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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00584 I; DEVELOPMENT SERVICES DATE ISSUED: 11/26/01 - 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110AB -00400 SITE ADDRESS: 14100 SW 112TH AVE NH 1 SUBDIVISION: THE COLONIES APARTMENTS ZONING: R -12 BLOCK: LOT : 1 -5 JURISDICTION: TIG Project Description: Reconnect only for unit NH 1. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: HOUSING AUTHORITY OF WA CO THE COLONIES 14220 SW 112TH AVE TIGARD, OR 97224 Phone: 503 - 639 -7408 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT CTR 11/26/01 $66.85 2720010000( Elect Final 5PCT CTR 11/26/01 $5.35 2720010000( Total $72.20 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 works 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 - 0089 You may obtain copies of these rules or direct questions to Permit Signature: it ` ed B n /� 7 9 I�I /i c Iss � Y� � • hi,- � ✓ 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 7:00pm for an inspection the next business day • Electrical Permit Application Date received: i /.4 4/ Permit no.: [Legc - c e j 6-c/ ' 1 � i . . 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: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: . Airc n : p B ld:. no.•4 j Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: l� �lliMIIIIINA Project name: ', n CO /e <� Descrip ion and location of work on premises: Estimated date of completion/inspection: ('ONTRACTOR APPLI('ATION FEE S('IIEDLLE 'OC �- 9 /r C ,f .. , - 1 --, / "F 4,=)A . . A-)-1/ Fee Max / 1 d _ . \ G /�f �N 1 Description — Qty. (ea.) Total no. insp Business name: C. /T New residential - single or multi-family per Address: dwelling unit. Includes attached garage. City: I State: I ZIP: Service included: Phone: I Fax: I E -mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: I Elec. bus. lie. no: Limited energy, residential 2 City /metro lie. no.: Limited energy, non- residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders — installation, alteration or relocation: 200 amps or less 2 Name (print): I Y I :. ,o 0 /7 S -1- S ' 201 amps to 400 amps 2 g + Z� n 5 11 � �/� 401 amps to 600 amps 2 Mailing address: V ���///���/// 601 amps to 1000 amps 2 City: ( 1 / C State:0 I ZIP: c / -7 "'c Over 1000 amps or volts 2 Phone: i a —,, , E -mail: Reconnect only / !� / , fs'S 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, 6'1, 7D1 200 amps or less 2 / t . . = ' U�// // Ci 201 amps to 400 amps 2 Owner's signatur• fA Date: �' (iU' L I 401 to 600am.s 2 ENGINEER 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 REVIENV (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories O Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other Per inspection I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other / ` Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ l0 (!� Ti 5 ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ credit card number I / within 180 days after it has been State surcharge (8 %) .... $ `i 3 `,/ Expires accepted as complete. TOTAL $ 7 ai , Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00/COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: • TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: 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 n A udio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 n Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n G arage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 ri V acuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 n 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, ❑ see "b" above. Audio and Stereo Systems Branch Circuits n Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 n H VAC Miscellaneous n Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 El Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over n Medical the allowable in any of the above Per inspection $62.50 iii Nurse Calls Per hour _ $62.50 In Plant $73.75 0 Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ 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\forms\elc- fees.doc 08/30/01 - CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / 1 - AM PM r BLD Location , Z -- z-e) // L f &'- -- Suite Ai- r MEC Contact Person - T:�ti , Ph �p 3 9- 7 f 78 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC a L:D 58 Retaining Wall ELR Footing Foundation Ce FPS Ftg Drain SGN Crawl Drain Inspe tion Notes: Slab SIT Post & Beam Ext Sheath /Shear eCC2 f) Int Sheath /Shear Framing Insulation Drywall Nailing Cc/c Yi / - 'pf$ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Misc: XIS *I _Le Se Re-id Final (� PASS PART FAIL PLUMBING Post & Beam -, Under Slab /"19r— (r`?yl�E ' ( CC cry.) n s (7* P Water Service r' W 'o, - i - O ✓► - IOrt` f f Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL E :Semite' Rough In UG /Slab Low Voltage Fire Alarm Final PART FAIL S� 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 Date /1 — Q P 01 Inspector Ext • Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.