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Permit
Aug 31 06 12:22p Stephanie Pate 503-469 p.1 5nr'Seell"9 -7./5' _C AEC j It: Building Division c �TUG 3 l 20 Request for Pernik Action or Refund suiLD N � i SRo SON TO CITY OF TIGARD Permit System eta 19125 SW Hill Blvd., Tigard, OR 972?3 . Pbeooc 503.718.2430 Pam 503.598.7960 ' ww,ggard- or.gvv FROM: ❑ Owner ❑ Applicant 0 ...or ❑ City Staff rslwete one,. REFUND TO: No= / P 7 " CU,e� / y - • (BWbteasor tmadde►.q . V 1 o Mailing Address: c2 CfS .41 /S 4 " / � � br2 cit I ® /state/zip; REDre,eiviv caz .a7do %0 JE?9i✓i✓C Phone No.: .r5 ', - 6' -.- D D 0c7/0 4 i" P E TAKE ACTION FOR THE rrEM(S) cmczen ( 9►. , br CANCEL PERMIT. APPLICATION. ''' AS' REFUND PERAer FEES (Attach za:e pt, if available). — 70 7 J T ricer , /ems ❑ REMOVE CONTRACTOR. FROM PERMIT (do not caned pcm). pmt #: _!- E22.ao1 , Grp 144.2. • Site Address or Parcel #: /4fe2e-s 5 4) / al' 7, / . Project Name: /tLl'lPC.P. 7. ' Sin Nam= Lot #: / - .3 1a ,. xdrfr,42-2~-,4- iv, Q 146:, A . �/ze.e A � Date 4 'Ji Si ��'�� _ _ . Print Nam 7-- "1 �/¢ .7 Ana - • e 1. Tie Ihsl ragOf e m. %abodes the sebum] of 41 Isar fiewbicAwtor« Ina or c b) net tepee than SO pe Beet of the pie fee toe it.nd Patel° poor to ■n+y inepoitioa mums. . 0 sot mote ewe So pewee steles ct ie+. feo..Ae t so epplierese is esnoe)e t bofeoe der ?Iwo tesxw elate hes beet espeeiddd. . 2. Wends wig be gemmed to die oeigjod Pim in tbo owns method it istach moue wee oxei►ed. 1 (!1 Ii .l•. ), 11 ti ::.'1 Rte; to 51s Date - - i , Q � Rte to :. Admix% Date By . . •e�i invoice rroee a d: Dite 8 xefime! Pl000es.e� • : � ,1 /�lIMESi.... A ra sobs mac 711740 K31 Date . - • - • it i %I.'ll� Date '/I31.11 M ethod ,,.9fJ1 Ate; . \ Mil d .,...\T`.... rv.wilr• ? R .f e. - • C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT PERMIT #: ELR2006 -00192 ,j� DEVELOPMENT H BMEN9 Tigard, -639 -4171 DATE ISSUED: 8/16/2006 PARCEL: 2S 110AB -00200 SITE ADDRESS: 14285 SW PACIFIC HWY ZONING: C - G SUBDIVISION: CANTERBURY SQUARE LOT: 1 - JURISDICTION: TIG Project Description: Studio II Frame & Gallery. Burglar 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: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: KOLVE, G C ADT SECURITY SERVICES, INC 14389 SW PACIFIC HWY 2815 SW 153RD DR TIGARD, OR 97224 BEAVERTON, OR 97006 Phone: Contact #: PRI 503- 469 -7100 FAX 503- 469 -7110 FEES Reg #: ELE 26- 209CLE LIC 59944 Description Date Amount [ELPRMT] ELR Permit 8/16/2006 $75.00 [TAX] 8% State Surcha 8/16/2006 $6.00 REQUIRED ITEMS AND REPORTS 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 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: J.� Permittee Signature: .Nc 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. Aug 16 06 07:07a Stephanie Pate 1 t 503469 p.1 Ek ^ctrical Permit A o k 1 FOR OFFICE 11SE ONLY Cat}' Of Tigard rkneelDv 76 (1 /pe„ ponrit No. -��i3O W/ e 13125 $ W }Isla Blvd., Tigard, OR 9 7223 AUG 16 2006 Pl an Review ~ _ Other ' Phone: 503.639.4 171 Fax: 503.593,1460 y W, Date/By: Inspection Line: 503.639.4175 '' mite It ady.'tsy: t. 's El Sec Page: for Internet: www.ei.tigad.or,us ‘../. 9 1 ' ( or I i'Ll v' VutificdlMcthod: ...r /� SuppleRrcnut Infuriation _ � s a ItIC . : PLAN REVIEW ❑ Ncw construction ❑ Addition •altcratiell /rcplaccmcnt • Please chock all that apply: ❑ Demolition ❑ Other: ❑tiervice over 225 amps, comm'l ❑fItizardous location ❑tiavice over 320 amps - rating ❑ Buildng over 10,000 sq. ft.. .. . , .. • • •. CA'fEGORZV OP CONSTRUCTION... :. :. ' . • of I. and 2- family dwellings 4 or more new residtvilial ❑ 1- and 2- family dwelling tEj Commercial /industrial ❑ Accessory building ©System over 600 volts nominal units in one sTrtrcturc• ❑ ylulti family Master builtl� ❑ OlhOr: ❑ Building over duo: stories ❑FCcden, 400 amps or more DOccupant loud over 99 persons ❑Manutiictured structure or . • : : JOB 'SI'T'E INFORMATIO\ AND 'LOCATION •. • . • .. ❑tignzs/lighting plan RV park �/ ❑thvlth• care facility ❑Other: Job no. : ,�o 1 / Job site address: / "- $44, �j9d�/ .-re.. ' ' 1� / r : Submit ,2 - sets of plans with any of the above. city/State/ZIP: Q e, 9 7-2 a The above are not applicable to temporary construction acMec. ," / 1��rrre Pt- FEE' SCHEDULE C Suitc/bldg,: ;apt. no.: Pro Warne: trcyeeptfoa _ I Oar. I I'm, I rn I .• �G� Cross strrcn/directions to job situ: 4 I New resldctttial sinple or multi dwelling unit. ' _ . Includes stanched garage. 1,000 sq. ft. or less 145.15 4 Subdivision: 1.01 n0.; L:i� a dd'I 500 sq. ft, orportion 33.40 _ 1 Tax map/parcel no.: - -._ • i Limited energy. residential 75.0 2 Limited energy, note- rtsidcptial 75.00 2 • . • . . •'DESC'RH 1ON OP WORK€.. • . ' !Mach manufactured urmodular • .1 i dwelling, say ice and/or feeder 90.90 2 • - i Services or feeders installation, alteration, and/or relocation _ / 200 ;imps cr Icss 10.30 + 2 - ❑ PROPIat7 ' • • OWNER I. 201 amps to 400 amps 106.85 2 - 401 amps to 600 amps 160.60 _ 2 Name; 601 amps to 1,000 amps 240.60 2 Address: - Oves' 1,000 amps or volts 454.65 2 Reconnect only I 66.85 2 City/Suite/ZIP: --. Temporary services or feeders installation, alteration, Bed /or relocation Phone: ( ) Fax: ( ) 200 amps or It's F 66.85 F Owner installation: This ins i being made on property that 1 own which is not 701 amps to 400 amps I 100.30 intended for sale, !case, rent, or exchange, according to ORS 44 7.449, 670, and 701. 1 401 ;imp,, to 600 amp• ! 133.75 Owner signature: Date: •__ Branch circuits - new, alteration, or extension, per panel O APPLICANT. I. COV'1'ACT •PERSON ... A. FCC for branch circuits wit -' w • - --- --- Mavis or feeder fee., each Business name: hrtnch circuit 6.6S 2 i B. Fcc er c ccuits Contact name; y 4111 - wi/lvo st h rn ' I'adcr le. 46.85 2 Address: r „ `^ first brand: circuit Each udtl'l branch cis ai: . _ _ _ 6.6 � ~ City /State/ZIP: Miscellaneous (service or feeder not included) Phone: (SD3 q/. 4, 4� -� I Fox:: ( ) Pump or irrigation circle 53.40 2 Sign or outliat lip 53 lighting .40 2 E -mail: S ilm;rl circuit(n) Or limited- I - ()UN'I Iartt^ l;Oli • __ .. - ~^ energy panel, alteration, or co extension. Describe: / ; Pa',c Business names AOT Security Services � I , - n1 Each additional inspection over allowable in any of the above Address; 2315 SW 153 Dr. ,, ---- -- ... . " _ Per inspection I 62.50 City/State/ZIP: Beaverton OR 97006 Inveslig ;ttiuu per hour (1 hr min) 62.50 i Phone: (503) 469 -7100 Fax: (503) 469 -7114 _ Industrial plant per hour 73.75 ELEC :T1UCAL PERMIT FEES* : CCB Lic.: 59944 � Electrical Lie.: 26.209CLE - Suprv, Lie.; 1.F.A339 Subtotal d 1 Supre. Electrician signature, required: - � � Plan review (25 %ofpermitfix:) iee - � �' State surcharge (3% of ptamit fOC) 6. 0° Print name: f 4-'E - 4 � llaoc: 067:T. - .- - • TOTAL PFC mn FEE 4- 9/ 0° Authorized sign;tture /,.e...414,2..1 'Thin permit application minx If a permit is not ahtainud within 1tf0 / ear; after it hea two occurred xi complete Print name: /< 4/ vj• I Date: . 1 • Fee methodology set by 7'ri- County llui:eiii , Irohi uy Seivwo Hoard .... - . - . -, J -• Number of imt+eaiiun, per perinn :rllteatel. nuildingNPomri .CLC•PcrmitApp.Jue 1 ;/0 }( /, / /' � �L a e d . 40-9615Tt1WU:AX). VVil :It