Permit 17 1 CITY O F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00470
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2007
PARCEL: 25101 AD -03100
SITE ADDRESS: 06950 SW HAMPTON ST 170 ZONING: MUE
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WEDDLE SURVEYING
Project Description: Voice and 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:
AMERICAN PROPERTY MANAGEMENT BROADWAY ELECTRIC - COCHRAN INC
PO BOX 12127 626 SE MAIN
PORTLAND, OR 97212 PORTLAND, OR 97214
Phone: 503- 284 -6133 Contact #: PRI 503- 234 -6564
FAX 503- 238 -2098
FEES Reg #: ELE 37 -546C
LIC 72942
Description Date Amount SUP 3447S
[ELPRMT] ELR Permit 12/18/2007 $75.00
[TAX] 8% State Surcha 12/18/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct qu.•ns to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ia � / , Permittee Signature: ' cce 1 !L
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
{
EleCtricali Permit Application _ r . • _ , `FOR OFFICE USE ONLY . .
City of Tigard Re c e i ved
13125 SW Hall Blvd., Tigard, OR 972 . DateB : a, , Sr D i Permit No: _ .2 oc 7 —occ/7U
Plan Review
Phone: 503.639.4171 Fax: '503.598.1960 1 �' D at � y: Other Permit:
Inspection Line: 503.639.4175 1 a (j ._i)L = -T� �� Date Red/By: Juris: ® See Page 2 for
IJ Notified/Method: � No Supplementallnformati
Internet: www on
.+.•�:;.y'w»r ate. �a.;�:- :. te, .3 - -
yr k:`.- - 'r' 4 . .R x:-
- ''sty � '�k_ ':,' � ` u . Tik - " 1=$' " r . - _ - -
:�:�w�k� - »��' - �e . ,'. _ ( ��,t..��jj .� � ;, _� • A _ � PI;AIY.�RP�•
❑.New construction ❑ t3 e a • i. n 1 t tJ �J _ :a w_ Please check all that apply:
❑ Demolition ❑ .
1h r. ['Service over 225 amps, comm'1 ['Hazardous location
-- `_,__ . #,,,_,,, ,. x 1 ,, n .. ,_;,,,, . £4 . ._. . Y ['Service over 320 amps - rating ❑Buildn over 10,000 sq. ft.,
rnP o g q�
, 'ry ',� k afib lftW &TRUCTIOIY y --. - 1 4 • °A ,-, of 1- and 2- family dwellings 4 or more new residential
I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
Multi-family DBuilding over three stories ['Feeders, 400 amps or more
El y ❑ Master builder ❑ Other:
�,� �_� _.. ,. DOccupant load over 99 persons ['Manufactured structures or
f l 3 ",� " ,70B34r13 I R�Z4TI 0 'Tl` _ „ .. ` lt,7* RV park
_ �... 4.�_r f• : •• - _ , __ '" L, • N C�';�tC�ly °_. � : ° � ° ❑Egress/lighting plan P
tD oo ❑other:
Job no.: Job site address: ❑Health care facility
6 54542 Q - �9Sa .Sl� (/} �Q�11 Submit 2 sets of plans with any of the above.
City/ State/ZIP: ` f v , 1 The above are not applicable to temporary construction service. ` fit U 1 • � ,, - I �' tv- 'rf ETA*: SCHED
Suite/bldg. /apt. no.: 170 Project name: We. Su ✓ vle y0hq -F'Y ) ' = . .' 1 *+
JJ Description Qty. Fm Total
Cross s 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
Tax map /parcel no,: •
Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
•_ .. i. �
_ t�;:.�," �.� Each manufactured or modular
\ rs l \ VO Cep 4 I ocafi\ (�-AS dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
•:
° i ? :a �, N -_snip 1 -? SWW o _'. ?, .. r,; . amps 0 trips 106.85 2
, ,. E"xPRQPER''l' UWAFER s '' ,-' �,< ----'' I�"F 4w '- " : 201 a s to 40 a
- _�-- y ----`-''''t°4--' ..,.,._.� t . �_ _..�. -. -� . ..., .,,_ -:.. 401 amps to 600 amps 1 60.60 2
Name: .601 amps to 1,000 amps 240.60 2
Address: . 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
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 I
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 • z . "- -EM- 0(i , .µ4 : Os \'t af-f P SON A. Fee for branch circuits with
TM .
- : - Ja , : - __� . ..- ...._ -_ -:d -:;r service or feeder fee, each
Business name: - branch circuit 6.65 2
Contact name: 'i v e . S (& C 1�� B. Fee for branch circuits
� - T without service or feeder fee,
Address: ` each branch circuit 46.85 2
Each add'l branch circuit 6.65 2
City/ State/ZIP: • Miscellaneous (service or feeder not included)
Phone: (91 1 ) 2...05 q -3,14 2 Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail:
s:'`. - -;, :'rtes; = „ .: ; - /n aa - _F.Y, :
=ks. Signalcircuit(s)
�c�_N -- :��y��:, >.°�. ;.' _( G” FOIY. �` sx��avi `��<pY��_.�� >- r.�: energy Panel, alteration, or
Business name: ` C ` k F_ extension. Describe: _. / Page -2 7S -- 2 •
Address: (, 2. co c) (✓ . A c. a \� Each additional inspection over allowable in any of the above
1 " Per inspection- 62.50
City/State/ZIP: c.s-k. c�� C)9.._ 4 - 2vt4 Investigation -per hour (1 hr min) 62 -50
' Phone: (5o3) 2_3({ _( t..i Fax: (9.3) Z ' % --2_o G S Industrial plant per hour 73.75
t Z, ;,. °:< ::-RW --- ;... 'CIRICALiP_ERiCiti i�ES =_"`,"..~ ,,
CCB Lic.: 7 2, Ct4 2. Electrical Lic.: 31 -' 'j , Suprv. Lic.: 3' '�- Subtotal 7 S^
•
Suprv. Electrician signature, required: . \I \ ' � - , ' Plan review (25% of permit fee)
Print name: �� Q��e___ \ c lll���� p aate: --- ���"CCC D i Z ,1 ( \ 01 State surcharge (8% of permit fee) j
c1 { 1 TOTAL PERMIT FEE ___g 1 ,----
AlrthorlZed Signature: This permit application expires if a permit is not obtained within 180
days after ithas been accepted as complete
Print name: Date: . Fee methodology set by Tri-County Building industry Service Board'
". Nnmt rr of incrwntinne nnr nnrrnit a unwed
CITY OF TIGARD
BUILDING DIVISION
4111k PERMIT #: ELR2007-00470
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12J1812007
Phone: (503) 639-4171 X H it
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1212012007 TIME: 7:01A1v1 PAGE: 47
SITE ADDRESS: 06950 SW HAMPTON ST 170 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: V1EDDLE SURVEYING
DESCRIPTION: Voice and data
OWNER: AMERICAN PROPERTY MANAGEMENT, PHONE #: 603-204-6133
CONTRACTOR: BROADWAY ELECTRIC-COCHRAN INC . PHONE #: f5O323'i-6M
Inspection Request Scheduled For: Date: 12/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 061907-01 503-310-3438
Correcti ns/Comments/Instructions:
A \
Jr/
PASS 0 PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: ()e) Date: 2 _J2. 4 O1 Phone #: (503) 718- 2-44\c,