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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY �141 DEVELOPMENT SERVICES PERMIT #: ELR2004 -00229 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/26/2004 SITE ADDRESS: ` SW 98TH AVE IS-7.5 PARCEL: 2S111CD -00300 0 SUBDIVISION: ALDERBROOK FARM ZONING: R -7 BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of data telecommunication & intecom paging system out side of bldg. Job # 010427. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X 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: Owner: Contractor: TIGARD CHURCH OF GOD HUGHES ELECTRICAL CONTRACTORS 15670 SW 98TH AVENUE 10490 NW JACKSON QUARRY TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: Phone: 647 - 2205 Reg #: L7- 22049850 SUP 2347S ELE 34-281C FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 7/26/2004 $150.00 Elect'I Final [TAX] 8% State Surchar€ 7/26/2004 $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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. Issued by �. ♦ Permittee Signature 5'�.-e - \:;.\() 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 06/24/2003 17:26 FAX 5035981960 CITY OF TIGARD 2002 _ FOR OFFICE USE ONLY -- - _ - - -. E lec t rical Permit A tIOII Received , , _ I �� E lect r ical � ...) 4 /J / /� Daten3 : ©T . � .. Permit No.f......4- VVr- U City of Tigard tike��++ Planning Approval Sign V Date/B : Pe mit No,: 13125 SW Hall 131vd-_ 1Q0 Plan Review Other Tigard, Oregon 97223 ` 6 Q Date/B : Permit No.' Phone: 503 -639 -4171 Fax: 5 1� Post - Review Land Use ` r , 11 i 4' Dato/B : Case No.: wv Internet: vw_ci.tigard.or.us G\c W \ \S , • I I . Contact ' :� See Page 2 for 4a> � 24 -hour Inspection Request: 10 5 Name/Method: Mal Su • • lemental Information. • . i;1 i+ :r1: ''I'!, ,. .q..i� ; :Y ^1T'' i.' . i' Ir . . ..� _ ...pc ;, r: �.:1� ; : i ;�. , : :: �t+�y�1� V��n 7 r1 ,,, + i I { 1I ,,.1 ; :I :�:�.., } � , ,. PL�ANLY2EYI��! ,1'lease5e 1irall'X�i.1G1�' : �: 1 �n: �iY:,'.';! rr+, �.trif �::: +�.:F, Kuc+iVi•:�!1���V,it[�'li'. i:LL.. : :.J �.C: ..�. .... .,..., � ., .. New construction Demolition ■Service over 225 amps- ■ Health-care facility commercial ❑ Hazardous location Addition/alteration/rt placement Other: El Service over 320 amps- rating of ❑ Building over 10,000 square feet, , ;.;J,,i- , :ii•';i : Lc +tn' 1;'t 171 ORY,1 11 ' : Id ; �( y3 S . " . I Iti1,i: 1'" "•: ii:; l' i i j ' ... 1 & 2 family dwellings four or more residential units in 1 & 2- Family dwelling ommerciaUYndustrial ❑ System over 600 volts nominal ono structure ❑ euilding over three stories ❑ Feeders, 400 amps or more Accessory B uilding n Multi- Family . ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Master Builder n Other: ❑ Egressflighting plan ❑ Other: r Submit sets of plans with any of the above. :rx���r 1. r. N D• C��l C1.'.i,1 j�'';; ' :: - �I'•:,,r„c�,�,AIJi;GrunH6! � S111E.IN�k'b � ' � �� '�"' O'i ' '�` le to temporary construction service. _ The above are not applicable `' ,s,: A qy _ �- , :1.69 i1 ,� i, ' � y.. ,,,, '"�+' t , 'r tt4:i! Y '..,.:. .... . Job site addr s J g ,�iG .:;;. .t; ; ":; � h�. v- �« ii, �J�=?'> c -:ii:�,�a:�l- .:..�r,::_.JN ::i .- <�- ;; : ",: };': Suite #: / �� s 0 Bldg• /At.##: Number of Inspections per permit allowed Q Description Qty Fee (ea.) Total Pro eCt Name: • �.- el ,G n New residential- single or multi - family per Cross job oss street/Directions to ob site: r \ i t r dwelling unit. Includes attached garage. Service included: 0 Lp (,-' _ 1000 sq. ft. or less 145.15 4 Each additional500 sq- . L . or portion thereof 33.40 , 1 Limited energy, residential 75.00 2 Subdivision: Lot #: Y.imited ener y,non residential - 75.00 2 Tax ma ■ / r creel #: Each manufactured home or modular dwelling + .':,,.1,,,,&' ' ' service and/or feeder 90.90 2 x n '- r ' , : ;i; i .. i . "'Ml 1 .e ,1, 0, .) • ' .. i ?- Pill+ li: . q, " ? `ia rl . 1 : `t Services or feeders - Installation, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106,85 2 401 amps to 600 amps 160.60 2 t� y .,. • , , }} ••r , ' : i , 601 amps to 1000 amps 240.60 240.60 2 ;Y�. !� y�.� l i „� 1'„ku +Itlf t 1J� '11 Q ;'; ,o�� TFA , E MI rytlr ,l? Isi.: 1 4 ` over1000cuspsorvolrs 54.65 2 Name: Reconnect only 66.8$ , 2 Address' Temporary services or feeders - installation, alteration, Pr relocation: City /State /Zip: - W 200 amps ar less 66.85 1 201 amps to 400 a 100.30 2 Fax: 600 am 133.75 2 to . w ' . d9 G1/.1441. : ISi rrl:, ���:�S',.:;;i'1S 00. .1 •' 1t � , I o . ,1: . :.< ri.:;, B a 4 rchcreults - new, alteration, or N ame: extension per panel: • _ A. Fee for branch circuits with purchase of 6.65 2 Address: service or feeder fee, each branch circuit _ City / State/Zlp- P. Fee for branch cirezirs without purchase of — service or feeder fee, first branch circuit 46.55 2 ' ; Phone: Fax: _ Each additional branch circuit 6.65 2 E-mai Misc.(Scrvicc or feeder not included): Each p or ir riga tion circle 53.40 2 41 ri-- Q el fl r a Esc Um 53.40 2 '0: .!;E. wit. ; _ e 0 I i i a.?l '''' E sign line lightin R }r; �'a f� .m' u � Wiz. ��rf � � Each ei or out Job No: Of Oy O ( _ Signal circuit(s) or a limited energy panel, alteration, or extension Page 2 2 Business Name: GOES c N EL.f * ' cr. _ I1IV ii .11".. Description: Q Address; 1 �`iV J I N 61'7005 • S cox' Each additional inspection over the allowable in any of the above: h/o?l City /State /Zip: � Ej i\ De_ Per inspection per hour (min. 1 hour) 62.550 _ Phone: Fax: (Q 1.CP "S377 Investigation fee: — CCE Lic. #: y 4 150 Lic. #: 3 y -,3.1?) C L P I.AFI Vr.... == ; e "; i"Iu1I! ' 0aillri0g0 ..t :-T'H. �. M 41Mtain li;: Supervising electrician • Subtotal - $ 15O.Q si ature re uired: � —I Plan Review_g5° %o of Permit Fee) $ Print Name: IL.I.I °. ' -' c. #: �1 S _ State Surcharge (8% of Permit Fee) S /2, 00 TOTAL PERMIT FEE $ UP 2 • 00 Authorized Notice: This permit applica expires If a permit is not obtained within Signature: Date: 180 days atter it has been accepted as complete. *Fee methodology set.by Trl -County Building industry Service Board. (Please print name) -14 0 /-0el ;;\Dsts\P ermit FormskElcPcrmitApp -doe 01103 0 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 689 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested /c ° AM PM BUP • Location / 7 sz, 7F°1 Suite MEC Contact Person Ph ( ` -OCR PLM Contractor 7 o " 7io Ph ( SWR BUILDING Tenant/Owner [ ..41_,C/l ELC Footing ELC Foundation . q Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation 'KKK Drywall Nailing J Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING C, Post & Beam Under Slab Rough-In bC1- Water Service Sanitary Sewer Rain Drains 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 ; A-02-7/ Service / Rough -In L�L. a-- - o ?- " J UG /Slab Low Voltage PM/ / G2 ( m f Fire Alarm at. Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date 2 - ?A> Inspector ` _ Ext Other: Final DO NOT REMOVE this Inspection record from t • job site. PASS PART FAIL