Permit •
CITY OF TIGARD ELECTRICAL ENER -
RESTRICTED ENERGY
�L�`''4 DEVELOPMENT H BMEN 639 -4171 DATE ISSUED: ED: 5% 0/0 SITE ADDRESS: 06825 SW SANDBURG ST PARCEL: 2S101DD -00400
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: C -P
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Installation of audio /stereo system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TOC MANAGEMENT SERVICES INC SPECTRUM SYSTEMS DESIGN
6825 SW SANDBERG ST MCGILL SYSTEMS INC
TIGARD, OR 97223 937 SW 14TH AVE STE 201
PORTLAND, OR 97205
Phone: Phone: 248 -0248
Reg #: ELE 26 -379CL
LIC 00079244
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 5/10/01 $75.00 2720010000 Elect, Final
5PCT CTR 5/10/01 $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
requir- = You o • •w rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 601 -0010 throug OAR 95 - 01 -0080. You may obtain copies of these rule : • : •uestions to OUNC at (503)
24:-1987.
Iss ed by ► _1;1 C Permittee Signature __Aim_ %_
OWNER INSTALLATION ON Y
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
! •
1
Electrical Permit Application
Date received: • - /D 4/ Permit no.: 1449,90/-'00/4.39
.A :. I _ City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory n Commercial/industrial O Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: S . e .. f ,cc Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: Subdivision:
Project name—-- c___ 1 Description and location of work on premises:
Estimated date of completion/inspection: ■ ' 2-5 00
CONTRACTOR APPLICATION FEE SCI !EDUCE
Job no: Fee Max
Business name: �p�ti �� ->t L Description Qty. (ea.) Total no. insp
fit" New residential or multi - family per
Address:q Gj 1 (o k dwelling unitIncludes attachedgarage.
City: - priv rt �,. St ate:p J ZIP: -i service included:
Phone:, , 7�,p, . o �4 Fax: o- 2 3 . E- mail• ,St 'n..: %p 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: `3QZy4. I Elec. bus. lic. no: - 2.( c .-
C- Limited energy, residential 2
City /metro •. no.: 48...1G, _ Limited energy, non-residential • 2
��� 5/I. oIo l Each manufactured home or modular dwelling
'ure o s s pervising electrician (required) Date
Service and/or feeder • 2
Sup. elect name (print): License no: Services Serncesor feeders— installation,
alteration or relocation:
PROPERTY ONVNER 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: 1E-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:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 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: '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 appl)) Misc. (Service or feeder not included):
❑ Service over 225 amps-commercial . 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1&2 O Hazardous location Each sign or outline lighting 2
family dwellings O 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 •
O Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egress/lightingplan O Other. Perinspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other 7
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ L,5J ° v
0 Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ (A • °O
Expires accepted as complete. TOTAL $ 8 / , 00
Name of cardholder as shown on credit card •
$
Cardholder signature Amount 440 -4615 (6/00/COM)
Electrical Permit Fees: Limited Energy Fees: > 4
• TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
- - rvice included: - Items . Cost Total 4, Check Type of Work Involved:
Resi • : ntial - per unit
1000 sq. " or less $145.15 4 ❑ Audio and Stereo Systems
Each addi •nal 500 sq. ft. or
portion th: eof $33.40 1 ❑ Burglar Alarm
Limited Energ - $75.00
Each Manuf'd H. e or Modular ❑ Garage Door Opener
Dwelling Semi or Feeder $90.90 2
Services or Feede ' ❑ Heating, Ventilation and Air Conditioning System`
Installation, alteration, •r relocation
200 amps or less $80.31 2 ❑ Vacuum . Systems *
201 amps to 400 amp • $106.: 2
401 amps to 600 amps $160 .0 2
601 amps to 1000 amps , $24 2 ❑ Other
Over 1000 amps or volts $4 - • .65 - 2 ,
Reconnect only '• • 6.85 2 •
Temporary Services or Feed= TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocatio ' 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 ❑ Fire Alarm Installation
or feeder fee. •
First branch circuit $46.85 HVAC
Each additional branch circ -it $6.65. ❑
Miscellaneous ❑ Instrumentation
(Service or feeder not include.
Each pump or irrigation circl- $ 3.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $ t .40
Signal circuit(s) or a limite • energy ❑
panel, alteration or ext: sion l $75 00 "45 --' � Landscape Irrigation Control'
Minor Labels (10) $125.10 ❑
Medical
• Each additional ins • - ction over
the allowable in an of the above ❑ Nurse Calls
Per inspection $62.50
Per hour $62.50 ❑
In Plant $73.75 Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
. r .o
Enter total of . • ove fees $ ❑ Other
c"---L2 8% State Sur harge $ I. Number of Systems
25% Plan - -view Fee
See "P P. Review" section on $ ,/, * No licenses are required. Licenses are required for all other installations
front of : pplication.
Fees: •
Total = alance Due - c.7
Enter total of above fees • $
oU
❑ T st Account # 8% State Surcharge $ � .
el_a)
Total Balance Due $
i:\dsts\forms\elc- fees.doc 10/09/00 •
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: X639 -4175 Business Line: 639 -4171
BUP
Date Requested ,
V AM PM BLD
Location 6 Z ) 5� 5 to 11 Suite MEC
Contact Person // n Ph 70/47 7' PLM
Contractor 5 cI'nwvl - l ervl S Des I • h • - - // SWR
BUILDING Tenant/Owner p /-fG - • // //4, Ca (,ti, id, 3) LC
t,
Retaining Wall - /" f.(, SiO4,1 - J LR r Uj` 1.3
Footing J
r
Foundation Access: ' FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam /i , / / �� - S
Ext Sheath /Shear �t� ((f'�° S /tee ►'►'[
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
M i �f II- _ i4 / e d - <5 -L3 / - D / f
Final
PASS PART FAIL
PLUMBING
Post & Beam /
Under r Slab C� S' e pi �� /e_c s-3/-6/ -- A40
P
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers n
Final
l L
PASS PART FAIL /
LEC L
Service /
�
Rough In v
UG /Slab
C2o__ w Voltas?
Fire Alarm
010 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 Z
Approach /Sidewalk Date Z — Z# O/ Inspector del a,40..e.(_, E
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
// y1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -1 Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested -S �� AM PM BLD
Location 6 k L f 51-4) .54-"- Fib ,/ Suite -- MEC
Contact Person KIM /14/14 Ph � j /Z — S J /G 3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR ..26D/ - / j
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 1 'did) ` S �
Susp'd Ceiling � Ti! V - �S e- A S '—
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab V'
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
(EL ECTRIrA7
Service
Rough In
UG /Slab e
ireF' Alarm
ASS' 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
Other oach /Sidewalk Date cc-3f— & / Inspector O/L./ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.