Permit . CITY OF TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
lI1� DEVELOPMENT SERVICES PERMIT #: ELR2002 -00187
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/18/02
SITE ADDRESS: 13680 SW SANDRIDGE DR PARCEL: 2S105DD -04900
SUBDIVISION: PACIFIC CREST ZONING: R -7
BLOCK: LOT: 025 JURISDICTION: TIG
Project Description: All encompassing low voltage.
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: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
D R HORTON HOMES AZIMUTH COMMUNICATIONS INC
5125 SW MACADAM AVE STE 145 P.O. BOX 508
PORTLAND, OR 97201 WILSONVILLE, OR 97070
Phone: 503 - 222 -4151 Phone: 503 - 639 -0110
Reg #: ELE 36 -94CLE
SUP 2312JLE
LIC 145828
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 9/18/02 $75.00 2720020000 Elect'l Final
5PCT CTR 9/18/02 $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)
246 -1987. cze-ir
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:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
44 . - Electrical Permit Application
. Date received: Op/02,— Permit no. v ,„- uQ , „ , l t
-' I i City of Tigard Project/appl.no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard, OR 97223 D issued: By: � ,/ � t no.:
City o�gard Add ' � G� I ^ p
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 11S%.-o0,. —DD a 7
T1 PE OF PERMIT
1 & 2 family dwelling or accessory O Commercial/industrial O Multi- family 0 Tenant improvement
ew construction 0 Addition/alteration/replacement 0 Other. O Partial
JOB SITE INFORMATION
Job address: ( ��.� Q / Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: 24 Block: Subdivision:
Project name: P I Description and location of work on premises: Quegx fowl ILl
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCIIEDLLE
Job no: Fee Max
Business name: A 21 Mudl+ Cow 4 4 K ) 1(4- T /l)��
Description oi- famibyper
Qty. (ea) Total no. insp
e n New res ( deaml- singleor®l6-
Address: )S SS. (.). 6D6 4 & ennin&Includesattachedgarage.
City: I) it_sno /1 LLE State I ZIP: 5,00 • Serviceincuded:
Phone:, j 6 3 631 O i l y I Fax :03 63i'ou mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: / 5�� I Elec. bus. lic. no: Yb — CE Limited energy, residential 4. t:Nt to I?, I 2
City/m fie. no.: 0000 Limited energy, non- residential 2
C7 / /gip Each manufactured home or modular dwelling
Si of supervising el (required) Date Service and/or feeder 2
Sup. elect. name (print): 0 L4 6 License no: 2.7 23ZE Services or feeders - installation,
alteration or relocation:
PROPERTI' OWNER 200 amps or less 2
201 amps to 400 amps 2
Name (print): �`• // 401 amps to 600 amps 2
Mailing address: • 1 _ 41 ! z 1 l \ 601 amps to 1000 amps 2
City: t Y.7 �,_; j .. ZIP: r 20 Over 1000 amps or volts 2
Phone:1. XL• • I 1 Fax: E -mail: Recommect 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, orreloeation. or
ORS 447, 455, 479, 6 1 � 201 amps to 200 to 400 amps
sass 2
2
Owner's signature: a Date: 1 401 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: Fax: E - mail: Each additional branch circuit
PLAN REVIEW (Please check all that appl)) Misc . (Service or feeder not inciaded):
O Service over 225 amps-commercial O Health-care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 18r2 O Hazardous location Each signor 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 O Feeders, 400 amps or more *Description:
O Occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
O Egressllightingplan O 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 man raids. pi jurisdiction *infusion for more information. Notice: This permit application Permit fee $ 75, /r(7
O visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been State surcharge (8%) .... $ ,
i accepted as complete. TOTAL $ / r
Name of cardholder as shown on credit card
Cardholder signature Amount 440 -4615 (6i00/COM)
•
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
• 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. ft. or less $145.15 4 RI Audio and Stereo Systems
Each additional 500 sq. ft or
portion thereof $33A0 0 1 '�+F' Burglar Alarm
Limited Energy
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 Other 01(A-4 601 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 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. 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 circuit $6.65 . ❑ . •
Miscellaneous • , ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each signor outline lighting $53.40
Signal anel alts ton or extension $75.00 ❑ Landscape Irrigation Control`
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.5 ❑ Nurse Calls
Per hour $ 62 . 50
In Plant $73.75 ❑ Outdoor Landscape Lighting`
Fees: ❑ Protective Signaling
Enter total of above fees $ 1 1 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.
Fees:
Total Balance Due $ 75, D
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $ L ai
Total Balance Due $ g J r IV
All New Commercial Buildings require 2 sets of plans.
• i:\dsts \forms\elc- fees.doc 08/30/01
CITY OF TIGARD 24 -Hour _
BUILDING Inspection Line: (503) 639 -4175 MST Zo 2_-00 3 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested /2 - AM PM BUP
Location /3 64 514-) 5 d I- I4 L ( Suite MEC
Contact Person Ph ( ) -S/ - 3 / PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR ,2 -o 2a7
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 A(a
Other:
V C/O e
Final / 5/ , l Z
PASS PART FAIL f
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
ow 'o a•L; -,
Fire • larm
r "-/ IL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• • SS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date C v (4 Inspector _ �. j c � � Ext
Other:
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 MST 033 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reg •sted / — AM PM BUP
Location /3 . � � /. ,, M �. Suite MEC
Contact Person Ph ( ) ..97 - C I 3(0/ PLM
Contractor Pe_ Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR ✓ 0 018 p
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
F • Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
47:5 PART FAIL
El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ECn l q
0 Inspector _' C) Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL