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Permit f ^ w III CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00476 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/21/2007 PARCEL: 2S113AB -00300 SITE ADDRESS: 16083 SW UPPER BOONES FERRY RD ZONING: I - SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG PROJECT: FANNO CREEK PLACE Project Description: Low voltage systems. (3). Data telecommunication, FIRE ALARM, access control. A. RESIDENTIAL B. COMMERCIAL _._ AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: • HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: . TOTAL # OF SYSTEMS: 3 Owner: Contractor: OPUS NORTHWEST LLC BERGELECTRIC CORP 1500 SW FIRST AVE. STE 1100 6026 NE 112TH AVE PORTLAND, OR 97201 PORTLAND, OR 97220 Phone: 503 -916 -8963 Contact #: PRI 503- 255 -1818 FAX 503 - 255 -1919 FEES Reg #: ELE 37 -682C L1C 110521 Description Date Amount SUP 5121 S [ELPRMT] ELR Permit 12/21/2007 $225.00 [TAX] 8% State Surcha 12/21/2007 $18.00 REQUIRED ISMS AND REPORTS 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 or 1.800.332.2344. / Issued By: ��,�_ Permittee Signature: X, ■10 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 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. r � I V ED � El Permit plicatiRECE FOR OFFICE USE ONLY }�, „DEC 2 1 2001 Received - City 13125 SW Hall Blvd., of Tigard • ii Permit No ;- -. Ti . , ard, OR 9722 Date/B D '7 i _�_ - OD Tigard, Pl Revie � /� p Other Permit Phone: 503 639 4171 Fax 503.598 b b" 6 " OF TIGA� Date/B 7.[v Inspection Line: 503.639.4175 ® ^ p� S( f Date Ready/By. luny ® See Page 2 for TIGARD Internet www.tigard -or gov F� UII.QI �lG D1 Notified/Method Supplemental Information ' TYPE OF WORK • • PLAN REVIEW g? New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION • ❑ Emergency system larger separately derived system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ", Job no.: Job site address: / ' / R 1 00HP or more 1 ���� ! F�D V � Rf V f?O SA S �C/1� �� ❑ Six or more resident units. occupancy ❑ ts. Recreational vehicle parks. City/State /ZIP OR / ❑ Health -care facilities ❑ Supply voltage for more than 1 r ` 1 J a ❑ Service or feeder 600 amps or more FEE SCHEDULE ❑ Hazardous locations 600 volts nominal s t y Suite /bldg. /apt. no.: 1r, 1 Project name: F�4r l . " /'c 0 �( ' Cross street/directions to job site: ' l \ J Description I Qty. I Fee. I Total I New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft or less 145 15 4 Ea. add'I 500 sq ft or portion 33.40 l Tax map /parcel no.: Limited energy, residential • 75 00 2 DESCRIPTION OF WORK (with above sq. ft.) / Limited energy, multi - family 75 00 2 L p V O I l 1 e 5+e ‘415 Sb - .6t� residential (with above sq ft.) / Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER ` - I : • ❑. TENANT . 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160 60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) I Fax: ( ) 200 amps or less 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 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ' I ' ❑ CONTACT PERSON • above service or feeder fee, 6.65 2 each branch circuit Business name: Bergelectric Corp. B. Fee for branch circuits Contact name: T1, • ] without service or feeder fee, 46.85 2 day /y_; re..-- first branch circuit Address: 6026 NE '1'12 th Ave. Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) _ City /State /ZIP: Portland, OR 97220 Each manufactured or modular 9090 2 dwelling, service and/or feeder Phone: ( ) 503 - 255 -1818 I Fax: : ( ) 503 - 255 -1919 Reconnect only 66.85 2 E -mail: Pi i ,'i t; f'@ bo ter J tr`i� a C©^ Pump or irrigation circle 53 40 2 ✓ / 7 l � CONTRACTOR Sign or outline lighting 53.40 2 electric Corp. energy p a ne l, a) or t o limited- Business name: Ber or Q gy panel, alteration, or Address: extension Describe. 3 Page 2 2 25 2 6026 NE 112th Ave_ City/State /ZIP: Portland, OR 97220 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) 503-25 1 Fax ( ) 503 - 755 -1919 Investigation per hour (I hr min) 6250 CCB Lic.:1 1 0 5 21 Electrical Lic.: 3 Su ic.: 2/ 5 Industrial plant per hour 73 75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: i `. -:- 1 �y,�, � Subtotal. Z — �/ Date: // �� 7 Plan review (25% of permit fee): Print name: `,v�2re�i�� 72/ / /�(/ / State surcharge (8% of permit fee) / 8 Authorized signature: / TOTAL PERMIT FEE. 2_44.3 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it'has been accepted as complete. • Number of inspections allowed per permit I\Building\Permits\ELC- PermnApp doe 05/23/06 440-4615T(11/05 /COM/WEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELAZOM, • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 �, 1i11 Inspection Requests (24 Hrs.): (503) 639 -4175 .! `+� `__.. INSPECTION WORKSHEET FOR DATE: 2,, 6431) TIME: PAGE: SITE ADDRESS: l to s3 U pout_ Cilflpt 3 CLASS OF WORK: SUBDIVISION: LOT #: 1 ? TYPE OF USE: PROJECT NAME: DESCRIPTION: b W V ��� Aqi OWNER: PHONE #: CONTRACTOR: Weg,0 , PHONE #: • Inspection Request Scheduled For: Date: 2.6r Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /I structions: • • • • • • PASS ❑ PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' u'' Date: ' '� Phone #: (503) 718-.4 •