Permit CITY OF TIGARD ELECTRICAL ENER -
RESTRICTED ENERGY
'�1 DEVELOPMENT SERVICES PERMIT #: ELR2004 -00127
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/17/2004
SITE ADDRESS: 11365 SW TIGARD ST PARCEL: 1S134DC -00700
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: Audio, data & Intercom
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
BAPS TEMPLE WINNER ELECTRIC INC
PO BOX 41160 5950 SW PROSPERITY PK
SAN JOSE, CA 95160 TUALATIN, OR 97062
Phone: 408 - 453 -6464 Phone: 638 -5028
Reg #: L4108-453-1646
SUS -4532W
ELE 34 -150C
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 5/17/2004 $225.00 Wall Cover
Elect'I Final
[TAX] 8% State Surchart 5/17/2004 $18.00
Total $243.00
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 p� Permittee Signature L ,
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
u1tzuizuu4 U9:38 FAX 5035981980 CITY OF TIGARD RI001
.
Electrical Permit 4p 171 7:i IP I WEI
FOR ()FFICIE USE ONI.I.' . .
, .
. ,
. •
1 1. . 1..___, .--
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 MAY 17 200k A Datr.03 .
Plan Fteview l 'aiii .4 Permit No , 16 - , OD ,
Phone: 503.639.4171 Fax: 503.598.19 '". i "'''''..'.X.41',• Date/B :. Other Perrri Oiled ' '
__a_ - 120 5
Inspection Line: 503.639.4175 4, n7LL, Date ReadAy: luny RI See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGAR 0 '''''''. Notined/meinea: Supplemental Information
::":24.11 ..' '..1: ':'." :! 1'' ... ' :' 1 .. :11) . 1, Alql"*Ii*di l rll i;. 1 ::' '.. ,.. ' :" :., 7. •
' New construction 0 Addition./alterationfreplacement
g
Demolition 0 Other Please check all that apply '.."
OSerrice over 225 amps, comm'l OHazardous location
DSeee over 320 amps - rating 0Buildng over 10.000 sq. IL
g 1 9110iiiiiilli .4
..:;:rigi.: 1. 1 .00X 1 144151(i,NiriiO4TIO?!1:. :. - i:6',.,i k.,:;•:...„1;1 rvi
1:. :: of 1- and 2-family dwellings 4 or more new residential '
I ... ,
El 1 - and 2 dwelling gl&Commercial/industrial 0 Accessory building USystem over 600 volts nominal units in one structure
OBuilding over three stories °Feeders, 400 amps or more
El Multi 0 M.aster builder 0 Other:
(DOccupant load over 99 persons I:Manufactured structures or
Jilial ti.irl: '!' . DrEgressilighting plan RV park
Oilealth.eare facility 00ther:
Job no.: Job site address: i/ .3 , 5 6 (Ai /,' (2..) s - Submit 2 sets of plans with any of the above.
City/State/ZIP: 7,i' ra a....i Ofle..<VDdi The above are not applicable to temporary construction service.
Illil'ilir: : .I ' ' ', ...• .: :.'1:;': P OPP.M40iViPtitE;'.1 1 ..S h :!''.. :'.. '
Suite/bldg./apt no.: I Project name: 2) A P5 "refl,pia-
_,____ Description I Qty. I_ Fee I . Tafel I "
Cross street/directions to job site: 77 SA-4di iliv ii,c(2' New residential single or multi dwelling unit.
Includes attached garage.
. .
1,000 sq. ft. or less `•,.) 145.15 1
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non.residcmial 75.00 2
!......'1 . 1:'..iliil 1:11 Tgrl !, $. 6 .040.0. - ; ! OF,;:Y!Coi*?1::$. " ti':i :! :'.! .•:! i . 1 :'.(. 3 i:i1 .: • .i Each manufactured or modular
dwelling, service and/or feeder _ 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 _ 2
. 1, 1 4•1 1 .1•if : ::!: ! : 6. r Ii ER : 1i 4: 11,1.11A.11111.1114 • . . '..1,1:111:1;j41 2°1 amPat° 4°° am" , 106.85 2
' 401 amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts _ 454.65 2
,.
Reconnect only 66.85 _ 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
, relocation
Phone: ( ) Fax: ( )
200 amps or lets 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 2 •
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
__.
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
:-.., ■ , ,i..411vvh.,1.41m,#;,, .11 tri qbaiiini4, VAi;) :.:• . •:, : ,. , A. Fee for branch circuits with
. .g.L::, • ' ':'.61410.1. 07 I„:.I. qr ■Ii .1.11.1:i t''''As" nr,t.'.1. r ' , .: setvice or feeder fee, each
6 65 2
Business name: branch circuit
B Fee for branch circuits
Contact name:
without service or feeder fee,
46.85 2
Address:
each branch circuit
Each add'l branch circuit 6.65 2
-
City/State/ZIP: . Miscellaneous (service or feeder not Included)
..
Pump or irrigation circle 53.40 J 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E
Signal circuit(s) or limited.
1! l'!...." ild : - . .i:V(JNTFACTOR I :::.1 I.:. ;..;• .., .::.., i:.:.;.1.I,11:::1::: . :1'....:,"..•1' : 1 , ,:;,;: e nergy Panel alterat or
exiemon. Describe ra 1 Page 2 -.-z ts' 2
Business name: %A ) ; Ai N 4tit etee_A,z_._
,... 2 1
Each additional inspection over allowable in any of the above
Address: 59 5 0 5 &'J 1 05 d''rz.• t, pr
Per inspection 62.50
City/State/ZIP: - ii, e l j, /44;40- o 6 7.- _ Investigation per hour (1 hr mm) 62.50
Phone: (3 ) Liy -(..) z.i? Fax: (.5 ) 63 V 4 /Z. qz_ Industnal plant per hour 73.75
7i'l'iil';iii•: . 1' ''...: '.. '. . '
CCB Lic.: / /..i 7i ci -„ Electrical Lic.: 34.4 C. Suprv. Lic.: .S 25
Subtotal
......._.
Suprv. Electrician signature, required: j et Up_6( Plan review (25% of permit fee)
Date:
Print name: • State surcharge (8% of permit fee)
ame: s.)Atk. t-^ A \)` er-j j __ 63 ,../
rural, pEaMIT FEE .7q3,
Authorized signature: [AA kA , _-----
This permit application expires if a permit a not obtained within 180
---- days after it has been accepted as complete
rint name' A Ack w ---i- Date: S"-j 1 - 0 t • ree methodology set by Tn-County Building Industry Service Board
•• Number of insnerrinnc n., np.....ar
CITY OF TIGARD 24 -Hour
BUILDING Inspection line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 8' 1 7 AM PM BUP
Location i i i 65 T7 t Suite MEC
Contact Person Ph ( ) PLM
Contractor cc Ph ( ) SWR
BUILDING Tenant/Owner Bit , J ELC
Footing
Foundation ELC
Access:
Ftg Drain - ELR 2 -- 017 / 2- 7
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam An&
Shear Anchors
Ext Sheath/Shear ��•l�
Int Sheath/Shear
Framing
D ywalon la / 'vr.,�� HP/201/5D reel— �
Drywall Nailing A � �I ° / ""�
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
in A PART FAIL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
E ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 8 - l 7 r 0 T Inspector AtiteseLey Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL