Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00261
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/11/2008
PARCEL: 2S 102AD - 01900
SITE ADDRESS: 08935 SW BURNHAM ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TVF &R
Project Description: Low voltage data system.
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:
TUALATIN VALLEY FIRE + RESCUE RITE WAY ELECTRIC
20665 BLANTON ST 2904 THREE LAKES RD. SE
ALOHA, OR 97007 ALBANY, OR 97321
Phone: Contact #: PRI 541- 926 -0504
FAX 541- 926 -2656
FEES Reg #: ELE 22 -77C
LIC 40077
Description Date Amount SUP 3249S
[ELPRMT] ELR Permit 9/11/2008 $75.00
[TAX] 12% State Surch 9/11/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questio s to OUNC at 503.246..699 -e- 1800.332.2344. �(
Issued By • /> �t Permittee Signature: —�� � G1(/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4 .,
SeP.10. 2008 10:41AM No.8973 P. 1/2
Electrical Permit Application fw � t1ti f`. :1. t; 1 t 1 1 1
: r " 1'. :. Ci ty of Tigxd G
13125 SW Hall Blvd., Tigard OR 97223
I t s i /0 g$ i4No,: & % - r
I N
-A. ` Phone: 503.639.4171 Fax: 503.598.1960 S EP 1 0 2 n 3 r Date/By: ew titer Permit: 1`. i t., P , inspection Line: 503.639.4175 U Date F. �: ' " H j y r - 'C ^7
Internet: wwW.ligaid -or.gov
C� ry OF T c , A , N otffied/Muthod _ CG surpplemorb l Information
,. TYPE.;O W, '.IL7�i ..ltl .` , ,..' .I'T 1'1 -.R Yi�FV
' �9$6�
0 New coristntetion [7 Addition /$Iteralion/replacemeiit Please cheek all that apply (smash a gets of plans w /items clleci ed below);
D Service or feeder 400 amps or more D $gilding over three stories.
❑ Demolition ❑ Other;
. , -,,.._ where the available butt contra El Mariam and boatyards, • :' '6i ToOkf '.OF C (INS f )CT excmcls 10.000 amps at 150 volts or D Floa0ng builtlmgs.
• ❑ 1- and 2 dwelling Commercial/industrial less to ground, or coca& 14,000 0 Commercial-use agricultural
El Acc essory building amps for all other iastsllaiio. buildings.
❑ Mtllti- fzlmily 0 Master builder ❑ Other Mire pump. 0 Installation of 75 1;,VA or
JOB s1 E II ItdA.1 tOlyi: ATI(( . ;:
Emergency sysitrm Iarger separately dented system.
Job no.: - 2_. ( Job site address: l_..._) 10011Pormore, cep y
❑ six or most residential units. D Itecrmsional vehicle packs.
City /State./ZIP: 1 cskr a T a Healtbcarc facilities. [] Supply voltage for more than Hazardous loo aio� 600 volts cwsninal.
Suite/bidg. /apt. no.: Project name: D Service or feeder 600 amps or moms.
Cro street /directions to job site: rrtarrtn . -" e l 7utat M.�
New residential single - or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,00 s4 R or less 14 4
Tax map/parcel no.:
Ea_ add'I 500 f_ or portion 33.40 1
residential
;DESCRIEP'�'IOI4 :�� :*'1'1!>' ,
75.00 2
Limited cacsgy,
- , (with above sq. $} 5.
Limited energy, multi- tamily
1 75.00 2
- & _ „x tsidential ( w i th about sc1 ft)
Services or feeders installation. alteration, and/or relocation
S li'IYL t ERTY OWN p
200 amps or less 80.30 2
CI ;fir
} z01 amps to 400 amps 106.85 2
Namt: 401 amps to 600 amps 160.60 2
, " v `e__, ��S CO 601 am ps to 1,000 atlrps 240.60 z
Address; Over 1.000 amps or volts 454,65 2
City /State /ZIP: Temporary services or feeders Installation, alteration, and /or
relocation
Phone: (p b 2� Fes ( ) 200 amp or less nw 66.85 1
Owner installation: This installation is being made on property that T 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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration or extension, Cr p and • A, Fee for branch • { I:ICAIV'I'' ❑; 0 aabove service or feeder t fee, •
T3tlsiness name: cacti branch circuit 6. 2
13. Fee for branch circuits --
Contact name: without service or feeder foe,
_ first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 M �
an 2
.-. Miscellaneous (service or, feeder not included)
City /State /Z1P: Eaoh manufactured or modular ' '
Mont; ( ) Pax :: ( )
dwelling, service and/or feeder 90.90 2
liccemaeot ordy 66.85 2
E - mail' Pump or irrigation circle T 5140 2
' CONTRACTOR Sign or outline lighting _ 53.40 2
Btlsincss name Sig Ctr
nal s uit(s) or limited-
energy panel, alteration, or
Address: {(�} C extension. Describe' DI* • Page 2 5 -. " 1 0 2
City /State/ZTP: A V � Each additional inspection over allowable in any of the above
Phone: (t 1� ) Z 6 . C_� I I'0X Gs--41 .) d •Z . - ! Pe r inspection 62.50 �—
+' s b investigation ptr hazer (1 1s min) _ 62,50
CCB Lie.: 400 `-f Electrical Lie.: Suprv, Lie._ 2 • Industrial' plant per hour 73.75
Suprv. Electrician .
5u
p an signature, required: r I Ef' ` V-- - �� _ W Subtotal: �!]
l'riltt name: — 41 _ 8 -: V 0 Date:
State surcharge (12% of permit fee):
. Plan review (2S% of permit fe r c�
t, � �� a
Authorized signature: c, - �p _ (� TOTAL PERivf1T FEE: ` /� ,
Print name: '� E'�1r� 1` •t D� teL.� — 1 � _ 0 � permit appiin unn expires If a permit is not obtain whtbio 180 G j F
1_w J ( - days slier it has beet accepted os wmptete.
* Number of inspections allowed per permit.
t :t. glemisitAaC orylo6 4404615rtti WOOl4tWan
CITY OF TIGARD
BUILDING DIVISION 1 PERMIT #: ELR2008- 00251
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/1000
Phone: (503) 639 -4171 Diu imv p ' , II
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/2/2008 TIME: 7:OOAh1 PAGE: 39
SITE ADDRESS: CLASS OF WORK:
08935 SW BURNHAM ST
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
TVF&R
DESCRIPTION: 1
Low voltage data system.
OWNER: TUALATIN VALLEY FIRE .1- RESCUE, PHONE #:
CONTRACTOR: RITE WAY ELECTRIC PHONE #: 6t1 916 -05# 4
Inspection Request Scheduled For: Date: 1W7/ �� Pour Time:
Code # Inspection Description • o ntikm # Contact # Message
199 Electrical final 076171 -01 503-.969 -9503 N. Y
Corrections /Comments /Instructions: mi lL,t
(-------------
.,... _____n)
\ ....__
F
\ \
A
` � U In/
PAS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C + NQ$i-c Date: 101 7-fl Phone #: (503) 718- 1A76______
CITY OF TIGARD
BUILDING DIVISION ti PERMIT #: ELR200B -00261
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/20013
- Phone: (503) 639 -4171 "Ip
Inspection Requests (24 Hrs.): (503) 639 -4175 J '.......
INSPECTION WORKSHEET FOR DATE: 9/17/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 08935 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TVF&R
DESCRIPTION: Low voltage data system.
OWNER: TUALATIN VALLEY FIRE + RESCUE, PHONE #:
CONTRACTOR: RITE WAY ELECTRIC PHONE #: 5'I1- 926 -0504
Inspection Request Scheduled For: Date: 9/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 07 -01 511- 926.0504 N
Corrections /Comments /Instructions:
to LNG §r.) s i1 10 w
❑ PASS Li PARTIAL APPROVAL XCANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: G' . INk a 1. Date: 111 1 I 1 Phone #: (503) 718 - Z fiii