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Permit } ' CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT AIL SERVICES PERMIT #: ELR2005 - 00083 ��1�I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/11/2005 PARCEL: 25101 BD -00103 SITE ADDRESS: 07895 SW HUNZIKER RD ZONING: I -L SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Additional security. 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: Contractor: H G M CO SONITROL PACIFIC BY NORRIS BEGGS + SIMPSON 8220 N. INTERSTATE AVE. ATTN: BLAKE HERING PORTLAND, OR 97217 PORTLAND, OR 97204 Phone: Phone: 223 - 5822 Reg #: LIC 53535 ELE 26- 370CLE FEES SUP 4045LEA Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 4/11/2005 $75.00 [TAX] 8% State Surcha 4/11/2005 $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: Permittee Signature: _ S.t `'y\IR,Q 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. "P1ectriNa,1 Permit Applic �� ' � � ' o. ' � k � t� `•a b /L FOR O FFICE . U S E O 4 � CE , :,,,„, ` .. ,.,, �,d� .„.„. ,„„,,t cgs ,. -,ris „Nt,„ , „ _.�. -A -k h i _, E. `3 s 1a ' , City of Tigard , na ` %/ — if eis t- ' � O� 3 `7� Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 APR ( ' Date/B : Other Permit: Inspection Line: 503.639.4175 ' r,-,, " a '' Ilk Date Read /B 0 See Pa e 2 for C ITY - - ,�d. y y g Internet: www.ci.tigard.or.us OF TIGARD Notified/Method: Supplemental Information [�� r i w " `•�I � : >Ri; VIE � - r A ° RE ' TT'EO' -a. ❑ New construction Addition/alteration/replacement Please check all that apply 1:1 Demolition 1:1 Other: ❑Service over 225 amps, comm'l ❑ Hazardous location Service over 320 amps rating Buildng over 10,000 sq. ft., :...; ' a n :. ,w , :;,. l ts'1,F, , : -4 ; ` of 1 d 2-family dwellings #r,,, - �, ; CA; TEGORY� „OFn�CONS,TRLI,G'T'TON',`� � - '`�i; ",� y 4 or more new residential ” �9M. e."' i2ij;= �- x}:_"-'= v`,. �i. �i�.<'..` 5.::< ��^. Y�,. fi:s',: 2'. ?:•9-.:;,,.�,'s'. _: -,v:, :ro:..c;. `T. ^ ^w,'�" :<.^: ;r,.P+Z°.k2'fi'�':,',- ".^. " "�4; "..... �. z :ds .� . ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure [—_] Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons ['Manufactured structures or .., `w .. , ~JOB, " ,.. ORM T�OI - '1 , ZOCATIO ` ' s F r i ❑Egress /lighting plan RV park a3(a - 35l 1g95 3 W — N i ❑Health -care facility ❑Other: Job no.: J ob site address: In �1C� Submit Z sets of plans with any of the above. City /State /ZIP: - 1 -- V G}a Q t Cry CI---1 -�3 The above are not applicable to temporary construction service. reN Suite/bldg. /apt. no.: Project name: r— ' �-'o^_Dt t4••''''''''-'114114:''''''''''14,;: 5'''FEE E:� :: \ Q--b ∎ - -PQ 1 y--' Description Q ty. Fee. Total Cross street/directions to job site: V 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 Limited energy, residential 75.00 2 • Tax map /parcel 110.: e non-residential 2 n}N Limite energy, n �de 1 75.00 = ;eF'��'�,.�- :,,;rte}; {�:: . - . ` "�,,. ��.,,�.� - - :,,�,,�•;;� , - �;;��.�.•, =a�: . :1 , 1 , .•, , . , q ; DESCRRIPTION ,OF WORK 5 u ' " 1 ° -; ,; Each manufactured or modular dwelling, service and /or feeder 90.90 2 ' f .AC _ViA r ` (&x 6 ∎ - Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 s :- - _,,:; a :. 4 , ,, :„ :. rr-,, ,', 201 amps to 400 amps 106.85 2 '1, ' ; ., PROPE OWNER ', '.,� x w,:- i s © ENAN ' r ,:• : t� '� • • -� ' " -- -- °�" "�'� °-� -- -" T . ry ° � , 401 am to 600 amps 160.60 2 Name: Q \ (`,LL \��1 V'ley — -Ss G- \ G -y0 1 (—(-0_, 601 amps to 1,000 amps 240.60 2 Address: \ T.\ r \S �1 S - ° Over 1,000 amps or volts 454.65 Z /a ( Reconnect only 66.85 2 City /State /ZIP: P t�Y�C� \C_ l c 5 97 a( - \ 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 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 ' " ; : 't ® b5NTACT' PER SON" ° A. Fee for branch circuits with P , - _. �: iAPPLICANT , .- _ 1 ` ': a ,,.. ,,, ,n. _ n.=-. .. ,. _ ,, o u. service or feeder fee, 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 Address: Each add'l branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 . 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - aL.: , .:aF: CON = - GTOR ? .;; '' ;V ` `r" energy panel, alteration, or 'b extension. Describe: 1 Page 2 5 --e 2 Business name: 5� .� - r - O\ VacjA Q L i Address: aaC � ``�11ti S-`k-e�� Each additional inspection over allowable in any of the above Q 11� Per inspection 62.50 City /State /ZIP: V a4_ \ C,Ck ` 0 8R._ -l x4_91 Investigation per hour (1 hr min) - 62.50 Phone: (563) J3._ ga., Fax: ( ) qt- - 3 Industrial plant per hour 73.75 `;" ` .0,q ^EI;'1 1nb( :1 : :t041T= FLEES 17 : CCB Lie.: 5 2, 3 5 Electrical Lie.: a( _ 31 \Suprv. Lie.: Lic.:Lipti5Lidi Subtotal ri5 , (.... • • Suprv. Electrician signature, required: , i ' Plan review (25% of permit fee) ,lets � A Ad l • Print name: - k A ' ` 11 , Dated 1 �� ( State surcharge (8% of permit fee) U ■ TOTAL PERtMIT FEE 1, (s'_ Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: ' Fee methodology set by Tri- County Building Industry Service Board " Number of inspections per permit allowed. C r\ Building\ Permits\ELC-PermitApp.doc 12/03 440 4615T( /02 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: §71b7 I 'T][AL WOE ONLY ,,. ..: _ . „ , _ . ,1 Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* - ❑ Vacuum Systems* [l Other: T EM ' d cr:: ' ,`airs . Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) • Check Type of Work Involved: [ Audio and Stereo Systems ❑ • Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation Ti Fire Alarm Installation [� HVAC Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* Medical ❑ Nurse Calls Outdoor Landscape Lighting* E Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations t.\ Building \Pcrmits\ELC- PetmitApp.dac 04/03 CITY OF TIGARD � BUILDING DIVISION PERMIT #: ELR200 � 00083 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4!1'1!2005 Phone: (503) 639 -4171 / "��W�uypugff li' Inspection Requests (24 Hrs.): (503) 639 -4175 _. ' INSPECTION WORKSHEET FOR DATE: 6/15/2005 TIME: 7:16AM PAGE: 110 SITE ADDRESS: 07895 SW HUNZIKER RD CLASS OF WORK: ' SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MERGENTHALER TRANSFER DESCRIPTION: Additional security. OWNER: H 0 M CO, PHONE #: CONTRACTOR: SONITROL PACIFIC PHONE #: 223 -5822 Inspection Request Scheduled For: Date: 6/1512005 Pour Time: Code # Inspection Description - Confirm # Contact # Message 199 Electrical final 009245 -01 5032235822 Y Corrections /Comments /Instructions: V , 3 k. 7 I V) (.1 � PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -./ Inspector: - Date: C ` /5 j ✓ 6 Phone #: (503) 718 -