Permit `' ELECTRICAL PERMIT -
CITY O TIGARD RESTRICTED ENERGY
_ALAI!
DEVELOPMENT Tigard. SERVICES 3 50 ) 639 -4171 DATE R MIT #: ELR2004-00349
1/19/2005
13125 SITE ADDRESS: 07117 SW BEVELAND RD PARCEL: 2S101AB 02201
SUBDIVISION: BEVELAND ZONING: MUE
BLOCK: LOT: 2 -3 JURISDICTION: TIG
Project Description: Limited energy for HVAC.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ZIMMLER DEVELOPMENT LLC AMERICAN HEATING
7165 SW FIR LP SUITE 100 1339 SW GIDEON ST
PO BOX 230698 PORTLAND, OR 97202
TIGARD, OR 97223
Phone: 503- 598 -3440 Phone: 239 -4600
Reg #: LIC 33135
ELE 26- 993CRE
SUP 2640LEP
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/8/2004 $75.00 Elect'I Final
[TAX] 8% State Surcharl 11/8/2004 $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 are set forth in OAR 952 - 001 -0010
through 0:.: •52- 001 -0100. You may obtain copies of these rules or direct questions to OU NC at (503) 246-6699.
Issued .y _ _III ,, , I,: I,: PermitteeSignature/&4 / Me/
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
BLS
Electrical Permit Application L FOR OFFICE USE ONLY
City g of Ti and Received � r '
Date/By: Permit No.: � / � �
13125 SW Hall Blvd., Tigard, OR 97223 Pla Review
Phone: 503.639.4171 Fax: 503.598.1960 �4 /,: jlhl Date/B : Other Permit:
Inspection Line: 503.639.4175 �1 :d am r� Date Ready/By: Jur 0 See e Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
t I ` ,�MPE :OF O
.WRK ° f I ' '�` '�: PI AVj REVIEW :: > ` :zt
��*, ... . ... �:�- �.:��s;+'u, •�T�;�„�J. �.. , x,..s..�, �.w.'S«u�at ..:� ,�''z�`�.�#Pi' - Win. ,�` ... _z:�:.;z - <�._. a- :�s,.. e ,.. _t�?z:.
V New construction ❑ Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location
,� _ ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
a „ C A E GO - CO_NST RGT3„ON �� :. of 1- and 2-family 4 or more new residential
_ . ; ,t . z 6 sin ..� i,3�r.,�,... H aag, ^. R i - . mr l- _ -=' a Y
❑ 1 and 2 family dwelling `r Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi family ❑Master builder ❑Other:
['Occupant load over 99 persons ❑Manufactured structures or
Wi lAigil T 3NFOFtIY ®'a r4 + r0r — s * RV park
idt. 4.�, ;- d d, “ . &., L.4. . 1,- .. .+. labAl. . :. , 3 ❑ E gres s/lighting plan P
Job no.: Job site address: . .,,‘...,1,i.... V J�D7 ❑Health - care facility ❑Other:
1� e.� Submit 2 sets of plans with any of the above.
City/State/ZIP'.-1— Ie 0 at i C?p ` The above are not applicable to temporary construction service
g G�(q'l�~� f E ” '" `. FEE* •SGHED LE . - E ,`' .'`• ..
Suite/bldg. /apt. no.: Project name: /1 ° ly ... ,_ �. r..A� . ._.,: _
/ Description I Qty. Fee. I Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
_ _ Limited energy, non - residential 75.00 2
pr O1 WORK --0- ' "_ Each manufactured or modular
1'1 Jr�... va ,� I - N, � ` e dwelling, service and /or feeder - 90.90 2
�(/�,,! Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
'- t R "`� "'�' PERTOWNER ' +Arl W ` 201 amps to 400 amps 106.85 2
' " no A 401 amps to 600 amps 160.60 2
Name: Z t i M L' V_ — 0 f0 Less/ 6 M tU ) 7" ---- -C 601 amps to 1,000 amps 240.60 2
Address: WO j d,s0 692 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: 'it if e h 6 2 ? 7 - / Temporary services or feeders installation, alteration, and /or
Phone: (563) 57 g _ 34z/cFd I Fax: ( ) relocation
200 amps or less 66.85 • t
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 exchange, 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
. ::a
Ir T . I � '" 61 "" . 9 A. Fee for branch circuits with
r =-, . I; -. .T , .:N l i wr p:. - 1- 'CONTAC E ON ._, ,
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name:
without service or feeder fee,
Address:
each branch circuit 46.85 2
Each add'1 branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
NO -4!*',' ,g g - `�' t °° -' en panel alteration, or
�t.�"�� `" _� >,�-� �,.�,� CQNTRACTO � °;��.,.1 ,��,�a'�����,�.,.tr'„ � gY P
Business name: � 't l 4 ' " f extension. Describe: Page 2 2
Address: Ir 6 l +„at Each additional inspection over allowable in any of the above
6�' r Per inspection 62.50
City/State /ZIP: pertiyhe Cti s 0 0 Investigation per hour (1 hr min) 62.50
Phone: CZ ) C I Fax: ( ) ,,.7 Industrial plant per hour 73.75
CCB Lic.:261 1 Electrical Lic.� 41 Suprv. Lie: ` " %� ' Subtotal 1.
Suprv. Electrician signature, required: , Plan review (25% of permit fee)
e`"
State surcharge (8% of permit fee)
Print nam
4 , t � ' r Date: I - TOTAL PERMIT FEE
Authorized signature: `_"
permit application lication ex ires if a permit is not obtained within 180
�T p days after it has been accepted as complete
Print name: ` * � ' '_ -" Date: jI '' 0/ * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building 'Permits\ELC- PermitApp.doc 12/03 440- 4615Tt10 /02/COM/WEB
I ,. .
CITY OF TIGARD ,. , .
BUILDING DIVISION PERMIT #: ELR2004 -0039
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/19/2005
Phone: (503) 639 -4171 l /a '
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' ■ __..
INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 68
SITE ADDRESS: 07117 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 2 -3 • TYPE OF USE:
PROJECT NAME: ANDRUS .
DESCRIPTION: Limited energy for HVAC.
OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: 503.598 -3440
I CONTRACTOR: AMERICAN HEATING PHONE #: 239-4600
Inspection Request Scheduled For: Date: 4/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 005226 -01 503 - 209 -0731 Y
Corrections /Comments /Instructions: i
Lis TO c k d a. ,_,-s
r
1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /it-IV Date: y ( Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2004 -00349
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/19/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/7/2006 TIME: 7:14AM PAGE: 94
SITE ADDRESS: 07117 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 2 -3 TYPE OF USE:
PROJECT NAME: ANDRUS
DESCRIPTION: Limited energy for HVAC.
OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: 603. 69133440
CONTRACTOR: AMERICAN HEATING. PHONE #: 239-4600
Inspection Request Scheduled For: Date: 4/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 003944 -01 603-209-0731 N
Corrections/Comments/Instructions:
,t.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
(l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:///�f j / Date: 6 & Phone #: (503) 718 -
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By A/ Inspection Description Date Passed By •
Footin /Setback `_Underground cover �I
Foundation walls _ Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post /beam structural
Shear walls /anchors ELR - Restricted Ener • y Permit
Roof nailing
Firewall
Description Date Pa sed
lrewall Low volta a VIIM'
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG-Structure set-up MEC - Mechanical Permit
Insulation_
Drywall nailing Inspection Description Date Passed By
Suspended ceiling Post/beam mechanical
Engineered soils Gas line
Welding Lab Final Mechanical rough in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
Fireproofing Lab Final Mechanical final
Final inspection
PLM - Plumbing Permit
BUP — Fire Protection System Permit Inspection Descriptio Date Passed By.
Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in
Sprinkler final Plumbing top -out
Fire alarm final RP /backflow preventer
Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By _ Culvert /catch basin
Footings _ Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab — Catch basin /Manhole SWR - Sewer Permit
Engineered soils —,
Al Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \ forms \InspRecordBUP.doe 04/17/01
4 ELEC CITY. OF TIGARD
TRICAL RESTRICTED ENERGY PERMIT
. 1I "i DEVELOPMENT SERVICES PERMIT #: ELR2004 -00349
`I. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/19/2005
PARCEL: 2S 101 AB -02201
SITE ADDRESS: 07117 SW BEVELAND RD ZONING: MUE
SUBDIVISION: BEVELAND LOT: 2 -3 JURISDICTION: TIG
Project Description: Limited energy for HVAC. .
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ZIMMLER DEVELOPMENT LLC AMERICAN HEATING
7165 SW FIR LP SUITE 100 1339 SW GIDEON ST
PO BOX 230698 PORTLAND, OR 97202
TIGARD, OR 97223
Phone: 503 -598 -3440 Phone: 239 -4600
Reg #: LIC 33135
ELE 26- 993CRE
FEES SUP 2640LEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/8/2004 $75.00
[TAX] 8% State Surcha 11/8/2004 $6.00
•
Total $81.00
CY
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 0
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -001.0 through OAR 952 - 001 -0100. You may obtain copies of these O
rules or direct questions to OUNC at 503 - 246 -6699.
"Y
Issued By: Permittee Signature: _
OWNER INSTALLATION ONLY ' � V
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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.