Permit ciTY OF TIGARD ELECTRICAL ENERGY
-
RESTRICTED ENERGY
��F� DEVELOPMENT H BMENT r S o ERV SERVICES (503) 639 -4171 DATE ISSUED: E �R10 -00289
13125 SITE ADDRESS: 11465 SW PACIFIC HWY PARCEL: 1SI36AD -05800
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage.Tank level system wiring.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: TANK WIRE X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUILON ENTERPRISES LLC BOYLES ELECTRIC, INC.
PO BOX 4453 P.O. BOX 1227
HOUSTON, TX 77221 BORING, OR 97009
Phone: Phone: 503 668 - 7440 -
Reg #: LIC 137002
ELE 3 -465C
SUP 3404 -S
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 12/11/02 $75.00 Elect'I Final
rm
[ELPLCK] ELR Pln Rev 12/11/02 $18.75
[TAX] 8% State Tax 12/11/02 $6.00
Total $99.75
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 b y / Permittee Si nature . /
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 in-\ (,'C /p.& (sac DATE:
LICENSE NO: at/DsiS
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
� �.. r I
E l e c t r i c a l P e r m i t Application t I I I I I I I . I t t\ I 1
RECEIVED Date received: ., • Pennit no.: `D 9
4 -I City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Date issued: By: Receipt no.:
Phone: (503) 639 -4171 DEC 1 U 2002
Fax: (503) 598 -1960 Case file no.: Payment type:
CITY OF TIGARD
Land use approval:
O 1 & 2 family dwelling or accessory Commercial/industrial O Multi - family D Tenant improvement
O New construction U Addition/alteration/replacement O Other: O Partial
Job address: i i y b5 S In/ 4.G1 rt'c 144.4 4 Bldg. no.: - Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: I Description and location of work on premises: 7444K Le r ,� f , Le act S -- LdI M $
Estimated date of completion/inspection: a
( 0\ I It \( 1012 \ 1 ' 1 ' 1 . 1 ( \ 11O\ 1 1 t: .( III:I)I 1.1 :
Job no: ()a. — . j,3 i Fee Max
Business name: (.- p S (= 1.e C t V' , L � 1'. C_ __ Qty. (ea.) Total to. hasp
New residential .singleor
Address: P . t : _ X Ia3� m ddW uld .Ioehdee�ch
aedgarage.�
City: � ONc , r I StateCS K I ZIP: - 4Q 0 q Servirehsc b
Phone: ( s..3-440.--) I Fax: ( •'3{,isi E -mail: woo sq. ft. or less 4
C 3` (44,s L Each additional 500 sq. R or portion thereof
CB no.: i
�-Q oO a Elec. bus. lic. no:
d Limited energy, residential 2
City i1i - tro lic. • .: ( of Limited energy, non- residential 2
,P r7 e i . I ) .0 Each manufactured home or modular dwelling
Si:1 of : • - electrician (required) Date Service and/or feeder 2
S elect. name (print) 01,,k vi L D F s License no: l 04 s Services or feeders — installation,
alteration or relocation:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's si i ature: Date: 401 to 600 :,.... 2
11 (: I \ 1:1 •:12 Branch dreaits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: 1 ZIP: B. For for branch circuits without purchase
of service or feeder fee, first branch circuit 2
Phone: Fax: E -mail: Each additional branch circuit
I'L \\ Hl 't 111% I1'Ica'e chech all ih:it :Iplil, I Misc. (Service or feeder not included):
O Service over 225 amps-commercial 0 Health-care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 18.2 0 Hazardous location Each sign or outline lighting 2
family dwellings O !Nulling over 10,000 square feet fora or Signal circuit(s) or a limited energy panel. I B
O Systmr over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building Over time stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV patio Each addhiomd inspection over the allowable in any of the above:
O Egress/lighting plan O Other:
Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee V$ S.°°
0 Visa O MasterCard expires if a permit is not obtained Plan review (at c a,c %Y$ I Ii• 3 S
Credit card number: / / within 180 days after it has been State surcharge (8 %) ' $ 6.00
Expires accepted as complete.
TOTAL $ ( eq. - ��
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440.4615 (6/00/COM)
.
, o ` •. . - r
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
- i y
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Number of Inspections per permit allowed Restricted Energy E „. $75.00
(FOR ALL SYSTEMS)
Service Included: Items Cost Total 4, chedk,Type of Work Involved:
Residential - per unit I , +- :1 s — 1%,
1000 sq. ft. or less $145.15 4 ' r I: ®r' 1. Aiidb and Stereo Systems'
Each additional 500 sq. ft. or
portion thereof $33.40 1 Bur lac Alarm
Limited Energy $75.00 ❑ 9
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener
Services or Feeders •
Installation, alteration, or relocation ❑ Heating, Ventilation and Air Conditioning System'
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems' '
401 amps to 600 amps $160.60 2
• 601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
Reconnect only $68.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system ... $75.00
200 amps or less $68.85 2 (SEE OAR 918- 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved: •
Over 600 amps to 1000volts,
- ---
see "b" above. ❑ Audio and Stereo Systems
Branch Circuits .
New, alteration or extension per panel ❑ Boiler Controls
a) The fee for branch dre uIts - -
with purchase of service or - 0 Clock Systems .
feeder fee. -
Each branch circuit . $6.65 2 ❑
b) The fee for branch circuits Data Telecommunication Installation
without purchase of service
• or feeder fee. ❑ Alarm Fire Ala Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous
(ice or feeder not included) ❑ Instrumentation
Each pump or irrigation code $53.40 Paging S
Each sign or outline lighting • $53.40 ED Intercom and ag ng ys terns
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control*
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical •
the allowable in any of the above
Per inspection $62.50 ❑ Nurse Cans
Per hour $82.50 .
In Plant $73.75 ❑ Outdoor Landscape Lighting'
Fees:
❑ Protective Signaling
•
Enter total of above fees $ ❑ Other
8% Slate Surcharge $
Number of Systems
25% Plan Review Fee
See 'Plan Reviev'section on $ • No licenses we required. Licenses are required for all other Installations
front of application:
Fees:
Total Balance Due $ . ,
Enter total of above fees $
❑ Trust Account i 8% State Surcharge $
All New Commercial Buildings require 2 sets of plans. Total Balance Due $
i Ndsts\forms\cic- fees.doc 02/05/02 •
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'BOYLES ELECTRIC, INC.
� John Boyles Office: 503- 668 -740 PO BOX 1227
Electrical Contractor Fax: 503- 668 -7615 Boring OR 97009
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. CITY OF TIGARD
(.'- !:Y Approved
: *'; : :. ' work as described
Se:: Letter to: Follow
Attach �'
Job Address: 0 , [ I:
BY _CLAf.4 rn 's � ty m ate: / a —i1 --eS