Permit CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
, c; I DEVELOPMENT SERVICES PERMIT #: ELR2002 -00106
65' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/10/02
SITE ADDRESS: 08060 SW PFAFFLE ST PARCEL: 1S136CD-00600
SUBDIVISION: SPRINT PCS WIRELESS MONOPOLE ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage for installation of Landscape irrigation Control.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: X
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EEI SOLUTIONS CEDAR LANDSCAPE
5665 SW MEADOWS RD, SUITE 300 14145 SW GALBREATH DR
LAKE OSWEGO, OR 97035 SHERWOOD, OR 97140
Phone: 503 - 294 -2150 Phone: 625 -3700
Reg #: LIC 75535
ELE 5843
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 6/10/02 $75.00 2720020000 Elect'I Final
5PCT CTR 6/10/02 $6.00 2720020000
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
2 46 -1987.
I ssued by i e /} Permittee Signature cry-1 1 y
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: n 2117 DATE:
LICENSE NO: 5-1(
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
r - - - ' -A Electrical Permit Application
. Date received: (p — —0 Permit no.: : , j y .00/.4 b
v.,� .
-, y, :•i 11 City of Tigard Project/appl. no.: Expire date:
City ofTit and Address: 13125 SW Hall 1y I�Zir , } D Date issued:
CM Receipt no.:
Phone: (503) 639 -4171 l 1... �V/
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
JUN U 6 2062
. T'PT' ? 7"2Rl%IIT
❑ 1 & 2 family dwelling or accessory 18( Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement O Other: O Partial
JOB SITE INFORMATION
Job address: 8Q(,Q SW PFAFFGE ST 7—/6—Alp 9.7Z. Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: CA MG Q eN pi At A. I Description and location of work on premises: [a m i ,pe SroVj y /ee 9
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE) :__
Job no: Fee Max
Desc
Business name: t h 1 vt dccc p e z---,4c. �Ptiou Qty. (ea.) Total no. insp
` � New residential - single or multi - family per
Address: ( L( I q S S CTc. 110 rec..4AN a dwelling unit. Includes attached garage.
City: S1 vrwBOC1 I State:0 /2 I ZIP: 9 t 440 Service included:
Phone:( 3 700 I Fax: G s _8 Gazi E -mail: 1000 sq. ft. or less • 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 75535 I Elec. bus. lic. no: $i} �
Limited energy, residential 2
City /metro lie. no.: 1 5g4L Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or readers — installation,
alteration or relocation:
- PROPERTY OWNER 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:
;2.v..
I E -mail: Reconnect only 1
Owner installation: The ation 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:
20 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER 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: ax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1 &2 0 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, ,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ 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/lightingplan 0 Other. Per inspection 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 i nformation. N otice: This permit application Permit fee $ J u
,EI visa ❑ MasterCard '4 expires if a permit is not obtained Plan review (at _ %) $
Credit card number: 1 308 5 . 3 6 / /r 3 within 180 days after it has been State surcharge (8 %) .... $ _
Exp ires TOTAL $ 81
R f r,ln 4 e I D _ G, ra c.,-- accepted as complete.
0 , of c oLr as on credit $ (/'
Cardholder signature Amount 440 -4615 (6/00/COM)
G .. Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total y .
Check Type of Work Involved:
Residential - per unit
1000 sq. ft. 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 ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System`
Installation, alteration, or relocation
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 _ _ $66.85 _ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260)
401 amps to 600 amps $133.75 2 •
Over 600 amps to 1000 volts, Check Type of Work Involved:
see "b" above. • ❑
Branch Circuits Audio and Stereo Systems
•
New, alteration or extension per panel ❑
a) The fee for branch circuits Boiler Controls
with purchase of service or ri feeder fee. I I Clock Systems
Each branch circuit $6.65 2
b) The fee for branch circuits ❑ Data Telecommunication Installation
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $46.85 •
Each additional branch circuit $6.65 ❑
HVAC
Miscellaneous
(Service or feeder not included) ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
Minor Labels (10) $125.00 K Landscape Irrigation Control*
Each additional inspection over ❑ Medical
the allowable in any of the above . .
Per inspection $62.50
Per hour $62.50 ❑ Nurse Calls
In Plant $73.75 ❑
Outdoor Landscape Lighting*
Fees:
❑ Protective Signaling
Enter total of above fees $
n Other
8% State Surcharge $
25% Plan Review Fee ' 1 Number of Systems
See "Plan Review" section on $
front of application. * No licenses are required. Licenses are required for all other installations
Total Balance Due $ Fees:
El Trust Account # Enter total of above fees $ 7 S .
8% State Surcharge $
Total Balance Due $
i:\dsts \fomu \etc - fees.doc 10/09/00
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ / ate
Received Da ue d / AM PM BUP
Location -VO l0 0 G � -� Suite MEC
Contact Pe son . b Ph ( ) 56 q - �-� PLM
p
Contracto $'O Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC /n
Ftg Drain Access: EL c3" ®a /d `('
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 Ct? I f
Other: 4{7 <�7 V U `-'fi)?/
Final
i .. JP iii • �.. J
PASS PART FAIL -
PLUMBING r J 4H7eCJh ) ' //
Post & Beam
Under Slab
Rough-In r , C cS F
Water r Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: '
Final
‘ d} . 9/ - / t,
PASS PART FAIL
MECHANICAL A - 11 ( y k Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PA RT FAIL
E �C
Service a 4 L ' ,� g9 /..,[ J4v,eisca
Rough -In l/� / P/ tl I ° yam
UG/Slab
Low Voltage 4-4 /'1 C r A_"' _ .
Fir larm
anal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ��/1Q / CR Inspector Field
Ext
Other: �/ C� -7
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Reque to 4 //3" AM PM BUP
Location $ ��� Suite MEC
Contact Person Ph 9O 9 ST Z PLM O
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation __ ELC
Access:
Ftg Drain - CO e0/ ELR — 67) �o
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: r
415::.,11A PART FAIL
If ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
LECTRI AL
S rvice
R gh-
UG b
Low oltage
Fi rm
ina ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA (�
Approach/Sidewalk Date v Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL