Permit t;;
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
l l DEVELOPMENT SERVICES PERMIT #: ELR2006 -00155
.40-1
A 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/5/2006
PARCEL: 1S135BA-02800
SITE ADDRESS: 10380 SW CASCADE AVE ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Fire Alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
LANPHERE ENTERPRISES INC FIRE SYSTEMS WEST INC
12530 SW CANYON RD 219 FRONTAGE RD N
BEAVERTON, OR 97005 SUITE B
PACIFIC, WA 98047
Phone: Contact #: PRI 360 - 693 -9906
FEES Reg #: ELE 37- 655CLE
LIC 49732
Description Date Amount
[TAX] 8% State Surcha 7/5/2006 $6.00
[ELPRMT] ELR Permit 7/5/2006 $75.00 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 cot es if these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: Permittee Signature: ,J�' - � �`. ,41.
7ZiatztiSe2244_, 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 Appl cation E FOR'OFFICE USE ONLY ..
�,
; Received i
City of Tigard Re e i Permit No. . 411_ � — /O 6 7 0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 I I I M 1418'liP , ,e �'� Date/B : Other Permit:
Inspection Line: 503.639.4175 J u I v - -_ Date ReadyBy: _ BI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: ,3 f J` Supplemental Information
'I?' € x #;irate . s , ;s - .3 - - # .�' .' f- v' " j .Q. ,-. }' -� ',.a a ,- € -p' R .. g -,, - --- 1, +. �`V,:, -,
', .44 '� 7- n Wir TIP "F )�ItK A � - ,, .. 2 - P REvjE , te
, ,,4„,,.ems + ,q . a - , e --+� ". `.` .,,-_ "_ - - --__ " _. -�'- 1
nTTs. F - k ' " ° �' " Y I Ple check all that apply:
El New construction A d pp y:
❑Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location 1
❑ Sery ice over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
- , xe 4 . m , , . CATEGORY OE uCONSTRUCTION A _ .' : of 1 -and 2- family dwellings 4 or more new residential • ❑ I- and 2- family dwelling 21. Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
El Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more „E,
.� -, ,, n: , j IN gam _ _ _ h > � ['Occupant load over 99 persons ❑Manufactured structures or c..) �"a 'JOB $ITE FORMATION L AND L .CATION, ;- 6
_ ❑Egress/lighting plan RV park
['Health-care
Job no.: Job site address: () 2, 8'3 S W .4 C ( u& 4 ✓e Submit , ❑e..
t facility 2 sets of plans with any of the abo ve.
abovve. c'
City /State /ZIP: 1 i q,,` ,,� "� Ga _, The above are not applicable to temporary construction service.
� VM '; 'FEE*` SCHEAi7LE-`` `•C9
Suite/bldg. /apt. no.: Project name: .�e Ydtn4 - - -°e °° h T'
�� °_ l ( Des criplioo J Qty. I Fee. I Total I *y
Cross street/directions to job site: _ _5 (j CVtd Q _snip' 21"'1 New residential single - or multi - family dwelling unit. C
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
Tax map /parcel no Limited energy, residential 75.00 2
'
Limited energy, non - residential 75.00 2
,r A '0 DESCRIF O1)VORK ' ° a f ? .�
R.�... s ... o . a .� ��� „� -_� 4 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
SPet.. ler tn ^ — Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
-1 . t : zr ; s 201 amps to 400 amps 106.85 2
i �. f�. . ® PROPER OWNER '_ '1 fi �,AI ®:,T EN � � P p
` s_'` _ s_' 401 amps to 600 amps 160.60 2
Name:
GeAV GrA-tt■N \--\,,.,44,, yA..1c.I -rte i sp b (A,. 601 amps to 1,000 amps 240.60 2
Address: 1 07 T . t.� L 6 j Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP : - 7 - �, . Temporary services or feeders installation, alteration, and /or
Phone: ( ) ,�V F ax: ( ) relocation
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
_ 474. 4,1010 AP PtiIGANT ' cii ®CONTA'7CF ERSON oz ' ' A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: .
Each add'l branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
, 14 t ; , CONTRACTOR - ' ` �„ 02' energy panel, alteration, or
���� extension. Describe: I Page 2 2
Business name: c-,.1. 3 757 er , `'t 3 1..�1}
Address: /� Each additional inspection over allowable in any of the above
bC 5 nf{2 \ T 1( i' ,�db
Per inspection 62.50
City/State /ZIP: Via I'AA lie‘ i Investigation per hour (I hr min) 62.50
ff
Phone: X366 ) 615 , - a6 Fax: (563) 20 fie, ( Z Lae-. Industrial plant per hour 7175
' g ,_ - ELgCTRIGAL'PERMTF :FEES* ` € ”
CCB Lic.:L ti's 3 Z Electrical Lic.3-7- 4 Suprv. Lic.343 /3• .
Subtotal --
Suprv. Electrician signature, required: 0 ; .
/M Plan review (25% of permit fee) ? '
State surcharge (8% of permit fee)
Print name: / . L 1 Date: /GG TOTAL PERMIT FEE `� ) rb
i
Authorized signature: / l This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 7 A a L S Date: 6// 5 /� 6 t Fee methodology set by Tri-County Building Industry Service Board
l •f Number of inspections per permit allowed.
is\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD
DIVISION i PERMIT #: CO
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 4E IP�lp gi ll
Inspection Requests (24 Hrs.): (503) 639 -4175 s ' __..
INSPECTION WORKSHEET FOR DATE: (t 1 Zz
(t-'
TIME: PAGE:
SITE ADDRESS: 0380 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ��
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: Ft •p6 S -r w - PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
IC14 eta' c__ 040z01-01 (Pk EtEr
Corrections /Comments /Instructions: (0- 45
R.0 Z1A,4\ .0 R
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6 F V I O O‘ 1 -o c o r1 (t o
P(to-03 2 C,6 6A. - se„ t k(
F i i L P FN'iars c;6 eriv
c)mt\ri pew iP �`� cZ. w r i u fur
I PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
l I FAIL n ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr" V~ 0 Date: _ 6.6 Phone #: (503) 718 '�