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Permit 4 0 Building Division hg L g �.i Applicant Request for Permit Action np_ �av City of Tigard TO: CITY OF TIGARD, BUILDING OFFICIAL 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: • 503.598.1960 FROM: Applicant Name: Diversified Construction Co Mailing Address: 12448 SW Orchard Hill Rd 7,` ,. ?9 h City /State /Zip: Lake Oswego OR 97035 VOID Phone No.: 503- 793 -2621 Fax No.: 503- 293 -1536 PLEASE TAKE ACTION CHECKED ( ✓) FOR THE FOLLOWING PERMIT: E CANCEL PERMIT APPLICATION. ii4. REFUND PERMIT FEES. Permit No.: ELC2004 -00206 S EGGo7 oo.5 - - 000?-5 & 5?9 Type of Permit: Electrical, new construction Site Address: 7307 SW Beveland Rd Subdivision: Hermoso Park Lot No.: 16 EXPLANATION: Electrical permit originally submitted by general contractor, did not require plan review. Site design plans by electrical contractor were significantly different 'VI s and did require plan review. It was decided by Hap & Brian to create new permit. _ �� 'Z /gE ,t/t/4 ° l0 0i /, i i& - A-72. 49/ . 5 6i Signatur : 1 .� !, = 4i Date: U S� Print Name: £Mgtt. i}'t q-?- Sk.J FOR OFFICE USE ONLY Route to Admin.: Date: . / 6 os By Tai Permit Canceled: Date: ,, /as' By: `r.''.. • Refund Processed: Date: 62_,e �-5 By: Cashier Receipt: Date: iy ,29 O, #: 4/Syd Amnt: $ a6?, A ... Payment Type: l' ..'__ Per: is \Building \Forms \RegPermitAction 09- 27- 04.doc CITY TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 - 00206 411 13125 SERVICES DATE ISSUED: 11/29/2004 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AB -01604 SITE ADDRESS: 07307 SW BEVELAND RD • SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT : 016 JURISDICTION: TIG Project Description: Electrical work for new office building. • 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: 1 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: 10 PER INSPECTION: 201 - 400 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: • PAT GILROY JARMER ELECTRIC INC 5100 SW MACADAM AVE SUITE 240 5105 SW 45TH AVE PORTLAND, OR 97239 PORTLAND, OR 97221 Phone: 503 - 225 -5559 Phone: 246 -5381 Reg #: LIC 6924 SUP 4044S FEES ELE 26 -144C Description Date Amount Required Inspections [ELPRMT] ELC Permit 11/29/200 $248.35 [TAX] 8% State Surcharge 11/29/200 $19.87 Total $268.22 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 or 1 -800- 332 -2344. Issued By: , y i Permit Signature: . 1OWNER INSTALLATION ONLY The installation is being mad rope ty I own 'w ich is not intended for sale, lease, or rent. OWNER'S SIGNATURE: I 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 6-"DP g -ooc/ Electrical Permit Application ' �® FOR:OFFICE'USE ONLY City 6f Tigard 1 L Received � isi L City g 'i L U DateB r Permit No." e► ,,� �„ 4 , AO A. 13125 SW Hall Blvd., Tigard, OR 97223 ��R J 1 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 _ � 1 3.4 i1 1 iA Date/B : Other Permit: Inspection Line: 503.639.4175 CITY � ► - dam �'' Date Ready /By: 0 See Page 2 for Internet: www.ci.ti ard.or.us D1 t"' Notified/Method: Supplemental Information g at 111... - r .,a 3 a ,i =i';1, ,,,x x ,TYPE OF *WORK. .5: 5tr ', '� . .: ` `,�� H' . ;� _,. '' _�, i' PLAN REVIEW' s ® New construction ❑ Addition /alteration /replacement Please check all that apply: Service over 225 amps, comm'I El Hazardous location ❑ Demolition ❑ Other: Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., - ,'K d� -. .; " .,�7 s :. ' V, x ,:o. „,.z,,,v,v , wet.„ ,,,xoa:ur. ... :, o..ioc aids ,.:: i,,,i4;;, , , , , ,, ,,, .'a:?ii.� ;., . ,- ,:'„'-d' ,, ;.;,, . � PR ,; C ATEGORYL OP'1 CONSTRUCTIOlVe' 3 ; .,, d- , , , e -, ' of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling 5 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 x�, - •�:- "3'i`i "'yx �;«u,« ,: �a ,u4: -a;, ,a.- F ' "' ;ia0,1'''''!fo - ; -^ or; - 4 , Ir dim' .; �- . .,,,µ : ark RV p ' �'' z , ,e'a 1 JOI3 'STI'E`i'EiNFORMAT I)?' LOC'ATI.* a`•:: f ❑E Egress/lighting htin lam P �``. "t�:���?,� �':< �a, o•« �, ��. n ��: �T�a. .� = �����:�..•���",,.�w�� ��:. =.; gT g gP ❑Health-care facility ['Other: Job no.: Job site address: 730 SW sEVt(,A1J) Submit 2 sets of plans with any of the above. City /State /Z1P: TRIACD oz. q -7 2-2-3 The above are not applicable to temporary construction service. t / O��! C / 7, - F s 2 k �,AFEE* 'SCiIE ; DULE ' Suite/bldg. /apt. no.: Project name: C(L �� ''` .. W Description I Qty. Fee. I Too tal Cross street/directions to job site: _i New residential single- or multi - family dwelling unit. Includes attached garage. 7 Z -t- i3 e i .t. 3) 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 °:,:�'� .:;r"r;t'�?F`£��_:. - •: *.,i °.� �.. - ,,,�,. ,,,�,,<. _ ..;. �;. t - ya »x:.t:=�:: :i #:• "..ixk ^5 "�:S € ^�.y�:�� " t ' r,. 7 r�, y l a ' DESCRIPTION ,OFF WORK t , t IL kf n " , l a, z „t : ,, ' Each manufactured or modular dwelling, service and /or feeder 90.90 2 T. I Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 i2 c �= - �- ._ $ >r .F k . : _ . ;- clt;s ., V � •: :, .,. , 3. 201 amps to 400 amps 106.85 ! 2 U l ; ` ® PROPERTY? OWNER ' # - .` --,, �s. I '' / ®0 �....v ..,. ., . �.',.,, , .....' .� " , ... ". , 401 amps to 600 amps 160.60 2 Name: 1 1-42..0 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 S/00 S W/ Mp..c �PsM Ss., Ti 2_'9 - o Reconnect only 66.85 2 City /State /ZIP: I:of .l_L A„,..sr, / OR... 91 239 Temporary services or feeders installation, alteration, and /or relocation Phone: ( 503 ) 21;5 - 555.9 Fax: ( ) 200 amps or less 66.85 1 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 . ", __ n <:.,,> , «i ,,• ,. ='.t;, -;, Ii " °k�'".s ," i:.t rr °, A. Fee for branch circuits with r� ... '°' "tr t® APPLICA -fi : r yA ° ` .. E 4 e ©NT ra PERSON :i serv or feeder fee, each Business name: ty e_,2 -SI rI 6... c �5 - �� - t po Co. 0 R. . branch circuit lO 6.65 �� 2 " B. Fee for branch circuits Contact name: "roM CLAQ K without service or feeder fee, 46.85 2 each branch circuit Address: 12 ' - 6 S YJ DR.C.HA _1) i,.i. I L..L- I7.4 . Each add'l branch circuit 6.65 2 City/State /ZIP: 1 A QS W e6D DQ c 7 D g5 Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (563) 793 - Z(v 2 Fax: : (5 2 - /5 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - � ; z t r °t= "�'g : , s , R energy panel, alteration, or �. ., �N.t .t< �,.�. � GQNTRACTiOR� a .�� .. extension. Describe: I Page 2 2 Business name: , l•AQME2. �k� - I - R - k L ". N A Each additional inspection over allowable in any of the above Address: S1 q5^ SW i-5 ANA. Per inspection 62.50 City /State /ZIP: ?D 2T L.AN. , 0 9-) 2:2_1 - 3(o Z S Investigation per hour (1 hr niin) 62.50 Phone: (5 S3 8 1 Fax: ( F ) Industrial plant per hour 73.75 3 ) Z-4 (o - „a1, ° „` ' E 'ELECTRICA:L: *;"' . CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal oL 9/3,3j-- Suprv. Electrician signature, required: Plan review (25% of permit fee) �/ Print name: Date: State surcharge (8% of permit fee) r - TOTAL PERMIT FEE ,,,,e....6 7 AZ Authorized signature: - S 4V1. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: -.'bgZ.tv_ S ` /111- C•A.->9„c.Z Date: 049 )Z / D� * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits\ELC -PernitApp.doc 12/03 440- 4615T(10/02/COM/wEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: k RES iID,,ENTIAL, WO� � ��'ONLY: "��.. � ., �':�.,k• ;�., � � • .. Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* • • ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: C ®M1VII+;RCIALIWW461: Y` ' `1 s: . -_, Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls - • ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation • ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems • • ' . • ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* •• • • ❑ Protective Signaling ❑ Other Total number of commercial systems: I *No licenses are required. Licenses are required for all other installations i:\ BuildinglPermits \ELC- PerniltApp.doc 04/03