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Permit
a - 6 C I T Y OF F T I G® ® ELECTRICAL RESTRICTED ENERGY PERMIT ' ° . . COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00015 Ii DATE ISSUED: 1/10/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25101 CA -00200 SITE ADDRESS: 07920 SW HUNZIKER RD ZONING: I -L SUBDIVISION: LOT: JURISDICTION: TIG Project Description: TRUGREEN LANDSCAPE. Data/Telecommunications. 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: COE MANUFACTURING CO, THE BRY -COM P 0 BOX 520 14244 SE BUSH PAINESVILLE, OH 44077 PORTLAND, OR 97236 Phone: Contact #: PRI 503 -761 -5156 FAX 503- 760 -7501 FEES Reg #: ELE 26-I165ELC LIC 124443 Description Date Amount SUP 1394LEA [ELPRMT] ELR Permit 1/10/2007 $75.00 [TAX] 8% State Surcha 1/10/2007 $6.00 REQUIRED ITEMS AND REPORTS 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 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: � /: - .� Permittee Signature: C -CL. - OWNER INSTALLATION ONLY The installation is being made on property 1 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. 1' - Electrical Permit Application FOR OFFICE LSE ONLY , � �� R eceived City of Tigard cov D eB . ` i Cl a 1 t No.: P. 13125 SW Hall Blvd., Tigard, OR 67223 7 , Phone: 503.639.4171 Fax: 503.598.1�t N 1 200 wan Review Date6 Other Permit: T 1 G n It U Inspection Line: 503.639 - A R D Date Ready/By: /i5 See Page 2 for Internet: www.tigard- or.gov Cg1 i OF n1VI SIC Noti6ed/Method Supplemental Information TYPE OF V Wap PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below): ❑ Demolition Other: ❑ Service or feeder400 amps or more ❑ Building over three stones. where the available fault current ❑ Marinas and boatyards. CATEGORY .OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. El 1- and 2- family dwelling Commercial/industrial ❑ Accessor buildin less to a exceeds a ons. ❑Com ings. use agricultural y building amps for all other installations. buildings. ❑ Multi - family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor Toad of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: / C-4�/ . 100HP or more. oaupancy. L� � ' i_ ,]?1�� ❑Six or more residential units. ❑ Recreational vehicle parka. City/State/ZIP: i Y A C et e ❑ Health -care ca toies. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: G/ /b _ ► — 6- e-6 ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: thseription 1 Qty. 1 Pee. 1 Total 1 • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. It or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. R.) 0 � X Limited energy, multi - family ,/� ( ` Z L F 4 (,41, C. residential (w 75.00 2 (with above sq. ft.) - Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 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 1 own which is not 201 ttrnps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps _ 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with Dit APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, Ai / each branch circuit 6.65 2 Business name: �G .7 � i- � L64G B. Fee for branch circuits Contact name: " t -� without service or feeder fee ✓ 46.85 2 / first branch circuit Address: ( 1/ ZLir-/ 5' if ( i4- Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: '14 (t ° .16 Each manufactured or modular 90.90 2 K.- dwelling, service and/or feeder Phone: (5 ) t 1 d / S r4•' Fax:: ( ) f 7 40. — e y Reconnect only 66.85 2 E - mail: `C" Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: ( - C (. L'� Signal circuit(s) or limited- i ` ( energy panel, alteration, or Address: , j � ' extension. Describe: , Page 2 2 U City/State/ZIP: _ e - 9 Each additional inspection over allowable in any of the above y l � s � �CZ tx y Phone: ( e -i , ,) � .s 1 /!� / ' / r Fax: ( Erd 3) / 160 JCS', Per inspection P (1 62.50 / _ �-t� Investigation per hour I hr min) 62.50 CCB Lic.: ( Zt f Z/L S Electrical Lic.' - /f ( p . Lic./ Industrial plant per hour 73.75 _ 9 ' ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: �i 1 C/ / / it ( Subtotal: 4 i� nn y Plan review (25 % of permit fee): Print i nt name: l � t i f ° Dat e: / ,,, re>. ©7 (8% 1 State surcharge (8 /o of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name: Date: This p ermit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. 1:\ Building \Permita\ELC- PermitApp.doc 0523/06 440-46I5T(I I/05/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: kasmENT IAL:WORg 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* 1;' :!'Other. /._f two l � COMMERC Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Data Telecommunication Installation ❑ 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: *No licenses are required. Licenses are required for all other installations 1:\ Building \Pennita\ELC- PamiIApp.doc 03!23/06 p • CITY OF TIGARD ; BUILDING DIVISION PERMIT #: ELR2007.00015 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2007 Phone: (503) 639 -4171 ICI Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/19/2007 TIME: 7 :01AM PAGE: 9 SITE ADDRESS: 0792() SW HUNZIKER R[) CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: TRUGREEN LANDSCAPE DESCRIPTION: 1 RUGREE;N LANDSCAPE•. Data/Telecommunications. OWNER: COE MANUFACTURING CO, THE, PHONE #: CONTRACTOR: UFRY - COM ' p�N6J PHONE #: 503-761-5156 � 5 Inspection Request Scheduled For: Date: 11/19/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message • 135 Low voltage 059927 -01 503.761 -5156 ¥ I Q KNAL Corrections /Commen {s /Instructions: \ • /V \ PAS' ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS L CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Cr 1 S Date: u j (II 61 Phone #: (503) 718- .1-tilf10 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007 -00015 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/0/2007 Phone: (503) 639 -4171 i i4it Inspection Requests (24 Hrs.): (503) 639 -4175 „'= INSPECTION WORKSHEET FOR DATE: /1/1612007 TIME: 7 :01AM PAGE: 74 SITE ADDRESS: 07920 SW HUNZIKER RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: TPUtREEN LANDSCAPE DESCRIPTION: TfdUGREEN LANDSCAPE. Data/Telec:ommunication. OWNER: COE MANUFACTURING CO, THE, PHONE #: CONTRACTOR: E3Ry -COM �£1v N ‘ 5 , (1 ()-\I A N\-- PHONE #: 503.761 -5166 Inspection Request Scheduled For: Date: 11/16/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 059741 -01 503. 761 -5156 N Y Corrections /Comments /Instructions: n PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS FAIL fJ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' V �� Date: 't I (31 Phone #: (503) 718- "f I �