Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00249
�.lill DATE ISSUED: 8/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101AB 01501
SITE ADDRESS: 07555 SW HERMOSO WAY 200 ZONING: MUE
SUBDIVISION: HERMOSO PARK LOT: 021 JURISDICTION: TIG
Project Description: Phones /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:
LIONEL LLC GUARDIAN SYSTEMS
7555 SW HERMOSO WAY 13500 SW PACIFIC HWY
TIGARD, OR 97223 STE 245
PORTLAND, OR 97223
Phone: 503- 620 -5203 Phone: 503- 639 -3723
Reg #: L1C 53683
ELE 34 -222CL
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/25/2005 $75.00
[TAX] 8% State Surcha 8/25/2005 $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: 114 ����'�� ✓, 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 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.
08/24/2005 15:41 FAX 5035981960 CITY OF TIGARD 2 0 o 1
•
, Electrical Permit Application • IOR orricE I til“)\1.1* '.., .
City of Tigard
. 4 IZ - -
411,,,
li C =1,W I El- NMI '-
Other Permit:
13125 SW Rail Blvd, Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 '1' Datc/B.
Inspection Line: 503.639.4175 ....q.41' 1..!_ Data Ready/By: ligil El See Page 2 for
Internet www.ci.tigard.or.us Notified/Method: Supplemental Information
lylii*E.***ORIC ' : ';'.:`: .. ...:.. , ?:''' 1 ■::!:11 1 k IZi,4 i ... ii,:‘ . iz!i....1 A , :\ , .., , :5 0
El New construction 0 Addition/alteration/replacement Please check all that apply. 1
L. o' other --T s..,,r T__ 44/1 VAL v. 1 0Service over 225 amps. comml 1:114arardous location
Demolition
['Service over 320 amps - rating a Baildng over 10,000 sq. ft.
:: • I ::', ' •• ': f;•:•: „‘ ::. :•-.•:••:•• : 411E16.0*Y.: oF•driP,OrRe01.13.N: :: : : '' ' :.1' .: ' ; '''. of 1- and 2-family dwellings 4 or more new residential
. .
0 1- and 2-family dwelling Commercial/industrial 0 Accessory building 0 System over 600 volts nominal units in one structure
['Building over three stones (=Feeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
. _. . . . , ,... ___,_. _.• . , . ,• .. • : 0 Occupant load over 99 persons ID Manu factured structures or
. :... , '!:roB SrFE EIFORMATION: AND: tiOCATID1!■I. ,,: . I: ,.:. , 7 : , °Egress/lighting plan RV park
Oflealth-care facility 12 Other.
Job no.: 7 Job site address: nSSS SU4 VI 6 0 6.ci \xi As\4
Submit 2 sets of plans with any of the above.
City/State/ZIP: - 1 - % Co /I g4 0 1Z-,, Cr1-2.2.-5 7...4:20 The above are not applicable to temporary construction service.
•• , Y.: S.:104:larlIOIM:.it!
SuiteJbldg./apt. no.: 2- 0 . 1 Project name: I'M vd G 143 S V. oCrTS
Dexertption Q I rft- 1 itid I -_,
Cross street/directions to job site: e- (3 rhrh . New residential sink- or multi-family dwelling unit.
Includes attached garage.
• 1,000 sq. ft or less 145.15 4
Subdivision: Lot no.: Ea, add'I 500 sq. It or portion 33.40 , 1
Limited energy, residential . 75.00 2
Tax map/parcel no.:
Limited energy. non-residential 75.00 2
.• .:• -: :, : .." .: '1' •'' ; " "f**E:30116* -.'..... .. ':: ' : ' :" ; . . :. . • : - Each manufactured or modular
Toil f'A ' dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps Or leSS 80.30 2
. .:--•:: •.: '_ .....n iikiii ‘...: .1 • • .. : , ,. , ., , 201 amps to 400 amps ,.. 106.85 2
401 amps to 600 amps 160.60. 2
Name: erik '< G g• AS5 . 1 2 . 0 0 r.s k co _
601 amps to 1,000 amps 240.60 2 .
_
Address: - 1555 sw V - NEfknig ft. tA-f4 4- 2.0-0 Over 1,000 amps or volts 454.65 2
Reconnect only 66,85 2
City/State/ZIP; . 1 k G Al2,4) 0 it_ . er17.2.3 Temporary services or feeders installation, alteration, anclior
ti
locaon
Phone: ( ) ------/----- Fax: ( ) relocatio
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 am ps 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
• • • • ,.... , _._ __ . . . .. , • r. . • • • ••
:. • •.•::. r ..!.1.. t ';:.., .:'" ' ... A. Fee for branch circuits with
. .
service or feeder kr, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee.
each branch circuit 46.85 2
Addrcss:
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 5340 2
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
' energy panel . alteration, or
extension. Describe: i Page 2 2
Business name: G u . az „ ry 5,: (1..1.
Address: \() SL y uc...z. c z... - c \_\ L, o t...A At a 45 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: ---- 002 c i esz„, Clag_ Investigation per hour (1 hr min) 62.50
Phone: (54 (63) - . -- 1 '...4 -\ I Fax: 6D3 ) ( sg . Industrial plant per hour 73.75
..:•:f•I' ...: 'ELECT R IOAL .miloterc.frats. - . .: ..... : -
CCB Lic.: 5 *. ( ..0 ( 6 3 Electrical Lie.: 'S LA - 2224 suprv. Lic.: 2 - 11 , - I LEA Subtotal
ovvv
Suprv. Electrician signature, required: .1 D 9, • -..9 '1 Plan review (25% of pamit fee)
r
Print name: `VD 4 12V.LL L. I 11 Est. Date: S115 \ o State surcharge (8% of permit fee) e f al
,
TOTAL PERMIT FEE y , 40
/ .
Authorized signalams: 'VD 0■AA-1&-t ..., - "? 1.1- 7116 permit application expires if a permit Is not obtalned within 1
Print name: 9:3 .4 t-l/L- ? 11 .--F- It_ I Date: Ti \ LS 1 0 c Fee met days after It has been accepted as complete
• hodology set by Tri-County Building Industry Service Board
•• Number of inspections per permit allowed
i:\haildinswermatUELC-Permitamtdoe 12103 4404615TO 0/01/COM/wee
i Y T R
C!T ■ OF ■ IGA. lD
BUILDING DIVISION PERMIT #: ELR2005 -00249
13125 SW Hall Blvd., Ti.-rd, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639 -4171 47410
�.�,
Inspection Requests (24 Hr : (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/7/2005 TIME: 7:00AM PAGE: 131
SITE ADDRESS: 07555 SW HER SO WAY 200 CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 021 TYPE OF USE:
PROJECT NAME: NW GRASSROOTS
DESCRIPTION: Phones/data.
OWNER: LIONEL LLC, PHONE #: 503 -620 -5203
CONTRACTOR: GUARDIAN SYSTEMS PHONE #: 503- 639.3723
Inspection Request Scheduled For: I : te: 9/7/2005 Pour Time:
Code # Inspection Description Con m # Contact # Message
135 Low voltage 015001 - 1 503 - 620-5203 Y
Corrections /Comments /Instructions: r 0 7k
C �� l� 7
i .
. .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ A ; L FOR INSP . TIC- n ADDITIONAL FEES ASSESSED
4 ,
�
g
Inspector: Date: I 7 �,j Phone #: (503) 718-