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Permit ELECTRICAL PERMIT - CITY TIGARD RESTRICTED ENERGY ;E41I DEVELOPMENT r S S E RVICES Q 639 -4171 DATE ISSUED: ED: E2 28/ 13125 SITE ADDRESS: 10215 SW HALL BLVD PARCEL: 1S135AA -01400 SUBDIVISION: METZGER ACRE TRACTS ZONING: C -N BLOCK: LOT: 037 JURISDICTION: TIG Project Description: 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: INTEGUMEND OREGON HEATING +AIR COND 10215 SW HALL BLVD PO BOX 397 TIGARD, OR 97223 DUNDEE, OR 97115 Phone: 503- 245 -2415 Phone: 503 -538 -2953 Reg #: ELE 522LHR LIC 125815 FEES Required Inspections Description Date Amount Low Voltage Inspection • [ELPRMT] ELR Permit 12/28/2004 $75.00 Elect'I Final [TAX] 8% State Surchart 12/28/2004 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. Issued by Permittee Signature s e . C )) OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day Dec 27 04 01:37p 503 - 537 -2172 p.1 ■., rr • Electrical Permit Application . OFFICE 1.LSE ONI • Date received: - i' / Permit no.:(.,6 _ // f y t ,,,�'jl City of Tigard 3 Project /appl. no.: 1 Expire date: City of Tigard � Address: 13 125 SW Hall BI vd 6l l$ Date issued: By: Receipt no,: Phone: (503) 639 -4171 Fax: (503) 598 -1960 iOEC 21 2004 Case file no.: ( ii Payment type: Land use approval: . 11 . P1.: OF' PERMIT . 7," / . , W ❑ 1 & 2 family dwelling or accessory • • ercia /in. ustrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration /replacement ❑ Other: CJ Partial JOH SITE INFORMATION . Job address: 16;a1 ... s.,I.j Q Q X31 l pldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: I Subdivision: Project name: • �v !Description and location of work on premises: Ii l( Pt Estimated date of comp1 lowinspection: CONTRACTOR APPLICATION FEE SCIIEDCI.E Job no: ^ il t� Fee Max Business name: ()Reagan 1-)( - 1(`(j fl( , l (� T' !� Descriptio Qty. (ea.) Total no. insp J New residential - single or multi -family per Address: P[� X Q� dwell ingunit -lnclodesaitachedgarage. City: • __A •' State: i� ZIP: r' l 1 j Serviceincluded: Phone: 5 3T_D_Cl 1- Fax: 337_.) t E -mail: 1000 sq. ft. or less 4 CCB no.: i.... S" I Elec_ bus. lie, no: Each additional 500 sq. R. or portion thereof Limited energy, residential 2 City/m a .C_ no. LI cta ^�-- Limited energy, non - residential 2 - _ Each manufactured home or modular dwelling 2 lSignaiur i sup - ing electrician (required) Date Service and/or feeder Sup. elect. name (print): lice, a vi, License no: - per'talt Services or feeders installation, alteration or relocation: PROPERTY OWNER 200 amps or Less 2 Name (print): . R Q d sa i 201 amps to 400 amps 2 m 401 a. to 600 amps 2 Mailing address: 1 C 1 t <: 1 ku k Q . I xl 1 601 amps to 1000 amps 2 City: 1-193-1q tate: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: 1 E -mail: Reconnect only I Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to In stalk* ion,a Iteration, orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's si:nature: Date: 401 to 600 amps I 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of - Address: service or feeder fee, each branch circuit 2 City: 1 State: [ ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: . PLAN REVIEW (Please cheek all that apply) • Misc. (Service or feeder not included): U Service over 225 amps - commercial U Health -care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1 &2 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, i r U U System over 600 volts nominal more residential units in one structure alteration, or extension* s r � 2 U Building over three stories Q Feeders, 400 amps or more *Description: i-rP- U Occupant load over 99 persons U Manufactured structures or RV park Each additional inspection over the allowable in any of the above: U Egress/lighting plan U Other: Per inspection I I I I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not ell jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ .TS.Gt -) U Visa Cl MasterCard expires if a permit is not obtained Plan review (at _ ° /r) $ Credit curd number: _..../ _1 ____ within 180 days after it has been State surcharge (8%) $ - I txpiror p complete. $ Q accepted as com fete. Nnmo of cardholder a shoavn on credit carrl S — --- .. Card older my,natnrc - - - ----- - — Amount 440 (6 /00 /COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Ole: (S93) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested — D AM PM BUP Location b a 1 5 Suite MEC Contact Person Ph ( ) PLM Contractor ' _— Ph ( ) 9- Ft SWR BUILDING Tenant/Owner 4LC Footing Foundation Access: ELC Ftg Drain R ,;?Oo e - ez 5 --- Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING P 4 4/ 4 ost & 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 Anal o C I Q f c S P FAIL CT A- Service Rough-In ( LC CP g 4 % 1 =4 UG /Slab ti K c7 o ..,,, .o a. Fire Aa PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date P. `- 9 -05" Inspector . _ - Ext Other: Final DO NOT REMOVE this inspection record from the job su = . PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line:. (503) 639 -4175 INSPECTION DIVISION Business Line: ,= (503)`639 -4171 MST BUP Received / Date Requested ( — 7 AM PM BUP / Location - / S / Suite MEC I Contact Person Ph ( ) PLM Contractor Ph ( ) - S a7S 7 SWR BUILDING Tenant/Owner _L_ ELC Footing ELC Foundation Acces , Ftg Drain � / = F/ - T ? S 1 EL R c � O �6 Crawl Drain � Slab Inspection Notes: SIT Post & Beam Shear Anchors T ' 1 Ext Sheath /Shear �� �7 Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 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 ELECTRICAL Service •ug -n U U ab Low Voltage Fire Alarm Fi Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. (PASPART FAIL SITE Please call for reinspection RE: • Unable to inspect – no access Fire Supply Line ADA — .0 1 Approach/Sidewalk Dat e - 7 ©3 Inspector / 'r' Ext Other: Final DO NOT REMOVE this inspection record from the Jo site. PASS PART FAIL