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Permit
ELECTRICAL PERMIT - CITY TIGARD RESTRICTED ENERGY 4.01,11. DEVELOPMENT H B Tigard, ) 639 -4171 DATE ISSUED: - 13125 ED: 6/8 01 err SITE ADDRESS: 14650 SW 97TH AVE PARCEL: 2S111AC 02700 SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5 BLOCK: LOT: 037 JURISDICTION: TIG Project Description: Installation of restricted energy for data telecommunications. Job No. C -21111 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: TIGARD TUALATIN SCHOOL DIST 23 CAPITOL DATA & COMMUNICATIONS 6960 SW SANDBURG RD 12810 NE AIRPORT WAY TIGARD, OR 97223 PORTLAND, OR 97230 -1029 Phone: Phone: 503 - 255 -9488 Reg #: LIC 142457 ELE 26- 1054CLE SUP 3132S FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 6/8/01 $75.00 2720010000 Elect'I Final 5PCT CTR 6/8/01 $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 anThittow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1 -0010 through,OAR 95- 01 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 1987. l / Perm ittee Signature �.��(L.dAr ` � Iss ed by 1 � : � IL 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 Electrical Permit Application Date received:/ OF P USE o , e ,i - /loo i Project/appl. no.: Expire date: A L City of Tigard Date issued: By: Receipt no.: CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR 97223 Case file no.: Payment type: Phone: (503) 639 -4171 Fax (503) 598 -1960 Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORM ATION , Job address: 14650 SW 986 AV. 97 ' ( '1y: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.: Lot: (Block: N/A (Subdivision: Project name: TUALT] (Description and location of work on premises: Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: C -21111 Fee Max. Business Name: CAPITOL DATA /COMMUNICATIONS Description Qty. (ea.) Total no. insp Address: 12810 NE Airport Way New residential - single or multi - family per City: Portland State: OR ZIP: 97230 -1029 dwelling unit. Includes attached garage. Phone: 503 - 255 -9488 IFax: 255 -9488 (E -mail: darrell @cepdx.com Service included: CCB no.: 142457 'Elec. bus. lic.no: 26- 1054CLE 1000 sq, ft, or less $ 145.15 4 City /metro lic.no.: 6380 Each additional 500 sq. ft. or portion thereof $ 33.40 _,,, A :;...! /" ME j / 6/8/01 Limited energy residential $ 75.00 2 Signature of supervising electrician (require Date Limited energy, non - residential $ 45.00 2 Sup. elect. name (print): Darrell McNeel License no.: 3132 -S Each manufactured home or modular dwelling ' PROPERTY OWNER Service and /or feeder $ 90.90 2 Name (print): TIGARD - TUALATIN SCHOOL DISTRIC 23J Services or feeders - installation, Mailing addr&560 SW SANBURG RD. alteration or relocation: City: TIGARL State: OR. (ZIP: 97223 200 amps or less $ 80.30 2 PI (503)431 - 4018 Fax: (503)431 - 4020 (E - mail: 201 amps to 400 amps $ 106.85 2 Owner installation: The installation is being made on property I own 401 amps to 600 amps $ 160.60 2 which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2 ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2 Owner's signature: , Date: Reconnect only $ 66.85 1 ENGINEER Temporary services or feeders - Name: installation, alterations, or relocation: Address: 200 amps or less $ 66.85 2 City: State: ZIP: 201 amps to 400 amps $ 100.30 2 Phone: Fax: E -mail: 401 amps to 600 amps $ 133.75 2 PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration, ❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel: ❑ Service over 320 amps - rating of l &2 ❑ Hazardous location A. Fee for branch circuits with purchase of family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2 ❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase ❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2 ❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65 ❑ Egress /lighting plan ❑ Other: Misc. (Service or feeder not included): Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2 The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2 Signal circuit(s) or a limited energy panel, alteration, or extension* ` 1 $ 75.00 75.00 2 *Description: Each additional inspectionover th allowable in any of the above: Per inspection I I $ 62.50 I I Investigation fee Other ❑ Visa ❑ MasterCard Permit fee $ 75.00 Credit card number: / / Notice: this permit application Plan review ( ) $ Expires expires if a permit is not obtained State Surcharge( 8% ) $ 6.00 Name of cardholder as shown on credit card withing 180 days after it has been $ TOTAL $ 81.00 Cardholder signature Amount accepted as complete. i . \ ' 9 �. :H�6� / VN. n O `7 �v _ A tyew w og � w 222 ��AS 0 r) , uc, w �k r E f � t "L A l F wA� a- 0 � ,qa v T io 'gy j � eC ^ �x z fy,slip "52 Q��ty " �S' / � ' ' s v i3 t`� s=ops Efssr 2vik. Q , .ph g rocs I S D • 6' rte-+- � DiJ 0 Wi z` Ir • ll ,j, IQ •-• I • _______.----Pq AD 14 ,c 4 y � 11 I E -3 o f - a ki 1 4..../......______H . -.:- a 1r ( N E_4 , 1 DRAMA c. *C. : e t , �+ t 1,2- D RAMA i . p STOR. ,I E I O° s- c ° � - I CORR '^ �' E -14 N - b rp Z n► CUST. 7 STOR. , E i 4. D © I E -15 I 1 ,4 _," 0007 \ 57- 1 "^ c, C-. i Q �O 4 Q �s4 TEAM ROOM �.�._ rC I E -16 I � 1ggso s� 97' 1. -ALL E -17 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 i BUP I f K D ate Requested ( ( /"7 AM PM BLD Location / /I S ® S/.4) o 7 Suite MEC Contact Person . _ , ) • Ph PLM Contractor ! y � Ph 479- 37O SWR BUILDING : Tenant/Owner SC1ii00 / - 1d 9 71' r cI ELC Retaining Wall ELR o 2 o ( , - -- 00I() Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam n , i / //_ Ext Sheath /Shear C� a 4 ,e7j Int Sheath /Shear Framing Insulation Drywall Nailing Firewall .. Fire Sprinkler Fire Alarm - Susp'd Ceiling Roof Misc: Final / � / _ y i/Q c / PASS PART FAIL ,PLUMBING" .',,,,: u :'. Post & Beam Under Slab Top Out Water Service Sanitary Sewer Final Drains a Final PASS PART FAIL MECHANICAL s;. . — Post & Beam • - Rough In Gas Line _ . C Il Smoke Dampers Final • PASS . -PART FAIL ECAL ervice Rough In UG/ ge FFee Alarm PASS • PART. FAIL :SIT °_f �. , _ : r 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: 41 U nable to ins [ ] pect - no access ADA F Approach /Sidewalk D / �) Other Inspector AI e Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job. site.