Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00385
� DATE ISSUED: 11/2/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101AB 01604
SITE ADDRESS: 07307 SW BEVELAND RD ZONING: MUE
SUBDIVISION: GILROY BUILDING LOT: 016 JURISDICTION: TIG
Project Description: Security, sound, camera, tvs, entry access, wire.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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: PROTECTIVE SIGNAL: X
INSTRUMENTATION: X OTHER: : X
TOTAL # OF SYSTEMS: 4
Owner: Contractor:
PAT GILROY NW SOUND AND SECURITY
5100 SW MACADAM SUITE 240 10300 NE MARX ST
PORTLAND, OR 97239 PORTLAND, OR 97220
Phone: 503- 225 -5559 Phone: 503- 254 -2811
Reg #: LIC 112538
ELE 34- 423CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/2/2005 $300.00
[TAX] 8% State Surcharl 11/2/2005 $24.00
Total $324.00
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- 01 -0 00. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: Permittee Signature: G(-- fsir
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 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.
Electrical Permit Applicati. ! ---- NED FOR OFFICE USE ONLY
13125 SW Hall Blvd Tigard, OR 97223
1
City of Tigard _
R -,_ •k_ Received iew ,
rmi
DatelBy: I I 7 106 ' fli,6 Pet NoS4122005 ig
., , •, I n .,_ .,. ..\ Plan Rev
Phone: 503.639.4171 Fax: 503.598.1960 oti 6 - Lu illiT Date/By: Other Permit:
Inspection Line: 503.639.4175 I-•• . I .. Date Ready/By: lair , lEl ScePage 2 for
stli... ...• •
Internet: www.ci.tigard.or.us Notified/Method: i RN Supplemental Information
A.• 0 -A
*k.k.1.'tt9ACEOPI,.Y,"!?::::-.'.j...;-:'.::::,-;,-:' ....-, -:. :.' : :::-,: .,..:..:.''!''' 4.A.
1 :21..New construction 0 AdditiWkeration/replacement Please check all that apply: '
0
OService over 225 amps, cornm'l 1:11-lazardous location
Demolition P Other:
OService over 320 amps - rating OBuildng over 10,000 sq. ft.,
:;.' •',;, •'. - • • • -• •' .' -- ; "...:CATBGORY:•CIP' ';'. -.• ••• 1 •Y -11 1• 'il'''• ' -• '' of 1- and 2 dwellings 4 or more new residential
0 1 - and 2-family dwelling 0.Commercial/industrial 0 Accessory building pSystem over 600 volts nominal units in one structure
PBuilding over three stories ['Feeders, 400 amps or more
ED Multi-family 0 Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
1 :. 3 :- • '!.]:'' • '''' DE plan RN park
Job no.: Job site address: 755,7 SW 6e..vela.44 Rd C1Health-care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: -- n6 a op_ q7 2,23 The above are not applicable to temporary construction service. I
. . ... .... . ..
:: - .,i 0 ," ...2 :::; : :! 1 ;::;.... ':;;. - :::..' ' . • ' "1
Suite/bldg./apt. no.: Project name: di / /1 y el Id
. Description 1 Qty. I Fee. Total I .* 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'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
', t ' .i : :: ;' ; . i. ' ;i 12 ' ' . ',.. : Each manufactured or modular
2
at,v dwelling, service and/or feeder 90.90 i
S e , 5 1 c a A v y le . fi a . , - hi e 5 1 relocation &wiry Services or feeders installation, alteration, and/or
M<C et,55-1 51vuttu.ted tql,frt 200 amps or less . 80.30 2
O *146 0; •';''''•:i'; •I;:•:•.::•; fisake, ,:.:•:. •,:,...: ,,,,-.:-::: :T 201 amps to 400 amps 106.85 2
41:; -,... -, • -.:•.,• . • • . ' ,''. -”, - • '..',, , ".,— - • ••• •• '' - '', ' : - ,... ' ' '' 401 amps to 600 amps 160.60 1
' Name: 1)1,00/t5trUA agYi.51114-011011, / OM Ciet.--frkt 601 amps to 1,000 amps j 240.60 I 2
Address: Over 1,000 amps or volts I 454.65 2
Reconnect only I 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503) 9q 3 . 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 i 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps j 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
: - bciNtif,:6ti riiii•tsioti ,,,•:,-:,,;•:,::•. A. Fee for branch circuits ivith I
service or feeder fee, each
6.65 2
.
Business name: branch circuit
B. Fee for branch circuits
Contact name: 0 without service or feeder fee,
5
each branch circuit 46.8 2
Address:
Each add'] branch circuit 6.65 I 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 1 2
Phone: ( ) Fax: : ( ) • Sign or outline lighting 53.40 i 2
E-mail: Signal circuit(s) or limited-
'11:••;:;,- :• r - i •;;;•• '• , ;it , •'1 - , '•:''C'1"• q: Wtt . - :,-: - . . : , ,... , .-- --- , .i energy panel, alteration, or
..
, ,:, •,.;:5 .i''!'' , ..1 . ... • ,!. ... !............ . . -.... • ,s,•„:i ,...,- .i;. ;;•.:;1?::- -: • .,•
extension. Describe: 1 14.. Page 2 2
Business name: AP w 5, 4 , cletz,0-71 Teal . .
Address: it, 00 ilk. /3'1'1 51.- Each additional inspection over allowable in any of the above
Pei inspection
City/State/ZIP: Prerl.ttel Ot q72-2-0 Investigation per hour (1 hr min) 62.50
Phone: ( I i Fax: (.6 2_51.f Industrial plant per hour 73.75
.;.. '': ' :.:. :
CCB Lie.: /f7_53 I Electrical Lic.: a g e tz3cE -psuprv. Lie.: 36,814E-A, Subtotal ‘? CV
Suprv. Electrician signature, required: t Plan review (25% of permit fee)
Print name: Do. A / 'A
_--.. ----- Date: io -- State surcharge (8% of permit fee) et-t
3 /6r
A..
.. TOTAL PERMIT FEE 3-4.f,
Authorized signature: 40/ This permit application expires if a permit is not obtained within 180
t
days after it has been accepted as complete
Print name: jeg pp i , „. . yt Date: - i / 5 . Fee methodology Set by Tri-County Building Industry Service Board
"'"' Number of inspections per permit allowed.
iABuilding\PermitskELC-PermitApp doe 12/03 440-4615T(10/02/COM/Wai
1 d dST:90 SO TE 100
CITY OF TIGARD �Z
1
BUILDING DIVISION PERMIT #: 0,0 6 S---a 33 Q'!r
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Uc�
Phone: (503) 639 -4171 emu" �o Pik "j
Inspection Requests (24 Hrs.): (503) 639- 4175 I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 7 30 7 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: •
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- 2 r -0 co Pour Time:
se # Inspection Description Confirm # Contact # Message
'(l C-1 j.. te l
r► 7 3-- c -
L
•rrectiorjis/ ,.mments /Instructions:
C C•
0-f
• PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cry VU Date: 3 �� C6 Phone #: (503) 718 -44
CITY OF TIGARD Q�C
BUILDING DIVISION PERMIT #:�D�S = UV 3
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 /ev " �tin�ii p i
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 7 7 '3.. 0 CLASS OF WORK: t
SUBDIVISION: LOT #: TYPE OF USE: t9
PROJECT NAME: 0\
DESCRIPTION: (\
OWNER: PHONE #: csc
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: /1 / 7 ds Pour Time:
Code #,_ Inspection Description Confirm # Contact # Message
1 :,� \ t ' c,S z8 I
Corrections /Comments /Instructions: 3
I
i '•,_ "1!
"I ❑ PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Gym , Date: �/ / 7, Phone #: (503) 718 -