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Permit a ' ��. .;� CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY >tl�l. DEVE H PMENq Tigard, � 639 -4171 DATE PERMIT E2/R15/020040377 SITE ADDRESS: 06665 SW HAMPTON ST 101 PARCEL: 2S101AD 00400 SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 034 JURISDICTION: TIG Project Description: Low voltage for 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: HAMPTON OAKS LLC HONEYWELL INC 6665 SW HAMPTON 15495 SW SEQUOIA 2ND FLOOR STE 100 TIGARD, OR 97223 PORTLAND, OR 97224 Phone: Phone: 968 - 3300 Reg #: SUP 941LEA LTC 150191 ELE 26- 207CLE APP. SAYS CF FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 12/15/2004 $75.00 Elect'I Final [ELPLCK] ELR Pln Rev 12/15/2004 $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 A,� 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 NOV -30 -2004 11 54 HONEYWELL 503 968 3398 P. 02/02 Electrical Permit .Ap 1 ti �. FOR OFrIcE City of 'i • , a rd 9•� a M Le DDate A Recved •, / y / �D Permit No.Q Q -- 0937 1 '-f 131 25 01 -L111 Blvd„ Tigard, OR 97223 Plan Review Other Permit ` Phone: 503.639.4171 Fax: 503.598,196 .J.0494-1- 03.598.1960 3 0 Fax "� +i Da tefsy: ®� e2 l/ 200 ' , �i El Se e PA c 2 for Inspection Line: 503.639.4175 Y.. D ate Ready/By: >; Notified/Method: I /�• Supplemental Inrormadon Internet: www.ci.tigard.or -us CITY OF TIGARD u - .•, , :i• >' -: I.�., _ .., ,. � .i <<..�:'r;" . . -. i .-' . •.. r - Q :,,. ..:I''- :, .1,,;.�h: - 11 :.'; ,'� j� -i.... ' .v ' ' P ' ,..fl 'p t� ,Qli 'l�� . TJf�3 • e ��1 . 7•il" rc "�SYr' :..( : i.'•..,.i r.. ... ,. . �.... � E New construction v❑ Addition /alteration/replacetnent Please check all that apply: ❑Service over 225 amps, cotnm'l ❑1- Iazardous location ❑ Demolition © Other: ❑ Service over 320 amps - rating ❑ Buildng over 10.000 sq. ft., , r, ,.,..:. : ,w :ur,a "✓:a+ n. :..�•._ ,., w,� s 4or Pt '� " Yn " ? ";'A`• t . r "ti ! � � .:!, i ii •' L:3a° �; °hh,frc'r.:! }i; t,.,..,::.. li dwellings ',!. , .n' ?: S' ra �f;! ^i'.l tt n„ , '1,S ': t ..t1:1: :, ••' - ?. I r. ; . r r , ..,._,....,'. o f 1- and 2-family B ..�:U,>• a:.:. l�i ,ii' .,.. y ��...,. ..•.,.,,.�����•S_i- : iC .�..;�.: - .:::: ; ' � ° � � ❑ 1- and 2- family dwelling U Commercial/industrial 0 Accessory building ❑System over 600 volts nominal units in one structure 1711uilding over three stories ['Feeders, 400 amps or more [] Multi- family ❑ Master builder 0 Other: F Occupant load over 99 persons ❑ Manufactured structures or y . ,e. t 1 e.:� r , � . f �..... Other ,„ ', "!:� j 4 a + "s ;:. r 'a* : i' 'i: G'. ess/li htin plan RV park r:,::, i. $?e �h ,i a S. "i :k' . :..,sl' P h, ❑l =� S gP p ;Np!K,;I iy 'ta - _;I +JU.u�;..iISdF �. tC .✓,�n e : "��"�I� -a. e,..l,1Xl, n�.:�ai ;r .. •I ,.•t`..i< . X24 0I 21 `l / W 0 g S IN o f t gi e , l D ❑Health care facility ❑Other: Job no.: Job site address: u 1 v I Submit 2 sets of plans with any of the above. City /State /ZIP: T.4 ire la/ i• The above are not applicable to temporary construction service. Project name ' g i t i tf Istli :i.:. rir.�! ,• , ` et.'!o _' .X'.. Suite/bldg./apt. r� �I Vl/�� l� , i l l Description Qty. ' . . ree. I Total •• Cross street/directions to job site: New residential single or multi- family dwelling unit. includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l_500 sq. #t. or portion 33.40 I Limited energy, residential 75.00 2 Tax map/parcel no.; • Limited energy, 75.00 2 rni non - residential +•` �: ?,: •P" :;;;;° .�. _- +F_Tr?.i.. i , u: ,�a...a,. "; V . i . ,q , :: 'G ! � ;I :. : .� , ;; ' i . ,p" Li C`�'i' ''t<�1 ,4,.. : -'' w E . §. '°i, .u. t; ,. �. , :;: Each manufactured or modular J:ht Jl �' f::; t' y: a: f� 24r. �. iir��r: IL'; iY := :>nh ^rYF:I� �� ,.� ....... �..�k ".'L"4��' "':`,'ai�RS;: °��: �, .�:k .,$. it;��:l ,l.i���a.:: " >.:1k� .�;'. dwellin•, service and /or feeder 90,90 2 4 � /� _•, _ . Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 Vift'- - rz ,w«.': :m,. ,�r_'.;,F,., 4 tEr'A ". ,Gri = ri , �:rr',, r „ „"ca!,' .. , _i•INi , {' aj i "'.`:.:r ::' 201 amps to 400 amps 106.85 2 ,;:.:�:: -;..,x .,.. .,•..�,.. " ...,0�'>��'�;��;:Q'�� ,,._�,.,,' a.S; . i. ,., .. , . +a;.....,..., ,..,..,..,'�I- . .... - h; 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 w Over 1,000, amps or volts _ 454,65 2 Address: Reconnect only 66 -s5 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 _ 2 intended for sale, lease, rent, or exchange, according to ORS 447, 4,49, 670, and 701. 401 amps to 600 amps 133.75 2 Owner Signature: Date: „ _ Branch circuits- new, alteration, or extension, per panel ,(. t a 9we: i 1 �' itg �' ' i. ° Fee for branch circuits with 'it<<' ” l :,' , �p�r+ .+ : ••• . :, ,' ;6 � 4 . lei t; C I RSI D, .; , • 1 . n ,1 ; " • , ,i a i .:r ='1' • � r. Milt' deeFaa. S: hr.:,p T. . •1:.': "' - : a. ..r..., ...,. r service or feeder fee, each 2 6.65 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46 -85 2 T each branch circuit Address: Each add'1 branch circuit _ 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) )~'ax: : ( ) J Sign or outline lighting 53,40 2 E circuits) or limited - .,',:.:.:!: :: , n ......,...- r'..:.: : :.: ;,t + ,;'. n.., ,' -'4 t . . energy panel, alteration, or 'egry a r, :�,� _ z1; '.. �:•.•.¢., S,.,i4.,. b • ��I :. ir .E� ,. : "'$�i'!.'_ .. .••• -SIC- '':`Ff 't`.::- '�il., ",� t YP Descr : '9i-.rr..., n.,� ti e:ct8tlston nbe 2 Business Page 2 usiness name: nV,^' )?A1 I ��p� n - 19 r V p O 4� VAN V Y 1� D 1! ach additional inspection over allowable in a ny of t he a bo ve Address: `-'�' 1 U per inspection 62.50 City /State /ZIP: i t Wl t OR "l1 Investigation per hour (1 hr min) 62,50 Phone: (F ?)) q 1 g, 53 D (0 Fax: ( ) R 1493-631 lradustrial plant pet hour 73.75 CCB Lie_: l5 0 ( I 1 Electrical Lie.: 2p - 245], (4 Suprv. Lie.: 614 } Subtotal 15 ` ; . ?,,, l --- plan review (25% of permit fee) Suprv. Electrician signature, required= �� - State surcharge (8% of permit fee) I Print name: --} { maYi1'L(/� Date! TOTAL PERMIT FEE [ Authorized signature: '_- This permit application expires if a permit is not obtained within 180 qA'�. , days after it has been accepted as complete Print Battle: , [A V Date: " Fee methodology set by Tri- County Building industry Service Board • • • Number of inspections per permit allowed. ..- •., _...,,..,,,,,,,,,,,,,< TOTAL P.02 CITY OF TIGARD 24 -Hour BUILDING nspeption Line: (503) 639 -4175 INSPECTION DIVISION Business Li,1 : (603) 639 -4171 MST BUP Received Date Req ested / � AM PM BUP Location ' / _ ,►rs�� • ! n Suite 1 c j MEC Contact Person Ph ( ) ?/,o $ - 353 PLM Contractor Ph ( ) SWR O N BUILDING Tenant/Owner 6- G ELC Footing C Foundation Access: ELR 3 77 Ft g Drain Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear (LA / & # /=_ .4g 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 P 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 WIT FAIL ;. Service Rough -In UG/Slab Low Voltage Fire Alarm ire • RT 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 " �- / I nspec t or ��� l Ext Other: Final DO NOT REMOVE this inspection record from the Jo site. PASS PART FAIL