Permit - .� ELECTRICAL PERMIT -
CITY OF TIGARD
RESTRICTED ENERGY
�A DEVELOPMENT SERVICES PERMIT #: ELR2000 -00280
j ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/27/2000
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 fire alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TOC MANAGEMENT SERVICES BACHOFNER ELECTRIC INC
6825 SW SANDBURG STREET 55 SE MAIN
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 620 -1710 Phone: 233 -2006
Reg #: LIC 00044569
SUP 2808S
ELE 26 -451C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 11/27/200C $75.00 2720000000 Elect'l Final
5PCT CTR 11/27/200C $6.00 2720000000
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)
246 -1987.
Issued by Permittee Signature 0 fPPG/c 977 J
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit App
Date received: // 27 Pennit no.:axaj0O 0020
„,,
,..
','x:1 City of Tigard RECEIVED Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171 I t . 2,
Fax: (503) 598 -1960 Case file no.: Payment type:
COMMUNITY DEVELOP1 2:11
Land use approval:
TYPE OF PERMIT •
❑ 1 & 2 family dwelling or accessory XCommercial/industrial ❑ Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION .
Job address: GR)25 Sill) L 1(1 Y01 St_ Bldg. no.: Suite no.: Tax map /tax lot/account no.: .
Lot: I Block: Subdivision.
Project name: 7, p .c , I Description and location of work on premises: 1, jr19 -\-0,_\\ c 1 ,1k ST, -_e r
Estimated date of completion/inspection:
_ CQNTRACTOR APPLICATIOn, FEE- SCHEDULE
Job no: y SOS . . Fee Max
Business name: Description Qty. (ea.) Total no. insp
>�achofner Electric New residential -single or multi-family per
Address: 55 SE main dwelling unit. Includes attached garage.
City: Portland I State: nR I ZIP: 9721 Service included:
Phone: 233 -2006 I Fax: 1E-mail: 1000 sq. ft. or less 4
26 -451 C Each additional 500 sq. ft. or portion thereof
CCB no.: 44569 I Elec. bus. tic. no:
Limited energy, residential 2
City/metro Limited energy, non - residential I 2
` Each manufactured home or modular dwelling
Signature of supervising el ctrictan (requir Date Service and/or feeder 2
Sup. elect. name (print): Will Bachofner License no: 28085 Services or feeders – 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: IFax: 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:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps . 2
Owners 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: '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): •
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of I &2 O Hazardous location Each signor outline lighting 2
family dwellings 0 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* I 7rj - 7$'” 2
0 Building over three stories 0 Feeders, 400 amps or more *Description: t ✓15i I tI t L LR S t 1
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other: Per inspection I I 1 I
Submit _ sets of plans with any of the above. Investigation fee
. The above are not applicable to temporary construction service. Other G
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ - 7 J
• • 0 Visa 0 MasterCard exp if a permit is not obtained Plan review (at _ %) $
I Credit card number: I / within 180 days after it has been State surcharge (8 %) .... $ (.t) —
• Expires accepted as complete. TOTAL $ Q)1 -
Name of cardholder as shown on credit card
$
i Cardholder signature Amount 440 (600/COM)
i
L
Electrical Permit Fees: Limited Energy Fees:
Ili
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: 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. R 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 Manufd 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 Vacuum Systems`
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 a Other
601 amps to 1000 amps $240.60 2
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.
Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel I I Boiler Controls
a) The fee for branch circuits
with purchase of service or
feeder fee. Clock Systems
Each branch circuit $6.65 2
b) The fee for branch circuits [7 Data Telecommunication Installation
without purchase of service
or feeder fee. Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 n HVAC
Miscellaneous
(Service or feeder not included) n Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40
Li Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension l $75.00 IS "
Minor Labels (10) $125.00 F7 Landscape Irrigation Control
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 I I Nurse Calls
Per hour $62.50
In Plant $73.75 ❑
Outdoor Landscape Lighting*
Fees: n
Protective Signaling
Enter total of above fees $ .
Ti Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $
* No licenses are required. Licenses are required for all other installations
front of application.
•
Total Balance Due $ Fees:
Enter total of above fees $
❑ Trust Account # •
8% State Surcharge $
Total Balance Due $.
•
i: \dsts \forms \elc- fecs.doc 10 /09 /00
/ /
CITY OF TIGARD BUILDING INSPECTION DIVISION P MST
24 -Hour Inspection Line: 639 - 4175_„ Business Line: 639 -4171
- Z BUP
Date Requested 43§1 AM PM BLD
Location `p F'•2-5 n 4.41 r � 'joG Suite MEC
Contact Person // Ph Z -LO 40' PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 4 ,900 G "UU Z pe)
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
Susp'd Ceiling
Roof
Misc:
Final
P ASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top
rS
Water Service
Sanitary Sewer
Rain Drains
Final �l
PASS PART FAIL
MECHANICAL
Post & Beam
$,(
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
if7CT
Service
Rough In
UG /S
Fire Alar
a
ART FAIL
SI I t
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 6
Inspector Approach /Sidewalk Date 6 `� O2 i / Itor
Other Ext
/ Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
05/03/2001 10:30 50:32230602 C .
01 •
page 1 ,
. SEARCH REPORT 05/03/01 11:28
•
f ---- workstation 2
LASSES ALARM '
/ALARMS ALL
ACCOUNTS 5404 through 5404
FROM Date 05/03/01 Time 8:00 through: Date 05/03/01 Time 11:27
Sonias version 6.3.1
5404 1TOC Management Svcs ADV plus
Single zone Secure
Number of AAMS: 0 03
05/03/01 9:39 �2 �
5404 :25 TAMPR ALARM SAM I In 11 � ( •
5404 :25 DROP LING In 11 L
05/03/01 9:41
5404 :11 tampr alarm SAM 1 In 11
5404 :12 DROP LINE In 11 •
05/03/01 9:44
5404A :12 TEST CALL ZN A' In 17.
05/03/01 9:45
5404 :24 UP Panel In 11
05/03/01 9:52 •
5404 :59 LINE2 Active In 11
5404 :59 TAMPR ALARM SAM 1 In 11
05/03/01 9:53
5404 :22 tampr alarm SAM 1 In 11
05/03/01 9:54,
5404 :00 TAMPR ALARM SAM 1 In 11
5404 :00 tampr alarm SAM 1 In 11
5404 :00 DROP LINE In 1
05/03/01 10:00
5404A :29 ALARM12 LOOP . In 11
5404 :29 DROP. LINE In 11
05/03/01 10:01.
5404A :22 alarml2 loop In 11
05/03/01 10:07
5404A :38 ALARM12 LOOP In 11
5404A :38 alarml2 loop In 11
05/03/01 10:50
5404A :32 FIRE 11 ALARM In 11
5404A :32 fire 11 alarm In 11
05/03/01 10:52'
5404A :13 CANCL Alarms In 11
5404A :28 FIRE 11 ALARM .In 11
5404A :30 fire 11 alarm In 11
5404A :41 CANCL Alarms In 11
* * ** End of Report * * **
•
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -417 MST
,/ BUP
Date Requested --'/ f AM PM BLD
Location Cor ZS Sw SG- d 6u7 Sr Suite MEC
Contact Person / / ��' Ph 2 , ; - Z 04)4 PLM
Contractor cr �c OF tJ e- Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR Z ,0 -t2 4 '
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 /J C
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING •
Post & Beam
Under Slab
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
(ELECIBICA
Service Cei
Rough In n
UG /Slab rr r
Low Voltage 4 `N 4
Fire Alarm
Fi
A 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
Approach /Sidewalk
Other Date ,` a/ Inspector L�� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
5/,-17
C O F TIGARD BUILDING INSPECTION DIVISION MST
-
2i..-H Inspection Line: 639 -4175 Business Line: 639 -4171
BUP 1 '�..
Date Requested 3"/ AM PM BLD
Location ( 2 S f - K.14--R / Suite MEC
Contact Person Ph 5L3 937 070 PLM
Contractor .6 Pell et./e__72._. Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR z GU -GV tO
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab � re__ £ f A rm SIT
Post & Beam
at Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall /J D (-7;4V—e-
Fire Sprinkler � [ ('�iI
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
RT FAIL
E LECTRICAL
Nice
Rough In
U , /Slah
..Low Vol
F.
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
Otheoach /Sidewalk D 3 ate / 7 / Inspector '���� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7' AM PM BLD
Location ]ae- 'OJ'l 5c✓ ��c Suite MEC
Contact Person Ph 70/ Z/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 2era -G U Z97
Footing Access:
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear �
Ina Sheath /Shear tC�G000 sOl /J� �
Framing
Insulation •
Drywall Nailing / C10/ - ■O C) 0
Fire wall ��001 a O 0
Fire Sprinkler
Fire Alarm / i [/ / / I
G cc
Susp'd Ceiling G
Roof
Misc:
Final
PASS PART FAIL S'
PLUMBING (7 P a l l l�
Post & Beam
Under Slab
Top Out
Water Service � G P q civ 1 1- A
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas
Smoke e Dampers
Final
PASS PART FAIL
L EC T R I
- Service
Rough In
UG /Slab
o t
Fire Alarm
F
ASS ART FAIL
S
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
Approach /Sidewalk
Other Date q - 02,6_ 0 / Inspector — _.�' � E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.