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Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT .,. DEVELOPMENT SERVICES PERMIT #: ELR2006 - 10028 DATE ISSUED: 3/24/2006 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 2S 102AD -02200 SITE ADDRESS: 08900 SW BURNHAM ST F004 ZONING: CBD SUBDIVISION: BURNHAM TRACTS LOT: 006 JURISDICTION: TIG Project Description: 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: BURNHAM BUSINESS + STORAGE LLC OREGON HEATING & AIR CONDITIONING 9500 SW BARBUR BLVD STE 300 PO BOX 397 PORTLAND, OR 97219 DUNDEE, OR 97115 Phone: Contact #: FAX 503 -537 -2172 PRI 503 -538 -2953 FEES Reg #: ELE 522LHR LIC 125815 Description Date Amount [ELPRMT] ELR Permit 4/5/2006 $75.00 [TAX] 8% State Surcha 4/5/2006 $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 ' ca '. - Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rule or direct ques •n • • C at 503 - 246 -6699. Is ed By: ! � A - / , _�� Permittee Signature: ` .o yl OWNER INSTALLATION ONLY 1 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. Mar 24 06 10:02a MS Rentals, Inc. 503 - 537 -2172 p.1 r E 1ectrica1 Permit -A L , _•V.- •_ m ; ED FOR 0 FFICE USE O . City of Tigard Received ,7 ,. -o‘ ,--pc Permit No.s4 %642 S':1 L3125 SW Hall Blvd., d 6 , Tigard, OR 97223 aH1i A �oo Plan Review I Phone: 503.639.4171 Fax: 503.598.19 Lk 4 e t e- i " • D .IBy, Other Permit: Inspection Line: 503.639.4175 •'1 Date Ready/By. 7 uris: r� el See Page 2 for Internet: www.ci.tigard.or.us O F T iGARD ~ W Notified/Method: � ) U Supplemental Cu formation El New construction ,'Addition/alteration/replacement Please check all that apply: 0 ❑ Demolition over 225 Ha tddous location 000 ❑O ther: .. _ ; n residential amps, ;; •:. : CA.TEGOR•Y`.OF GOhIS'IRfJCFXOL� ;- ;: : .: -.. Service over 320 amps ratio Bu n over 1 0 5 . ft. of 1 and 2 family dwellings 4 or more new resident al ❑ 1- and 2 - family dwelling ELCommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi- family ❑Master builder El Other: ❑Building over three stories ❑Feeders, 400 amps oc more ['Occupant load over 99 persons 0Manufactured structures or • • . } JOB; . $1#:: . INFORISLtTION`AND. LOCATION . . .. .. _ . ': :: ❑Egressilighting plan RV park ❑Health -care acility ❑Other: lob no_ • LL. . -o 1 1 (} Job site address: ( S• i - ` i- y -� at 1r r}c t - Submit 2 sets of plans with any of the above. City /State/ZIP: i ` ' 1? l l f ^ F Li. The above are not applicable to temporary construction service. Suite/bldg./apt ,z -- .. . , ,4..- : :; , :. :. . no.: Project name: ; ,: `' "H`;;;;.: '... ... - S CHEAi J := ..w: ?:' .. Dtsmptioo - I Qty. Nee. ';.. Total .• Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft or less I 14515 I 4 Subdivision: Lot no.: Ea- add'l 500 sq. ft or portion 33.40 1 Tax map/parcel no_: Limited energy, residential 75.00 2 energy, es! 75.00 2 Limited nttgy non-r en - D�IP1'XON OE � W - ..,. ' = = c :- < .. Each manufactured or modular �� V dwelling, service and/or feeder 90.90 , 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 8030 2 > - __ : ...... .... �...ti,..�,,. , ' .'. O: .PR�EK`ISc:04V1yitai ::;s ", :`: ` °i:.; 5:ii3.;:::i,.9-, E ,` • _ 201 amps to 400 amps 106.85 2 TEAfA7!1�T'r "= ; s ' ; `'' ';. 401 amps to 600 amps 160.60 Name: p (i` H. ? i K TI E: 601 amps to 1,000 amps I 240.60 2 Address: r- Over 1,000 amps or volts i I 454.65 2 Reconnect only 66.85 2 City /State /ZIP: may(.{ 1 (' 7 . Temporary services or feeders installation, alteration, and/or , Phone: relocation ( ) Fax: ( ) 200 snips or less i 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps i , [00.30 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- Fee for branch circui with D :9EPC XCAN T is Business name service or feeder fee each 6.65 2 branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, Address: each branch circuit 46.35 2 - Each add'l branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Far:: ( ) Pump or irrigation circle 53.40 I 2 I Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- ,,,.. ., •.:.. ^ - ` CONTRACT Itr -; :: _ . p p3� •• ::: • • energy panel, alteration, or Business name: EATIN ING1 IN extension. Describe: 1 Paget •b L 2 Address: - "' Each additional inspection over allowable in any of the above P.O. BOX 397 _, Per inspection 62.50 City /State/ZIP: 992 HIGHWAY 99W Investigation per hour (1 hr min) 62.50 etINDF- OSEGTON 07315 Phone: (. ) S137c ,2 gS3 F ax: ( ) Industrial plant per hour 73.75 • CCS Lie.: _ ` . ELELIRICtL PERMIT FEES *, :';.- { a��j l C J Electrical Lic.: J� C { -}(. Suprv. Lie.: ' J C.V..�Li/'' Subtotal Ll t-' Suprv. Electrician signature, required: ��� - Plan review (25% of permit fee) Print name: Date: ` State surcharge (8% of permit fee) f-_, ( . _ > - s.. TOTAL PERMIT FEE ' '�6 �3zed. ulhori zed. signo:tur,_.- 1 C T aia p*,n.,ir .P4 d." •= Jr a ik , it is o< nbt in.l 1.i.. 190 _. i:laui].i:., . . ..., - -- ..., ..,_,._._.. .. # Vuth ;nsPecl OnS PC' 17 , it aitowect 1 II" CITY OF TIGARD -� . �Z- BUILDING DIVISION PERMIT #:a 006 —/0 .)--O , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Ai p� fl l Inspection Requests (24 Hrs.): (503) 639 -4175 :�' '__-. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: Fir v — CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: c ©, oc (M w` ; ® g tk LL PHONE #: Inspection Request Scheduled For: Date: 3 -30 -0 G Pour Time: Code # Inspection Description Confirm # Contact # Message I,'! I 9' J �s3 S - D--qs - __. 9 Corrections /Comments /Instructions: C W ' \ 1, PASS n PARTIAL APPROVAL CANCEL n NO ACCESS I I FAIL fl CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 4 e`V l.- Date: 3 3 0 ( Phone #: (503) 718 - vitit6