Permit :_,,_ ,,.
44,, CITY OF TIGARD
�,L,e��,�,j DEVELOPMENT SERVICES RESTRICTED ENERGY
PERMIT #: ELR98 -0107
DATE ISSUED: 04/16/98
PARCEL: 2S1O1AC -01400
SITE ADDRESS...:O7125 SW HAMPTON ST
SUBDIVISION °BEVELAND NO. 2 ZONING:MUE
BLOCK • LOT °020 JURISDICTN: TIG
Project Description : Installation of signal circuit or limited engery panel.
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 • PROTECTIVE SIGNAL..:X
INSTRUMENTATION.: OTHER..: •.
TOTAL # OF SYSTEMS: 1
Owner: FEES
EQUITY GROUP type amount by date recpt
7125 SW HAMPTON STREET PRMT $ 40.00 DEB 04/16/98 98- 304993
TIGARD OR 97223 SPCT $ E.O0 DEB 04/16/98 98- 304993
Phone #:
Contractor:
MATRIX COMMUNICATIONS $ 42.00 TOTAL
4243 SE INTERNATIONAL WY
STE C REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Low Voltage Insp
Phone #: 654 -3000 Wall Cover Elect'1 Final
Reg #..: 000743
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952- 001 -0080. You may obtain copies of
these rules t' ect questions to OUNC at (503)246 -1987. /� /�
Issued y ,� - �,,s.., AI _.. •♦ A i1 . P e r m i t t e e S i g n a t �_� r e, j.0e,c �(!.v,{/ AE/ -
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
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
06/17/97 11:49 $503 684 7297 CITY OF TIGARD I j002 /002
,-
CITY OF TIGARD Ele tt� �i i permit Application Plan Oh -.- r
13125 SW HALL BLVD. RECEI�3 Recd B 71 r 407 _,'_
TIGARD OR 97223 �� Date Recd
Phone (503) 639 4171, x304 APR 1 G 1998 V Date to P.E.
Inspection (503) 633-4175 Print or Type Date to DST
Inetal te�oti wi ll not b accepted Permit # 61-2 9( -C/D7
Fax (503) 6S4 -7297 p g A Called
1 Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) L U •� (J "5?'U Service Included: Items Cost Sum
Address Sl O Ha Yvp } i-Th 4a. Residential - per unit
- 1000 sq. ft_ or less $110.00
City /State/Zip - 1 ►� O i� 4
Each additional 500 sq, ft. or
Commercia? Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
D elling Service.or Foerar - 563.00 2
2a. Contractor installation only:
(Attach Copy of all current Ilcen . es) 4b. Services or Feeders
Electrical Contractor it /ml _J ,,r Linfa L r / Installation, alteration, or relocation
Address • 1, L 0- � i J 200 amps or less 560.00 2
201 amps to 4-00 amps 580.00 2
City * 1_-1 State OR, Zip 9 o a 401 amps to 600 amps 5120.00 2
Phone No. c0= - 513- 9 r .3 601 amps to 1000 amps $190.00 2
Job No. .. a I l-I -00 t. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. alp % +i -Gal- Exp.Date 1 --1 -9 • Reconnect only $50.00 2
OR State COB Reg. No,_ 3a. Exp.Date 140 -a9 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alleratlon or relocation
ate, 200 amps or less $50.00 2
Signature of Supr. Elec'n _, _ i ce- .-4 201 amps to 400 amps $75.00 2
401 amps to 600 amps 5100.00 2
I _ !�� - f - ` Over 600 amps to 1000 volts.
License No. Exp.Date JO - I -99 see `b' above.
Phone No. 0�-- 5 i 3_q) CIS
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owners Name feeder fee.
Address Each branch circuit $5.00 2
b) The tee for branch circuits
City State Zp• ---- without purchase of
Phone No. service or feeder fee.
First branch circuit 535.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e Miscellaneous
(Searvice or is wr nol kxauded) .
Owner's Signature Each pump or irrigation circle 540.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required) :* Signal circuits) or a limited energy ! I n
panel, alteration or extension l $40.00 1 a ,c 2
Minor Labels (10) 5100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential unite in one structure 41. Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour S55.00
as described In N.E.C. Chapter 5 In Plant $55,00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: _ /�
Not required for temporary construction services. 5a. Enter total of above tees $ �f
5% Surcharge (.05 X total fees) s 2
NOTICE • Subtotal $ _
5b. Enter 25% of line Sa for
• PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reaulred (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IP CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # .V L
Total balance Due s __F_L�,
L1DSTS1ELCBBAPP Roy was
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location .--- I - a %nri Suite MEC
Contact Person Ph PLM
Contractor R,4 A �c' Ph (AS Y jccv SWR
BUILDING Tenant/Owner & �'C.t.t ELC _
Retaining Wall J) ELR (e
Footing Access:
Foundation it FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab �f,2E �G /9,f SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ^�
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer •
Rain Drains
Final
PASS PART FAIL
MECHANICAL
•
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS- - 'PART FAIL
/ E � LECTRICAL .
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fina
PART FAIL
E a.
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other ��� �
Other Date 3 - S 9 Inspector Ext
Final
PASS PART FAIL - DO NOT REMOVE this inspection record from the job site.