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Permit • y f' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT PERMIT #: ELR2006 - 10008 44, ,, , , I I r�EVELOPMENT SERVICES DATE ISSUED: 4/1/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25101 BB -01400 SITE ADDRESS: 12070 SW GARDEN PL BLD5 ZONING: C -G SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG Project Description: Voice and data cabling 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: RREEF ESP TECHNOLOGIES 720 SW WASHINGTON ST STE 630 7929 SW BURNS WAY STE. F PORTLAND, OR 97205 -3508 WILSONVILLE, OR 97070 Phone: 503- 224 -9450 Contact #: PRI 503-628-4195 FEES Reg #: ELE 34- 269CLE LIC 73872 Description Date Amount [ELPRMT] ELR Permit 4/1/2006 $75.00 [TAX] 8% State Surcha 4/1/2006 $6.00 REQUIRED ITEMS AND REPORTS Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: Permittee Signature: 2' Jh OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. .!1ectF,Sca I errrnit Applicati rir' � E py \�'l1rp�� FOR OFFICE USE ONLY • CI}�� Of T Received j Permit No. J db$ `J �t ftval�d` Date/By: " , -'0 !- - ,9 to 13125 SW Hall Blvd:, Tigard, OR 97223 ry PtanReview Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 k( ' V 2 �y * •% , N 4 44j" � + ' DateB Inspection Line: 503.639.4175 '/ Date ReadyBy:/ 0 See Page 2 for Internet: www.ci.tigard.or.uS CITY OF TIC N otified/Method: C�' Supplemental Information R Ill tni : nlialelelh) as k : ,; t 1, ", ' q 4 .V r. >.z ;v i -.— ,- e • . I 15 T M t, ill . r-'1 ,i 'NA. '�1 w CQ ; - '''r IV # ' 16t' 4.4 : . {tS, ' `.``�. . ° . :'A., a a . , .x ∎ ∎ i , :; , @ � b, ■.. r ;4 . �' nia- 1 . r y„ -n t ^. x 6 � ,e , r , p..A ' ,.,,,, l ,ti ;,M� a, u , , , .,, ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: • ❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'l ['Hazardous location e „ - .. � zyw k &. r . Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., tt ,ly ', gi , . � if ap : l l i firva � or :.' s 019 ,1 of 1- and 2- family dwellings 4 or more new residential - w. °.A sxa. a:. rw ^ k..: s, w -sae.. 74A a, ',S14xrit: . t= ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories ['Feeders, 400 amps or more ❑ Multi family ❑ Master builder ❑ Other: DOccupant load over 99 persons ❑Manufactured structures or " G 4F . xm= ,,qt wt+L�m.., , rr.,a + + t --At «;rc: q }. f mre e wer o ,, a - ' , ` ' RV park , .. 1r ", ,c um , t i r „a, • 6 k� R , ?'"I I r�' � :� � VieP " "1 al v DE plan p C 3� b�.o_)c� SO 6A� w el.k� ❑Health -care facility ❑Othee. Job no.: Job site address: Submit 2 sets of plans with any of the above. City/State/ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: U l .. Description 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'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: km 3t 4ax�w gym ��� b �, � � �� �� fi � i k , ` Limited energy, non - residential 75.00 2 I �kf , " *37, �,,�� .��'� •.,�� ,' - , � , „ , „ � ,, Each manufactured or modular 00 t C � \ _���� ���� dwelling, service feeder 90.90 2 Services or feeders rs ins installatillati on, alteration, and /or relocation 200 amps or less 80.30 2 ii s"� : 7^1wot w tw• . a ar > 201 amps to 400 amps 106.85 2 .; .l aI M I C 'I AI R' . ...; t I...,.,` "..®� ` , • ti2i.r± 401 amps to 600 amps 160.60 2 Name: Uq - °\ N - 601 amps to 1,000 amps 240.60 2 Address: "--'\, 1 Over 1,000 amps or volts 454.65 2 1 CO %poz_tc ` � �� Reconnect only 66.85 2 City/State /ZIP: �Jp l A-ANC 6\ _ 9,J 3 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 '4 - , N. r I' "„ " '#' ;� '''.e4 '' f' "'' " "a , . "ab'" `''' A . Fee for branch circuits with tr. , „, m ' r :� µ „ 4 3e ` { . 4 9,,1$0 tE:Rwxm1,,, 41, ---25 service or feeder fee, each 6.65 2 Business name: _ __ __ — v � branch circuit _, City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E mail: Signal circuit(s) or limited- ° „ zr � � "�`% a energy panel, alteration, or inkte.."r l� a iitimp iw n © 1„ C'`'i k '..: ; , a. v `�n ,a ,. , Irtl:�s' Page 2 // extension. Describe: 1 � 5 Business name: ,E.5".--) 4A ( ' ' , t 5 _ q9 ` Each additional inspection over allowable in any of the above Address: G �C) S.-c t -c_ & 62.50 7 l t�C ��� t , / f '1-' Per inspection City /State /ZIP: ()f kcoci! I( OK G .7 ) 0 Investigation per hour (1 hr mm) 62.50 7 J Industrial plant per hour 73.75 Phone: ��. ��' Fax: (�c 3 ) Z— 7 Sj / ?� qt r'` 1 "i fiaPtE�ES?si F Y, (✓c S ) ' Z� T /L am~ c T E MMil E,i0 TT .. - CCB Lic.: 73 b7 ' a/ , El le ectrical Lic.:�. z(�,q� Suprv. Lic.: z2$(a Subtotal �s (] Suprv. Electrician s tl�r8; requ — I ^ bG Plan review (25% of permit fee) State surcharge (8% of permit fee) ( ) Print name: Date: TOTAL PERMIT FEE SLOE) 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 Tn- County Building Industry Service Board '" Number of inspections per permit allowed. . is\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(101021COM/WEB Electrical Permit Application - City of Tigard Page 2 = Supplemental Information LIMITED ENERGY PERMIT FEES: W",0 s 0, 4, rCt GInix t5. `N 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: p 77 rn r '�"' +�i 'F- n�«aayu.2umN'i ' ]' �,�� 3 J 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 • Intercom and Pagmg systems ❑ Landscape Irrigation Control* n Medical n Nurse Calls I I Outdoor Landscape Lighting* ❑ Protective Signaling Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i.\Building \amits\ELC- PetmitApp doc 04/03 CITY OF TIGARD BUILDING DIVISION PERMIT # j %— lc� 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: Phone: (503) 639 -4171 ��a�l4 '� I Inspection Requests (24 Hrs.): (503) 639 -4175 ` ^ , n 1 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: ) Z Z -- P 1 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #W;D)7S0 C'9 CONTRACTOR: PHONE #: Inspection Request Scheduled For: *ate: 4 - 4, O6 Pour Time: �o`de�# , p Inspe • Description Con 'rm # Contact # Message / q 9 1/ V ' Fi.et- . P. , o_,.:, - _•..11 -nts /Instruction - • I I, .... OM fi r . '' .. ''*---) - PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: V "e `-'y Date: Li a Phon #: (503) 718 - �� CITY OF TIGARD • • EZW • BUILDING DIVISION PERMIT #:006 _ /e0 o 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 �?�� 41 Inspection Requests (24 Hrs.): (503) 639 -4175 " __.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: /. 0 76 - ft CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 -(0-0(2 Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: a . 1' PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL N CALL F R iNspEDTioN ❑ ADDITIONAL FEES ASSESSED Inspector: ►` Date: I II +) b Phone #: (503) 718- 2 414