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Permit C ITY OF TIGARD ELECTRICAL PERMIT • PERMIT #: ELC2005 -00095 At DEVELOPMENT SERVICES DATE ISSUED: 3/1/2005 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 25101 AB -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. Job No. 6037 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: 2 W /SERVICE OR FEEDER: 32 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: 1 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 FEES Reg #: LIC 6924 SUP 4044S Description Date Amount ELE 26 -14-14 4C [ELPRMT] ELC Permit 2/14/2005 $614.00 [ELPLCK] ELC Pln Rev 2/14/2005 $153.50 REQUIRED ITEMS AND REPORTS [TAX] 8% State Surcharge 2/14/2005 $49.12 (additional fees not listed here) Total $750.17 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 -3, 234 Issued By: t .. _ Permittee Signature: 6 1_ c 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. 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. Building Division '''':'�� Applicant Request for Permit Action .W 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 Ib,' j -61911 / 411E- �`,/n" City /State /Zip: Lake Oswego OR 97035 VOID Phone No.: 503- 793 -2621 Fax No.: 503- 293 -1536 W PLEASE TAKE ACTION CHECKED (✓) FOR THE FOLLOWING PERMIT: ? CANCEL PERMIT APPLICATION. .1. REFUND PERMIT FEES. Permit No.: ELC2004 -00206 c g F24,200 5"— 0009S 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 ,W, 2_5 and did require plan review. It was decided by Hap & Brian to create new permit. x f'd .5 AE Fv % 0/ A 7Z'f,T f -- / � t72.. f - /5 64f Signatur : ____ �j . , � 1,� Date: <b s'' Print Name: E66t4... A 5(c,l FOR OFFICE USE ONLY Route to Admin.: Date: . / 6 os By TPA Permit Canceled: Date: d2, e/ds By: 1: Refund Processed: Date: a US By: 4W Cashier Receipt: Date: /j 9 o y #: 1 -4.5 - ye) Amnt: $ a6 p, a,2._ Payment Type: l'.- Lica� Per: is \Building \Forms \RegPermitAction 09- 27- 04.doc Electrical Permit Ap > < FOR OFF ICE, US ONLY . R eceived 1 City `of Tigard Date/B :0. ; 1- 5 --- - (� Permit No.: ' r —Oc� S 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 2 5 2005 ° ..l' �' { Date/By: Other Permit: Inspection Line: 503.639.4175 • "i l , Date Ready/By: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: /CI Supplemental information CITY OP Tit; A : .r u7 - . � : }x* ` 'V51 s ,,,I - T T OI Z,,c,. , r . „:;. t�; y'n . y .,, PL Z IigH... iW /. w4rmv Ati� '� ".E ; 10 New construction Ai Addition / ent y Please check all that apply: ['Service over 225 amps, comm'l ['Hazardous location ❑ Demolition ❑Other rt. Y _ K _ a _ _ ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., rls p • •a , l,,, , ,o ,._ ,� -� , '�' �;,, y ep - te , :_':,:�`• k;''4e,i1c tiMr r 'S ••u CATEGORX OF: CON§J JGTION� ..... ct '. a of 1- and 2 -farm! dwellings 4 or more new residential r �_ - � -. :,s. =:mot � _�.., ��� `r� Y Ss ❑ I - and 2- family dwelling ` V Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ Multi - family 0 Master builder ❑Other: ['Occupant load over 99 persons ❑Manufactured structures or 91;1'.i•:., •; "•� JOB:;SE 1 INFOItM.ATIgN AND; LOCATION `i %s;t � .Ot, s RV park � •- � t:.. �- .. _... ,_ . ., . _ x:�;.,�'�`<� -- „�,: +;q1:';: ❑Egress/lighting plan Job no.: (.p 3 7 Job site address: 7307 �w .E -" - -' d ❑ Health -care facility ['Other: Submit 2 sets of plans with any of the above. /.��o � 'R — Q City/State/ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: O 444 4•' ^ - " • _ ' . FEE' -'SCHEDULE ;: ; ��� I :'k ; �,e .: �' L. :': Description I Qty. I Fee. i Total I 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: Lot no.: Ea. add'! 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 A `, i,r.• DESCR OF WORK ::::?,..:: " .',. ;''"`•, ;o-: Each manufactured or modular ,( : _? AA . �Q - 6 dwelling, er ic service s feeder 90.90 2 • Services es or feeders installation, alteration, and/or relocation 200 amps or less (. 80.30 d / ird 2 -0.r t ,; Ay .F,.: „p.., . _ . rv:. es r; w 201 amps to 400 amps 106.85 2 t ❑. PROPERTI' UWNER.. :i. �: ❑, - I`EIVANT'3 P''k is P'a:.'* . t tea- •h;?a -•y 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 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 i? r” `_,. . V ' r - ® C ONTAC T, E R SO N�I, ;r N �; A. Fee for branch circuits with - - P service or feeder fee, each 32 6.65 Z /2 f 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'1 branch circuit 6.65 2 City/State /ZIP: . Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - y `. 3 "". IS? tl• 1. y ." , ' tr r,; - •. ) :4r.'! 'rya:-• energypane ,alteration, .�'9c 3. .;i .,; ,r -� ',;f:.'��,. M., i' �t ": - =; or �R".. -. - .,..""':�'- .. ...,- ';i -,.v CON'I'RAG'TORis;,p;....?�.: •:5; 3.�.r±�a::��.��; _ , • .. - ,.,��iu�u,.:_.. >,., extension. Describe: Page 2 2 Business name: ...-ft-/4 M £2- E E .T ✓ t e. l TkiC� Address: Si o S se_,..) ey S ' S;- 2-0 O Each additional inspection over allowable in any of the above //�� , Per inspection 62.50 City/State/ZIP: / j ,t_,¢ AJ 4 Q 2 '9 7 2 2 / Investigation per hour (1 hr min) 62.50 Phone: (S33 ) 2 go:, — 5 - 3 6 / Fax: (S03) 241/1 e) 3 7 Industrial plant per hour 73.75 f ;°<<ty`k -`=,`- u;1 ELECTRIC.AL` k'f na; CCB Lic.: 40 `1 - Electrical Lic.: 267 / 4 1 1 /C— Suprv. Lic.: gogy5 Subtotal (pqt- Suprv. Electrician signature, required: 1 e..---..--.—____ Plan review (25% of permit fee) - 1-- State surcharge (8% of permit fee) 'T 6 7 Print name: j jz l 4 a 7 ,_/, / £ ate: / / TOTAL PERMIT FEE 7s•) Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed . is\ Building \Permits\ELC- PermitApp.doc 12/03 440.4615T(10/02/COM/WEB CITY OF TIGARD BUILDING DIVISION �° �� PERMIT #: ELC2005 -00095 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005 Phone: (503) 639 -4171 ' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:00AM PAGE: 55 • SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Electrical work for new office building. Job No. 6037 OWNER: GILROY, RAT PHONE #: 503 -226 -5559 CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246-5381 Inspection Request Scheduled For: Date: 10/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 1- Electrical final 017519 -01 503-246-5381 N Corrections /Comments/ Instructions: IS] PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: //i4.-4-- � Date: • Phone #: (503) 718 - e� CITY OF TIGARD • ra • BUILDING DIVISION Ifr PERMIT #: ELC2005 -00095 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005 Phone: (503) 639 -4171 �mllf/ j, Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/3/2005 TIME: 7 :09AM PAGE: 78 SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY )EFICE BUILDING DESCRIPTION: �foctricaLwork.for.new office building. Job 6037 OWNER: GILROY, PAT PHONE #: 503 - 225.5559 CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246 -5381 Inspection Request Scheduled For: Date: 6/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 105 Underground/slab cover 008253 -02 503 - 246.5381 N Corrections/Comments/Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS (l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date:4 Phone #: (503) 718 - CITY OF TIGARD .1 - te BUILDING DIVISION PERMIT #: ELC200&00085 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005 Phone: (503) 639 -4171 : *ii Inspection Requests (24 Hrs.): (503) 639 -4175 —Jai 1_.. INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7 :08AM PAGE: 55 SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Electrical work for new office building. Job No. 6037 OWNER: GILROY, PAT PHONE #: 503- 226 -6558 CONTRACTOR: JAMMER ELECTRIC INC PHONE #: 246 -5381 Inspection Request Scheduled For: Date: 4/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 125 Wall cover 004641 -01 503.246 -5381 N Corrections /Comments /Instructions: Nj - / y rp )1, ❑ PASS Y1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /- / _ Date: 7 3 -- L.C ." J Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION cr PERMIT #: ELC200 &00095 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005 Phone: (503) 639 -4171 *ow lIF1`A Inspection Requests (24 Hrs.): (503) 639 -4175 A INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7 :10AM PAGE: 61 SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Electrical work for new office building. Job No. 6037 OWNER: GILROY, PAT PHONE #: 503 - 225 -6559 CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246 - 5381 Inspection Request Scheduled For: Date: 4/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 126 Wall cover 004407 -01 503 - 246 -6381 N Corrections /Comments /Instructions: Nt P.kist .■\K 7 . ❑ PASS ❑ PARTIAL APPROVAL lc CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ,/- /3 -� Phone #: (503) 718 - r CITY OF TIGARD �� ..._= rr BUILDING DIVISION PERMIT #: ELC2005.00095 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005 Phone: (503) 639 -4171 k viPi� y p�� � l� � \ Inspection Requests (24 Hrs.): (503) 639 -4175 ' INSPECTION WORKSHEET FOR DATE: 3/28/2006 TIME: 7 :10AM PAGE: 65 SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Electrical work for new office building. Job No. 6037 OWNER: GILROY, PAT PHONE #: 503. 225 -6559 CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246 -5381 Inspection Request Scheduled For: Date: 3/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service/reconnect 002966 -01 603.246.6381 Y Corrections /Comments /Instructions: %' ' NklitLatk tilki \ W " L " „.. . " N.i.... Mikik,Z.. 1 "*.k., ftt_..A9,„, - I 6 04 - 11,.*NAIL:44416),_ J ,,,.-, 1 I 1 1 Oa ❑ PASS 0. PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS I Ofiati- ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I. Air .1 Inspector:iP fr Date `o�c Phone #: (503) 718- I -71 CITY OF TIGARD �� - • 1-lALL'T3ami� /7 . LE , BUILDING DIVISION PERMIT #: ELC2005-00095 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005 Phone: (503) 639 -4171 ommre4miypp�'� C � ( W Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:00AM PAGE: 54 SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Electrical work for new office building. Job No. 6037 OWNER: GILROY, PAT PHONE #: 503 -225 -5559 CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246.5381 Inspection Request Scheduled For: Date: 3/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 002579 -01 503.246 -5301 N Corrections/Comments/Instructions: gElva. aNtrx) ),....; 00 U PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL [ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1.23 - SAS-- Phone #: (503) 718 - f Inspections Required for: ELC2005 -00095 1 ✓ Code Inspection Description — I PASS Date 1 By — 1 [ ✓ Code Inspection Description PASS Date By J BUP - Building Permit ELC - Electrical Permit _ 405 Excavation 105 Underground/slab cover 410_ Fill 110 Temporary electrical service 415 Grading X 115 Electrical service /reconnect 205 Footing _ X 120 Electrical rough -in 805 MFG-Structure grading /footing X 125 Wall cover _ 210 Foundation walls 130 Ceiling cover 21 Footing drain _ 135 Low voltage 220 Slab 140 Sign installation 310 _Crawl drain — 145 A/C or heating unit circuit _ 225 Post/beam structural 150 Hot tub /spa/pool i __ 230 Underfloor insulation 195 Misc. inspection: ��•... __ 235 J Shear walls /anchors X 199 Electrical final JL/S) __ 1``fu� - 240 Exterior sheathing 245 Firewall ELR - Restricted Energy Permit 250 _Roof nailing – 135 Low voltage 255 Wtr proofing basement walls 195 Lo voltage 260 Tilt -up panel 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing MEC - Mechanical Permit 810 MFG Structure set-up : 605 Post/beam mechanical 280 Insulation 610 Gas line I 285 Drywall nailing 615 Mechanical rough -in 287 Suspended ceiling 620 Hydronic piping 295 Misc. inspection: 625 Duct work 899 MFG-Structure final l 630 Fire damper _ -- 498 Grading final 635 Smoke detector shutdown � 299 Final inspection 640 Exhaust hood _ 695 Misc. inspection: 699 Mechanical final .t a BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 305 Plumbing underslab _j 915 Fire alarm rough -in 310 Crawl drain 920 Suppression trip test 315 Post/beam plumbing 1 995 Misc. inspection: 320 Plumbing rough in 1 998 Alarm final 325 RP/backflow preventer 999 Sprinkler final 330 Water service _ 1 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 1 405 Excavation 345 Culvert/catch basin 1 ' 410 Fill 350 Septic tank -] 415 Grading 395 Misc. inspection: I 205 Footing , 399 Plumbing final ! 210 Foundation walls 215 Footing drain . 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: T —_ 499 Final inspection 599 Final inspection L _� I: \Building \IVR \InspCard- AOP.doc 02/02/2005 • C ITY OF I ; ELECTRICAL PERMIT PERMIT #: ELC2005 -00095 �i�t DEVELOPMENT SERVICES DATE ISSUED: 3/1/2005 z l'. 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639 -4171 • PARCEL: 2-5101 AB -01604 SITE ADDRESS: 07307 SW BEVELAND RD /-fP_�, /�/ SUBDIVISION: HERMOSO PARK _ -' ZONING: MUE BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical work for new office building. Job No. 6037 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 HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: 32 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: 1 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 24g • er tO/ 5105 SW 45TH AVE PORTLAND, OR 97239 �- 4 � PORTLAND, OR 97221 Phone: 503 - 225 -5559 Phone: 246 -5381 FEES Reg #: LIC 6924 SUP 26 Description Date Amount ELE LE 26 --1414 4C [ELPRMT] ELC Permit 2/14/2005 $614.00 [ELPLCK] ELC Pin Rev 2/14/2005 $153.50 REQUIRED ITEMS AND REPORTS Pm [TAX] 8% State Surcharge 2/14/2005 $49.12 (additional fees not listed here) Total $750.17 0 a 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 O 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) O 246-6699 or 1-800-3)2=2344. .. By: y Signature: --'-r Issued B ,..� �_,. -` �,,�, Permittee Si nature: L =� �� -�:? -ti � ( OWNER INSTALLATION ONLY CI 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. 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.