Permit ELECTRICAL PERMIT -
A '(• CITY OF TIGARD RESTRICTED ENERGY
'�r� DEVELOPMENT SERVICES PERMIT #: ELR2002 -00247
" �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/18/02
SITE ADDRESS: 13035 SW PACIFIC HY PARCEL: 2S102BD -03000
W
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT: 035 JURISDICTION: TIG
Project Description: Security system installation.
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:
INSTRUMENTATION: OTHER: SECURITY X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TRUCK TERMINALS INC SONITROL PACIFIC
1825 SW PHEASANT DR 8220 N. INTERSTATE AVE.
BEAVERTON, OR 97006 PORTLAND, OR 97217
Phone: 223 -5822 Phone: 223 -5822
Reg #: LIC 00053535
ELE 26- 370CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/18/02 $75.00 Elect'I Final
[TAX] 8% State Tax 11/18/02 $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
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: `Z)-(20 L7.
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
w ��' Electr P ermit ' , 1 I ' 6 ?E 1 received:iI.. a
•� , fi as-- Permit no.FL a.. p p „4 7
v.'ill'l`‘ City of Tigard Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR•N € 8 2OO )D ate i ssued: Byas I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 CITY 01 - I IGAFJ ase file no.: Payment type:
PLANNING/ENGINEERING
Land use approval: .
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory )4 Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
• Job address: 1 - 55 ' - u p0.CjG }..V1 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: l Subdivision:
Project name: iA 1' Y\ f kv\a I Description and location of work on premises: SQ�a 4j
Estimated date of completion/inspection: • U
ffirt KIWI I1 tEa IC I I�i11i �9,l ll 1 .l I
Job no: 3p3 4_ nl Fee Max
Business name: c» 1 c0,0 +1 L Description Qty. (ea.) Total no. bop
c ^^ New residential - shigle or multi- family per
Address:
p aaQ �f(L a - e dwelling unit. Includes attached garage.
City: V cw .A.-keL,p,d I State:Qy- I ZIP: Va \ 1 Serviceincluded:
Phone: aa3 -S13 as I Fax: I E -mail: 1000 sq. ft. or less 4
CCB no.: 5 335 I Elec. bus. lic. no: " _ �j.� (sr./7R Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lic. no.: 'S �t /Q — / /-O 3 i3 Limited energy, non- residential 2
��� I , - t O v Each manufactured home or modular dwelling
Signature of supervis g lectrician (required) Date Service and/or feeder 2
' Sup. elect. name (print): ,S..42 i op) • License no: Z40 le ' Services or feeders installation,
alteration or relocation:
- ' 'PROPERTY OWVNEt ...
200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 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 signature: Date: 401 to 600 amps 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
Each additional branch circuit:
PLAN REVIEW' (Please check all that apply) Misc .(Service or feeder not included): •
❑ Service over 225 amps - commercial O Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each sign or outline lighting. 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, r J � 2
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* - C
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ 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 $ '1 5 •(S
rm
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
' Credit'card number: / / • within 180 days after it has been State surcharge (8 %) .... $ (_
Expires accepted as complete. TOTAL $ $ i
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00/COM)
Electrical Permit Fees: Limited Energy-Fees:
• ;�I
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
11 Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items . Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. fL or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof - • - $33.40 1 ❑ Burglar Alarm
Limited Energy. , $75.00 • ---
Each Manuf'd Home or Modular Door Opener
Dwelling Service or Feeder $90.90 2 ,
Services or Feeders 0 Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 Vacuum Systems`
201 amps to 400 amps $106.85 2
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 $66.85 2
• Te,mporard E.crviccs _r Foeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation , Fee for each system $75.00
200 amps or less $66.85. 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 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or - • ❑ Clock Systems
feeder fee.
Each branch circuit - . $6.65 - — 2 - ❑ Data Telecommunication Installation
b) The fee for branch circuits " • • - - - -. — '
without purchase of service n Fire Alarm Installation
or feeder fee. - - - -• -
• First branch circuit $46.85
Each additional branch circuit $6.65 . ❑ HVAC
. ,
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 0 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy o
panel, alteration or extension 1 $75.00 ` 5 — ( ❑ Landscape Irrigation Control"
Minor Labels (10) $125.00 n
Medical
Each additional inspection over
the allowable in any of the above 11:: Nurse Calls
Per inspection $62.50
Per hour - $62.50
In Plant $73.75 D Outdoor Landscape Lighting*
Fees: '&] Protective Signaling •
Enter total of above fees 1- 15 n Other
8% State Surcharge $ C • 00 Number of Systems
25% Plan Review Fee
• No licenses are required. Licenses are required for all other installations
See "Plan Review" section on $
front of application.
Fees:
Total Balance Due $ S\ , - ao
• • . Enter total of above fees $ 1 5
❑ Trust Account # 8 % State Surcharge . $ Q `o • $`4-3 Total Balance Due $ t
•
i:\dsts\forms \elc- fees.doc 10/09/00 •
•
-
ciTY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requ AM PM BUP
Location / 3 O 3 - Suite MEC
• Contact Person (l/J/71 Ph ( ) 2 3 'S 2 = 7 ' PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR 6 al 7
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
4.0j11° 1 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
4.: PART FAIL
❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Date EiC m G Q� Ins pector 1-49 c /
Approach/Sidewalk ) y^ Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL