alteration, or extension* _ '� 2 Q Building over three stories Q Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable hi any of the abort: 0 G;ressiliglUingplan 0 Other Per inspection 1 1 I f Submit sets of plains iv tb any of the above. Investigation fee The above are trot applicable to temporary construction service. other — Not an putsateaor acc u ept credp car*, please con juai,ilicrion rut =Az iufornutioa Notice: This permit application Permit fee $ _ lJ U V • asterCard : expires i f a permit is not obtained Plan review (at _ %) $ _ _� A . I I 1 within 180 days after it has been State surcharge (8%) ..__ $ t V Y /t taiwoi t - • . i tss accepted as complete. TOTAL $ cardholder ass, . moo credit . • Cardholder dgr,ature Amount V 00 ` /- 4441615 (6io0/Ct)M) 3 7 1 /..,c,o, . i • • • Sent By: NETWORK CONNECTORS INC; 5036504810; Sep -5 -01 9:45AM; Page 3/3 Electrical Permit Fees: • Limited Energy Fees: COm late Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Number of Inspections per permit allowed Restricted OR $75 00 ALL SYSTEMS) EMS) •Service included :: Items Cost Total 4, Reslderltfaf - per unit : Check Type of Work Involved: • 1000 sq. ft. or less • _ I $145.15 . 4 t Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy : 575.00 • Each Manufd Horne or Modular Dwelling Service or Feeder 590.90 _ 2 p Garage Door Opener Services or Feeders • ❑ Heating, Ventilation and Alr (`,pnditioning System" Installation. alteration, or relocation 200 amps or less • _ 580.30 2 201 amps to 400 amps 5108.85 2 CI Vacuum Syste • 401 amps to 600 amps 5160.60 2 601 amps to 1000 amps $240.60 2 ri Other Over 1000 amps or volts 5454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders Installation alteration orrrelocsiltion TYPE OF WORK INVOLVED - COMMERCIAL ONLY 200 amps or less : $66.85 2 Fee for each system 575.00 201 amps to 400 amps _ 5100.30 2 (SEE OAR 918 - 260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: • see "b" above. . Branch Circuits ri Audio and Stereo Systems New, alteration or extension per panel ❑ a) The fee for branch circuits Boiler Controls with purchase of service or feeder fee. ❑ Clock Systems . • Each branch circuit $6.65 2 branch b) The fee for prcuils Data Telecommunication Installation Without purchase Of service or feeder lea ❑ Fire Alarm installation First branch circuit : $48.85 Each additional branch circuit _ $6.65 ❑ HVAC Miscellaneous (Service or feeder not included) n Instrumentation Each pump or irrigation circle $53.40 - Each sign or oottine lighting 553.40 ❑ Signal rsrcuit(s) or a limited energy Intercom and Paging Systems panel, alteration or extension 575.00 Minor labels (10) $125.00 ❑ . Landscape Irrigation Control' Each additional Inspection over the allowable in any of the above Medical Per inspection $82.50 Per hour 562.50 ❑ Nurse Cans In Punt • $73.75 ❑ Outdoor Landscape Lighting' • Fees: • • Li Protective Signaling Enter total of above fees $ 8% State Surcharge $ LI Other 25% Plan Review Fee Number of Systems See 'Plan Review" on $ front of application * No licenses are required. Licenses are required for all other installations Total Balance Due $ Fees: El Trust Account h Enter total of above fees $ -75.— • 8% State Surcharge $ CO. • Total Ba lance Due $ ? I • iAdsts\forms\elc- fees,doc :10/09 /00 • • • • I CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested /b - /c -- AM PM BLD Location 7 (e3 2— D cicAi -e Suite MEC Contact Person I - 1, D r • Ph C)' 7 7 5 (v q ! qS PLM • Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR ? CU/ Dv Z 3 3 Footing Access: Foundation FPS Ftg Drain # SGN Slab Crawl Drain Inspection Notes: c 9 SIT Post & Beam Ext Sheath /Shear . Int Sheath /Shear Framing Insulation , — Drywall Nailing _ /-o . , Ai.io.t_s L lr Firewall Fire Sprinkler s Jr - - Ar • - - - e. _ _ • /f" iorL Jr Fire Alarm Susp'd Ceiling - - - ��� - - - - , / 0 i / / / Roof yi S /i� sk5(� Arc rv` [— ci, Misc: Final 4 �! r . /� P ASS PART FAIL PLUMBING Post & Beam / / Under Slab _., - - .ice 4' Top Out . Water Service 1 /x / nI> a c 1. d' ) //?c...7 (..27/7/ o 7 v` Sanitary Sewer Rain Drains F11L77 1 Final PASS PART FAIL MECHANICAL Post & Beam / Rough In c�� , FI WA 0 I Gas Line �—v Smoke Dampers Final 1 PASS PART FAI kr,; - zo o m , m , � A ELECTRICAL • Service Rough In . 1 IS/Ria w 4 Fire Alarm ilti.a.. 0F 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Other Date dee rc6 Inspector _. _ _ ..i.r Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.