Permit . A CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00218
bJllj� DEVELOPMENT H BMEN9 Tigard, -639 -4171 DATE ISSUED: 8/3/2005
PARCEL: 1S136AD-04000
SITE ADDRESS: 11525 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: VILLA RIDGE LOT: 007 JURISDICTION: TIG
Project Description: Voice and Data wiring.
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:
SMITH, EDITA M ESP TECHNOLOGIES
833 NW 170TH DR 7929 SW BURNS WAY STE. F
BEAVERTON, OR 97006 WILSONVILLE, OR 97070
Phone: Phone: 503 628 - 4195
• Reg #: LIC 73872
ELE 34- 269CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/3/2005 $75.00
[TAX] 8% State Surchart 8/3/2005 $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 95 - 001 -0100. You may obtain copies of these rules or direct OUNC t 50 - 246 -6699.
Issued By: `' Permittee Signature:/'(• LJ
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.
,L\\
Electrical Perm . ! o _ . . ' . c FOR OFFICE USE ONLY
_. 1 Received Pet No.:
City of Tigard Date/B : 05 �j � r l. _i0 — oU?!
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other permit:
Phone: 503.639.4171 Fax: 503.5A10{9:60 3 2005 "'41r,.r. I � Date/B
Inspection Line: 503.639.4175 ` Date ReadyBy: ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
.h , ''?.4., tf ` w fTZ'x" w . , a{ ,F 4,, } C. :7 t it ' 4 i !� i i''" f� .. .•_�, i..r °,1
it 0 t'' r' . A' - ni61 a) ' 6 ii` i 0 d: T / ,'C r c ' �dl py,, .,�. xNlt � .,'- ' nN rg all " —" . ,�, r i e'
'_N AM- x . +• .rr' ., :. 1' lc r . .w.,: a 1 ku1,41. , , is f::'lli�i n. a , ;� e
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l ['Hazardous location
❑ Demolition ❑ Other ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
`,j , ", K . k^+ , `! ^ M14 " """ t . - eg f�` >. 1c d � „,,
' of 1 -and 2-family dwellings 4 or more new residential
,a .J t �fR i�4a:., ``;, q Q � �O •y� aLl ay'.4.x �«i� tT .7.s ' a' . �',y3'� Y
❑System over 600 volts nominal units in one structure
ID 1- and 2- family dwelling' Commercial/industrial ❑Accessory building ❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
s .q u� «w Y vr •, } »,w ev1 °'
a RV' park . . " �i '�.h3 L P .3 ,, s r " ii a rs. ••..n s�� A , ❑Egress /lighting P
am: 'M" �^.;:vx zm n ['Other:
no.: r2 �f i e el Job site address: /525 Rd • ❑Health -care facili
, r t/! Submit 2 sets of plans with any of the above.
City/State/ZIP: /r) ( ) (7 `7 2-2_3 The above are not applicable to temporary construction service.
! G r 1 ; ?7p 4 d ii t p: k '''
..7p
Suite/bldg. /apt. no.: Project name: F3-4..._ S f r1s Description I Qty. I Fee. I Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
.. -! r, a.. csr. a rn wyl ', Yl'y1rt'
T; -, r ,
ICR ,3 a 'ta �t Each manufactured or modular
• / dwelling, service and /or feeder 90.90 2
1 L' Io' �L C- (� � Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
,... ,�,r r..� r :A 201 amps to 400 amps 106.85 2
i� D I ...,� ..,.: ,i �` s 'I' _ ` 7" 160.60 2
401 amps to 600 amps
Name: esl` 5
1 ti 601 amps to 1,000 amps 240.60 2
4
, , Over 1,000 amps or volts 454.65 2
Address: 1I 5'a.,5 S (P) p �� C/ '/"'`'c - / G4 Reconnect only 66.85 2
/
City/State /ZIP: � /f (-.) C / ° z 3
Temporary services or feeders installation, alteration, and/or
� 4 ° ` relocation
Phone: ( ) l 1 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
�;' ,' ! d A. Fee for branch circuits with 4
(?p vie':'
�,.�.,��� '�h��°`'.� r. ,. �..;,�7»..:,r,� service or feeder fee, each 2
6.65
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: Each add'I 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-
, i ,,, ., �,.,.,; ;,. � � ,�,.� �,.s��� �' f#•-'; �:�,"� ' f'R energy Panel, alteration, or ( ( /��� 2
r3 egiri : 'N,> ` ` "� ;4',4.. ", 10- P .t r }g?G.a ° '' e;i: �J• ��C l
— °— extension. Describe: Page 2
Business name: r`5 iJ Ter It l o� ( <'3
1 Each additional inspection over allowable in any of the above
Address: 7 ci 5 f ^ 1
7 ' t r/1� r() ,Z 7th t / Per inspection 62.50
City/State/ZIP: ' . Investigation per hour (1 hr min) 62.50
(N 1 ��� "`' l ��" ` �� �� 7v Industrial plant per hour 73.75
Phone: ()))610,--11[415 Fax: (S " ,) 6,1 Z 2 7 , dust ;u ` _ "fr9er? * , i v' .
i T2 F, ,:q a.ti;l" t E attAIC,',. i` x Er, ' - F.;' �'�E$ -6.„c,;....
CCB Lic.: $7 Electrical Lic.: 3L4_ Ya Suprv. Lic.: Subtotal 1 75, 60
Suprv. Electrician signature, required: 334 S« Plan review (25% of permit fee)
State surcharge (8% of permit fee) ro D C.)
Print name: yr 7 Date: 10/25--- TOTAL PERMIT FEE 47 00
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.
is Building \Permits\ELC- PemtitApp.doc 12/03 440 46 15T(10102/COM/WEB
CITY OF TIGARD _ ,
BUILDING DIVISION PERMIT #: ELR2005 -00210
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/3/2005
Phone: (503) 639 -4171 ,
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' R._..
INSPECTION WORKSHEET FOR DATE: 9/7/2005 TIME: 7:08 PAGE: 122
SITE ADDRESS: 11525 .PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PACIFIC TERRACE LOT #: 007 TYPE OF USE:
PROJECT NAME: FAST SIGNS '\.
DESCRIPTION: Voice and Data wiling.
OWNER: SMITH, EDITA M, \\, PHONE #:
CONTRACTOR: ESP TECHNOLOGIES \ PHONE #: 503628.4195
Inspection Request Scheduled For: Date: 9/7 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
`\
1 r Low voltag - 015020 -01
503-520-0625 N
4 % 0 \ FiNp.L a7 \.\
rrections /Comments /Instru •• \
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: qV U . FA Le Date: I ii (0S Phone #: (503) 718- 2'14