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Permit CITY OF T I G A R D ELECTRICAL PERMIT - RESTRICTED ENERGY � DEVELOPMENT I Tigard, ACES 639 -4171 DATE RMII #: : ELR 19 200 00194 SITE ADDRESS: 08015 SW HUNZIKER ST PARCEL: 2S101 BD -00300 SUBDIVISION: ZONING: I -L BLOCK: LOT: JURISDICTION: TIG Proiect Description: Installation of voice & data cabling. Job #23052 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: LOSLI, E HOWARD TRUSTEE AND NETVERSANT CASCADES INC SEABROOKE, CAROL ET AL 9020 SW GEMINI DRIVE BY PERFORMANCE CONTRACTING, IN BEAVERTON, OR 97008 CHARLOTTE, NC 28217 Phone: Phone: 503 - 646 -0533 Reg #: ELE 34- 258CLE LIC 47238 SUP 2867JLE FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 07/19/2001 $75.00 2720010000 Elect'l Final Elect'I Final 5PCT CTR 07/19/2001 $6.00 2720010000 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 - 00180. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Issued by AC, � / .' Permittee Signature /2/ & '/7 7)j 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: Cc - DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day L1l °� : Electrical Permit Application • Date received: I AM_ .i/ /�.., -O(� 1 14 \ Project/appl. no_: Expire date: �. —.,ir City of Tigard ' = - 2 23 Dntelasued; Receiptno.: Ciry ofTigard Address: 13125 SW Ha Blvd, Tig Phone: (503) 63941 Case file no.: Payment type: Fax: (503) 598 -1960 Land use approval: T1i 1'E 01: 1'ERhI1T S Commercia1Jindustrial 0 Multi- family CI Tenant improvement 0 1 2 ns try dwelling or accessory Addition/alteration/replacement CI Other- 0 Partial Q Nee w constnrction JOB SITE 1NhOKfhl IA 1'ION 1 - c I. Bldg. no.: Suite no.: Tax map/tax lot/account no.: Job address: $Q � S.4AJ - t Lot: Block: Subdivision: � - Project name: t r i Milt. l rLl'1r om. Description and location of work on premises: v al ae -r Estimated date of completion/inspection: LEE SCHEDULE I:ON R APPLICATION Fee Job not 230.52. patct4ption El (sue.) Toil 11EN Business name: A) ETV Ir g.WytT- • av • – Sew residential- sdnglcor id family per warn( ri1 t�fz -i to dwellittgudt.loeludeasttached Address: I • SrJ Service included: s City: �� u • p r--) State: d ZIP: q 76 ei ' 1000 sq- ft or less Fax: (o to U / 3 ''' Each ad dition al 500 sq. ft. or portion thereof ii phone:503. i 'go .as--3, 3 _ CCB no.: 0 0 q 12 3 Elec. bus. lie. no: ZSSC C� Limited energy, residential __ 2 Idmit energy, red hom or non-residential modular dwelling E■ WWII Signature of su.ervising electrician (required) � U t /metro ISC. no.: 0003.S3 tl 1 Each manufactured home or _ -' D ale ( Service and/or feeder 2 i re d l �$c _ rv'[ces orfeeders– installation. Ii ____________ lteratioe or relocation: PROPI :itTY OWNER 200 amps or less 201 amps to 400 amps 2 Name g address: s: ��' C WO; S Sit tit 401 amps to 600 amps relMiumMilinim © Mailing address: 601 amps to 1000 amps EZMIMIIMIIIMMI Suite: ZIP: Over 1000 amps or volts 1 phone: lO8 3 Owner e I own Temporary service: or feeders - . 11 Owner installation: The installation is being made on property Installation. alteration, or relocation: 2 which is not intended for sale, [case. rent, or exchange according to 200 amps or let's 2 ORS 4-47. 455, 479, 670, 701_ 201 amps to 400 amps 2 MENEM Date: — 401 to 600 are • s Owners signature: _ — — Branch circuits - new, alteration, hN(: INLh:R or extension per panel: A. Fee for branch circuits with purchase of 11 service or feeder fee, each branch circuit __ . �ddtess: Fax: B. Fee for branch circuits without purchase 2 Stale:' o f service or feeder fee, first branch circuit ■ Each additional branch circuit: � 2 Phone: Misc. (Service or feeder not Included): . !'LAN REVIEW (Please check all that apply) �� family CI Service over 225 amps-commercial CI Haaltht �ch,unipor irrigation circle .� arefoeitity s ratingof l&2 0 Hazardous location CI ami ly y z over 320 amp Signal circuit(s) or a limited energy panel. 75.6. 2 dwellings CI Buildinaover10 ,000squaro feet or r - O System over 600 volts nominal more residential units In one structure a1 rra CI Building over three stories CI Fectlerx 400 amps or more +Descri . lion: _ o Occupant toad over 99 persons CI Manufactured structures or RV park Each additional inspection over the allowable Inn any f� above: Other Per inspection CI 0 Egress/lightingpl� Submit — sets of plans olds any of the above. Other The above are not applicable to temporary construction service. Per $ – __1§_15:2,____. mit fee N • nu Jurisdictions aceepl aunt unit please call j"dedC On for mace 'domelike- Nodce: This permit application Plan I t fee (at _ %) $ -- O expires if a permit is not obtained State surcharge (8%) .. -- $ Visa O M di and C / 01 / 01 within 180 days after is has been S to sur $ l$ . O t card ndm el PI - Ot7Q(1- ��ZQ 3�LI - Expires accepted as complete. warn t.. eat d o $ 440 -4615 (Mar /COM) ante of cardholder as shown on credit card 81. �� J� � p�r� pr!r'elre - , Amount CITY OF BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested �� AM PM BLD Location 6 C Sw /4k -r��1 Ice"- 0 /�"c � Suite . MEC Contact Person 6 l u. Ph '7f 3_ c ( 6 75 PLM / v r Contractor Mel � Sq el Ph SWR Tenant/Owner P.,4 u C 5 ELC Retaining Wall ELR ZU / — ( 4 - ) / Cf Footing Access: l Foundation FPS Ftg Drain SGN Slab Crawl Drain Inspection Notes: 40410 °- ac ( q I e__ 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 :c'r . p Post & Beam Under Slab �l� / — Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL _¢s :; ° y , Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ' Service Rough In ow Volta ire arm • S AS S PART FAIL 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 2 �9 / Other Date ///������11 ((�% Inspector Gr Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.