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Permit CITY OF TIGARD ELECTRICALPERMIT - RESTRICTED ENERGY ,T�i DEVELOPMENT SERVICES PERMIT #: ELR2004 -00364 `--' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/29/2004 SITE ADDRESS: 10775 SW CASCADE AVE PARCEL: 1S135BC-00600 SUBDIVISION: ZONING: I -P BLOCK: LOT: JURISDICTION: TIG Project Description: Voice & Data. 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: AMB PROPERTY L P AZIMUTH COMMUNICATIONS INC BY TRAMELL CROW NW INC P.O. BOX 508 3131 S VAUGHN WAY # 301 WILSONVILLE, OR 97070 Phone: Phone: 503 639 - 0110 Reg #: ELE 36 -94CLE SUP 2312LEA LIC 145828 FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 11/29/2004 $75.00 Elect'I Final [TAX] 8% State Surchart 11/29/2004 $6.00 • 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 quest to OUNC at (503) 246,6699. Issued by _Y./La ._ Permittee Signature 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application FOR OFFICE USE ONLY ` •`' City of 'Tigard Received 7! c( Date/By: / y Permit No. a_. , c �abJ ,, 7 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 141. rdi�,''dp I t ' B Date : Other Permit: Inspection Line: 503.639.4175 `' , ' Date Ready/By: iffl H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information .: ` -' k mm,," ;a. _ ! S s' ', :r.F; . �., -IA : I : :.:fge. :: 'i, :*Fi E �: r 3 } . r : . a ,.., > . p;.�. :. .x, n:e: ' - �" �1 ....�� , ,- � : Y OF .,�A�� °� � �s ��- � � � � " � � � � �� P LAN RE � � ,c v. �,�:. - .7 � ?',:.�s.,m5+��.�'< ...a <, `.ss� .� m .- tsai .. �." � _ ,,.., �.», .�a.- „.,, ',x y �a"�a'ixma �3. ,. - -_" _. r >.. - - ❑ New construction r5is Addition/alteration /replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, cornm'l Hazardous location T i .T ,, ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., .r!CtSE O Y O�rCOSTR n` :� of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling I'1 Commercial /industrial ❑ Accessory building System over 600 volts nominal units in one structure ['Multi ❑ Master builder ❑ Other: ['Building over three stories EFeeders, 400 amps or more s ` r ❑Occupant load over 99 persons EManufactured structures or e l A r RV park ` , g. -,. . , : A JOB . , - JT, � <T(N A1VI} L ©,C = . r L $ „ z .. ,-;,, ., , ,, p , ['Egress/lighting plan ❑ Health -care facility ❑Other: Job no.: Job site address: ( c)--/--, Sit), C A-SCR Qj A d E Submit 2 sets of plans with any of the above. City /State /ZIP: 'r 4 0 The above are not applicable to temporary construction service. Q ' : ';;^'., EE,,SCHiDJI, ; ?•µ;,a , ;- :`;;C;: Suite/bldg. /apt. no.: Project name: I b .05 . Description I Qty. Fee. Total ` 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'1500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no. Limited energy, non - residential 75.00 2 :AV u „s . D ; S, CRIP7?O / E J W i. _ ,�= 4.4 i4 � ,:t Each manufactured or modular r, �/� dwelling, service and /or feeder 90.90 2 �r V v 1 CE / ba t A Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 . ; � ,u ,,rx. o ... . : ;. w w .-_. ,, 201 amps to 400 amps 106.85 2 tl PRpfirM°' , � TEN -' �. • ;�f . c.141 u .� a l` .. - - E. �' "' "'? e 401 amps to 600 amps 160.60 2 Name: S O(4.-' 601 amps to 1,000 amps 240.60 2 Address: 101 1 S (a Ccl y),... A, Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 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 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 A t � ` , APP L IG A N T: E ;gam r`° ,4 : . .r iC® C ERSO ` A. Fee for branch circuits with n service or feeder fee, each 6.65 2 . _,_. ,- ,.h .,. ,, Business name: /1 Z I M,IA.-�( -i- �+om t�LU di t C.,1 t» 5 branch circuit Q B. Fee for branch circuits Contact name: I� L(� 6 without service or feeder fee, 46.85 2 each branch circuit Address: D� �O � 508 Each add'l branch circuit 6.65 2 City/State/ZIP: M iscellaneous (service or feeder not included ty W l t S o �l>71 � t E c � � �C��7 C� ( included) A Pump or irrigation circle 53.40 2 • Phone: (502 ) 7 _ Z R 'tS Fax: : (54:8 ) 63q _ . Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- 1 i W. QNTIiA� TOR . c ' ilat 1., , energy panel, alteration, or .�,� - . ' extension. Describe: 1 Page 2 2 Business name: (2 ..... 4 ( MK, rth cA-i AL _S Q (� f�r� Each additional inspection over allowable in any of the above U Per inspection 62.50 City /State /ZIP: (f)\ is OAJ 0 L L ,L. E 6 q-2 Investigation per hour (1 hr nun) 62.50 Phone: (5 3) V �� _ Q 1 (G , Industrial plant per hour 73.75 Fax: (5 0 .3 & 9 - (� j AICIP '`: � E`.4.:c. TRiCCA_ l_ PE MIT F ES*<z:, = ,. s z = '''' Se'' CCB Lic.: 3/ . c 'tf C LE Electrical Lic.: (Lf 5 Suprv. Lic.: 3/2 .ei Subtotal Suprv. Electrician signature, required: `a ^^ Plan review (25% of permit fee) Print name: • rG 2 LIT . lk / (S' c ate: I I State surcharge (8% of permit fee) �-�) ea (( ` � l TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp doc 12103 440- 4615T(10/02 /COM/WEB Electrical Permit Application - City of Tigard , Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: FRESIDEN' ai WOR W74; 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* ❑ Other: — �,.s.: �; • A+.t& , laa..: e_:r.,.... : A . Y - .2.vG <. ..-. � # X.k Fee for each commercial system $75.00 (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 i:\Building\Permits\ELC- PermitApp doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -41 MST BUP Received Date Reque • �� PM BUP Location /1 ? '7'S � e MEC Contact Person Ph ( Jiger) PLM Contractor Ph ( ) SWR BUILDING • Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR V e 3k" Crawl Drain Slab Inspection Notes: � ��- SIT Post & Beam Shear Anchors Ext Sheath/Shear �2/L) i Int Sheath/Shear Framing Insulation Drywall Nailing PJ �fi��:r ` I Air � /L ma Firewall Fire Sprinkler matiA1 wrif i Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL ( PLUMBING' Post & Beam Under Slab Rough -In Water Service Sanitary. Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL Service Rough -In UG/Slab •w Volt Fire Alarm in. Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 4a210 PART FAIL S 0 Please call for reinspection RE: Unable to inspect - no access Fire Supply Line 4 ADA f2' Q - /6/ Approach/Sidewalk Date ` Inspector Ext Other: ((( Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL