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10340 SW NIMBUS AVENUE BLDG N N :QA'd{ SRHWIN MS OKOI CL oc � a � v� OQ W O M O 10340 SW NIMBUS AVE N nBUILDING PERMIT CITY *60 TIGARD PERMIT#: BUP2004-00460 DEVELOPMENT SERVICES DATE ISSUED: 9/28/2004 13125 SW Hall Blvd., Tlaard.OR 97223 ('5031639-4171 PARCEL: 1S134AA-02100 SITE ADDRESS: 10340 SW NIMBUS AVE N SUBDIVISION: ZONING: I-P BLOCK: LOT: _ JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: T!PE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: NONE sf N: 3: E: W: OCCUPANCY GRP: TOTAL AREA: 0 sf HOOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf I _FT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BAThJ: IMP SURFACE: PRO CORR: PA.2KING: VALUE: $ 67.700.00 Remarks: Re-roof. Owner: Contractor: ROBINSON, CONSTANCE A + GRIFFITH ROOFING ROBINSON, LYNN + BELL, KAY ET 6815 SW 11 1 T AVE BY INSIGNIA COMMERCIAL GROUP BEAVERTON,OR 97005 BVhVEe TON, OR 97008 Phone: 643-1596 Reg#: LIC 0000009g2g5 FEES _ ! MET RECINgINSPECTIONS Description Date Amount Final Inspection I[iUILD] Permit fee 9/28/2004 $569.26 ITAXj R",%,State Surchart 9/28/2004 $45.54 Total $614.80 CL oc F" This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and Al other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is �ot started within 180 days, of issuance, or if work is suspended for more thAn 180 days. ATTENTION: Oregor law requires you to follow the rules adopted by the Oregon Utility Notification Centra. Those rules are set forth in Of R m 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by W calling (503)246-6699 or 1-800-332-2344. Issued By: � Permittee ----- Signature: _ Call 639-4175 by 7 p.m.for an Inspection the next business day BufldingPernApTapinft City of Tigard p��p 1 D""received: --- �rnrt��• y � gtW16RAl"Q2i004 Project/appl.no.: Expire date: c''tynfTigard Address: 13125 SW Hall Hlvd,Ti - Phone: (503) 639-4:71 CITY OF TIGARD Date issued_ By: Receipt no.: ' Fax: (503) 598-1960 _BUILDING DIVISION Came file no.: Payment type: Land use approval:_ l&2 family:Simple Complex: 0 1 &2 family dwelling or accessory Ul Commercial/industrial ©Multi-family ❑New conatructio lition ❑Addition/alteration/replacement Q Tenant improvement U Fire sprinkler/alarm Other: ro ;n6 address: L 1Tell Bldg.no.T_ 3uiteno.: Lot: Block: Subdivision: Tax map/tax lot/account no.: Project nama: ,� �,��< —�� Descrip 'on and locatip�of work on premises/special conditions: Tp ar 0" arc "T I)o-TyV It r]Gds A 1 � Name: Mailing address: 1&2 firmly dwelling: City: State: Z1P: Valuation of work ......................................... S -- Phone: Fax: I E-mail: No.of bedrooms/baths.................................. Owners representative: _ M Total number of floors.................................. Phone - _9qgC, JFax5W-.5*?j;_1fidV-maiI: New dwelling area(sq.ft.)............................ Garage/carport area(sq.ft.).......................... _ Name: Covered porch arra(sq.ft.).......................... Mailing address: P)ln Sv,) JJ\LW kVcn" Deck area(sq.ft.).......................................... _ City: State:p R I Zip:cl 1005 Other structure area(s .ft.).......................... Phone << Fax j (r y - , -mail: ComimerclabledawtrhU ARM-family, Valuation of worst ........................................ S (01, "OL) Existing bldg.arca(sq.ft.)............................ 229 Business name: 1 New bldg.area(aq.ft.) ).................................. Address: _ City: State: pZIP: UL, Humber of stories......................................... KI Type of construction ..................................... Phone- y3 .1,59 Fax - f E-mail: O!"Upancy group(s): Existing: CCB no.: [ 15 _ New: -- City/metrolic.no.: LJ51JLr Notice:All^mritractors arrd subcontractors are required to he licensed wiL't the Oregon Construction Contractors Doar d under Name: `i CV —_ provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed.If the applicant is IL IL city: State: O ZIP: t exempt from licensing,the following reason applies: M Contact person: Plan no. &2ZM, — a e. U. 5Farrj0j- -mail: .— ----- --- ---- .J m Name.-TtA Contact person: h Fees due upon application.............................S Address: a Date received: -- W �. --1 City,: State:C, ZAmount received........................................... PhoneF; .yy3- Fax:-;)3-tlt{3-email: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Ni it wwktkm wow aa*endk oem can I ror M attached checklist.All provisions of laws and ordinances governing this ❑Via O MaterC.nd work will be complied with,whether specified herein or not. Cremt end"Mb": -- Rr Authorized signature: Date: -- � S Print name: -Z ry J n G ---- CafdWder-Ian.aieArwim Notice:This permit application ex,-,ices if a permit is nm ektained within 180 days ager it has been accepted as complete. 4/04613(&%K)OW CITY OF TIGARD 24-Hour BUILDING ry� Inspection Line: (503)631"175 � MST INSPECTION DIVISION Business Line: (503)639-4171 60O SUP Received Date Requested �` �1—AM PM— _ OUP Location q61—� -Suite �- MEC Contact Person - A4- ,. Ph PLM Contractor Ph BUILDING Tenant/Owner ELC _ Footing ELC Foundation Access. Ftg Drain ELR _ -- Crawl Drain Slab Inspection Notes: Q SIT — -- Post; beam Shear Anchors Ext Sheath/Shear -_- Int Sheath/Shear Framing - - -{-- - - ----- - Insulation Drywall Nailing -- -_ -- --- Firewall Fire Sprinkler - -- - - Fire Alarm Susp'd Ceiling ASS PART FAIL - ----_._._.-._.-------- Post&Beam Under Slab - -- - Rough-In Water Servi--e - Sanitary Sewer Rain Drains - ---- -�� - Catch Basin/Manhole Storm Drain - Shower Pan _ Other: - Final PASS PART FAIL MECHANICAL __—_-- Post b Beam Rough-In Gas Line Smoke Dampers - -- -___.__`v _ .-- —•-- o- - -- Final N iPASS PART _FAIL ELECTRICAL _ Service m Rough-In 6 UG/Slab aLow Voltaga --- - - -- --- -- --_ Fire Alarm Final r] Reinspertion fee of$_ —__ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL r-- SITE Please 11 for rein pection RE __- - Unable to Inspect-no acc9ss Fire Supply Line ADA Approach/Sldewalk DIM Other: Final NOT REMOVE this 1 wlsoft9W theta job Bib. PASS PART FAIL CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT M: ELG98-0037 ' DATE XSSUEDa 01/22/98 13125 SW Hell Blvd., Tigard,OR 97223 (503)094171 PARCEL: 16134AD-06201 SITE ADDRESS. . . : 1O34O SW NIMBUS AVE MN SUBDIVISION. . . . : ZONING: I–P BLOCK. . . . . . . . . . : LOT. . . . . . . . . JURISDICTION: TIG Pt o j ect Descri pt i on: TCB - installation of data telecommunications system �. ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDCRS---- -----MISCELLANEOUS----- ( 1O00 SF OR LESS. . . . s 0 0 – 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . s 0 EACH ADD' L 5O0SF. . . : 0 201 -- 400 aimp. . . . . . . s 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 – 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . s 1 MANF. HM/ SVC/FDR. . : 0 601+a►mps--1000 volts. : 0 MINOR LABEL (10) . . . : 0 ---SERVICE/FEEDER---- ----BRANCH CIRCUITS----•-- ----ADD' L INSPECTIONS—— 0 – 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . : 0 201 – 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . 1 0 401 – 600 amp. . . . . . : 0 EA ADD' L BRNCH C1RCs 0 IN PLANT. . . . . . . . . . . : 0 601 – 1000 amp. . . . . . 0 -----------------PLAN REVIEW --------- 1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR )- 225 AMPS. . : CLA66 AREA/SPEC OCC. s Owner: -------------------------------------------------------- FEES ------- -- BRUCE RUDMAN type amount by date recpt 10866 WILSHIRE BLVD PRMT f 40. 00 ARA 01/22/98 98-302585 STE 905 SPCT f 2. 00 DRA 01/22/98 98-302685 LOS ANGELES CA 90024 Phone ##: Contractor: ---------------------------------------------•--------.---------- OPTEC INC f 42. 00 TOTAL. 7324 SW DURHAM RD ------- REQUIRED INSPECTIONS --- -- PORTLAND C.1 97224 Ceiling Cover Elect' l Service Phone ##: 639-2871 Wall Cover Elect' 1 Final Reg #1. . : 000641 This permit is issued subject to the regulations contained in the Tigard Municipal Cade, State of Oregon Specialty Codes and all it`mr applicable laws. All work Mil! be done in accordance with approved plans. This permit will expire if work is not started within R1 days of issuance, or if work is suspended for more than 188 days. ATTENRONt Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thofe rules et forth in GAR through OAR %2-111-1987. You may obtair a copy of these rules or direct questions to (XK 2WI987. Permittee Signature: Issued ac sem ----- – - -_.____---- ------__– ---OWNER INSTALLATION ONLY------------------------------- The installation is being made on property I own which is not intended for J sale, lease, or rent. OWNER' S SIGNATURE: -___--_– DATE s _ — W ----------------------- CONTRACT R I ONLY– ------------------------------------ SIGNATURE OF SUPR.l�ELEECI N: DATE: _ LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++{•++++++++++++++++++++++++++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next business day ++++++++++i•+++++i•+++++++++++.. ++++++++f+++++++++.++++++++++++++++++++++++++++++ CITY.OF TIGARD Electrical Permit Application Plan 13125 SW HALL BLVD. Rec'dMZ TIGARD ON 97223 Date Rec'd Date to P.E. Phone (503)639-417 1, x304 Print or Type Date to DST _ Inspection (503) 639-4175 Permit if Fax (503)684-7297 Incomplete or illegible will not be accepted Called_- _ 1. Job Address: 4. Complete Fee Schedule Below: Name of Development _ Number of Inspechnns par permit atlowed Name(or name of business). 7- C Service Includad: Items Cost Sum Address./3 / tf�_� 07�, 4a. nesldentlal-per unitc� 1000 sq.ft.or less $110.00 4 City/State/Zip _ � �-,!222 �� _ F_ach additional 500 sq,ft.or portion therecl _ $25.00 1 Commercial Residential❑ Limited Energy i $25.00 Each Manul'd Home or Modular Dwelling Service or Feeder $88.00 _ 2 2a. Contractor Installation only: (Attach copy of all curre a1 4b.Services or Feeders Electrical ontractor _�� ( �/�'� Installation,alteration,or relocation Address ��yJw _/ oltsyyn, ,p�- 200 amps or less ____ $80.00 2 201 amps to 400amps _i �0 00 _ 2 City/�ORT/,�1r.r State �Zp ir7�l.h 5' 401 amps to Boo amps $120.00 _ Phone No. - 601 amps to '000 amps $120.00 2 Over 1000 Amps or volts 2 .lob No. - y � $340.00 2 '- Reconnect only $5ri.00 2 Elec.Cont. Lice.No. Exp.Date ---- -OR State GCB Reg. No. 1 7 Exp.Date 4c.Temporary Services or Fooders COT Business Tex or Motro �EYp.Qate Installutlon,alteration,or relocation 200 amps or less $50.00 _ 2 Signature of Supr. Elec'n � 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. ,� T J_.X Exp.Date�C��=9� ft*"b"above. Phone NO._ �3�_i - 4d.Bnnch Circuits New,alteration or extension per panel 2b. For owner installations: a)The lee for branch circuits with purchsas of service or Pont Owner's Name _ foodar lee. Address - I Each branch circuit -_ $5.00 - 2 State Zip__ without The fee for branch circuits without purchsss of Phone No. service or feeder tee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 2 intended for sale, lease or rent. 4e.Miscellaneous (Service or feeder not included) Owner's Signature Each pump or Irrigation circle $40.00 2 Each sign or outline lighting $40.00 _ _-.- 2 3. Plan Retry qr/section(if required):' Signal circuits)or a limited energy panel,alteration or extension2 Minor Labels 110) � Please check appropriate Item and enter fee In section 5B. In 4 or more residential units In one s!ructure 4f.Each additional Inspection ova >- Service and feeder 225 amps or more the allowable In any of the above System ovar 800 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 _ fib ns described In N.E.C.Chapter 5 In Plant __ $55.00 C7 W `Submit 2 sets of plans with application wt.dre any of the above apply. 5. Fees: J ,i7 pC7 Not required for temporary constru^tion services. Ss.Enter total of above fees $ 6� 5%Surcharge(.05 X.total fees) $ NOTICE Subtotal $ Sh.Enter 25%of line So for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review f rreauired(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 11Tntst Account fa _ , Ct� Total balance Due s rU)STMELC96 APP Rev 9'99 CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd.,Tlg84OR97223 (5a1)639-4171 — RESTkICTED ENERGY PERMIT Me ELR97-•0134 DATE ISSUED: 05/07/97 PARCELe 1S134AD-06201 SITE ADDRESS. . . : 10340 SW NIMBUS AVE #N SUBDIVISION. . . . : ZONING: I—P BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTN: TIG Project Description: RX A. RESIDENTIA: --------- B. COMMERCIAL------------------_---------_ AUDIO & STERFO. . . a AUDIO & STEREO. . e INTERCOM & PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . e GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . e MEDICAL. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . . OA iA/TELE COMM. . s X NURSE CALLS. . . . . . . . . VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC l_I TE s OTHER: : s HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : ?NSTRUMENTATION. s OTHER. . e . . TOTAL_ M OF SYSTEMS: 1 Owner: ---------------------------------------------------- FEES ------------ BRUCE RUDMAN type amount by date recpt 10866 WILSHIRE BLVD PRMT t 40. 00 JSD 05/07/97 97-294245 STE 905 5PCT $ 2. 00 JSD 05/07/97 97-294245 LOS ANGELES CA 5`0024 Phcne #a 31.0-474-4770 Contractor: --------------------------------------------------•------------------ OPTEC INC 42. 00 TOTAL 7324 SW DURHAM RD ---- ----- REQUIRED INSPECTIONS ----- PORTLAND OR 97224 Ceiling Cover Elect' l Final Phone 11: 639-2871 Wall Cover _ Peg 1k. . : 000641 This peroit is issued subject to t'e regulations contained in the Tigard Municipal Code, State of Dre. Specialty Codes and all other Pe y' applicable lams. All work will be done in accordance with approved plans. This peroit will Rxpire if work is not started within IN days of issuance, or if work is sws'eodod for owe than IN days. I s s u ed y — ---OWNER INSTALLATION ONLY----------------------------- — The installation is being made on property I own which is not intended for W sa'• a , lease, or rent. OWNS.:R S S I GNATURE s _ DATE e _ w m __.----------------------CONTRACTOR INSTALLATION ONLY---------------------------- SIGNATURE OF SUPR. ELEC' N: DATE: LICENSE NO: Call for inspection — 635-4175 CITY OF,TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd b� 13125 SW HALL BLVD mate Rec'd:_C) TIGARD OR 97223 PRINT OR TYPE t V 503-6394171 X304 Permit#: F 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL _, �,/E'i}�dT CO�h try �eO�/� Restricted Energy Fee........................................ .00 (FOR ALI.SYSTEMS) JOB Street Address SW#r G ADDRESS X-3 Y0 Chock Type of Work Involved: City/State / (7Brip�� Phone N / Audio and stereo Systems _ (o ._'! ' Name ❑ aurglur Alamo OWNER liatling Address -- ❑ Garage Door Opener' City/state Z!p Phone N� ❑ Nesting,Ventilation and Air Conditioning System' Name Q El Vacuum Systeme' P7-&C __7_oyG ❑ Other CONTRACTOR Mailing Address .24.2 ' S.W. r c.�i>• 1�e IYPE OF WORK IN'VOLVFD-COMMERCIAL __ (Prior to issuance a City tate Zip hone N Fee for each system.............................................. 0.00 copy of all Ilrxnses % ,. +,I e (SEE OAR 918-260-260) aro required If Oreg(n Contr.8b LIc.0 FOrp.Date expired in C.O.T. (/ /j? S - .,V_y 2 Check Type of Work Involved: data base). Electrical Contr.Lic.N Ex Dab /� ❑ Audio and Stereo Systems C T Metro � xp.Date Boiler Controls Owifer's Ne _ ❑ Clock Systems JWNER- Mailing Address y APPLICANT 1�1 Data Telecommunication Installation City/State Zip Phone N ❑ J Fire Alarm Installation This permit is issued under OAE 918-320370.This applicant agrees to make only restricted energy installations(100 voH amps or less)under this ❑ HVAC permit and to do the following: ❑ Inatmmentation 1. Only use electrical licensed persons to do Installations where required. Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems These have asterisks('). All others need Iirensing; ❑ 2. Cell for inspections when Installation under this permit are mady for Landscape Irrigation Control- inspection at 603-6394176; ❑ Medical 3 Purchase separate permits for all installations that are not reedy for an ❑ Nurse Calls inspection when the inspector is out to Inspect under this permit; 4. Assume responsibility for assuring that all corrections required by the E] Outdoor Landscape Lighting' inspector aro done,and; L7 Protective Signaling 5. Assume responsibility for calling for a final inspection wh"n all of the corrections are completed. ❑ Other Permits aro nun-transferable and non-refundable and expire if work Is not started within 180 days of Issuance or if work is suspended for 180 days. / _Number of Systems The person signing for this ermit must be the applicant or a person No 1k,@nses are required Lk ensu are rw ulred for all ether installations authorized to bind /Kllc i ENTER FEES 6%SURCHARGE(.06 X TOTAL ABOVE) _ Authority if other than App;icant TOTAL j !Vesce doe I M ,r CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171 Date Requested: - I —, —�-- A.M. --__ P.M.—_. MST: (,ocation: — �Q� 0 S-W BUP. Tenant: /� C -- Suite: - Bldg: Contractor: —_ Phone: ,N " /� 70 — mm Owner:--------- ----- --- --- L d� I:LC:.�/1�- -- - -- — --- -- ELR: -- __ SIT: _ WILDING BLDG(con't) PLUMBING MECHANICAL ELIrCTRICAL SITE Site Post/Beam PosV'3eam Post/Beam i -Cawrsswar SewerRtorm Footing Reof UndFl/Slab Rough-In Ceiling Water Linz Slab Framing Top Out (Dei Line Rough-In Ufa Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault I3-mt Damp Drywall Storm Furnace Ternp Service. MISC. Masoury Ceiling Raiu Drain A/C 130 Slab Shear/Sheath Fire Spklr/Aim Crawl/Found Dr Heat Pump It _ Approved Approved Approved Approved Approved Appr/Sowlk Not Approved Not Approved Not Approved W61 pproved Not Approved FINAL FINAL FINAL FINAL FINAL a _J m W J -- ———-- --- ---- —- - - Cl Call for reinspection inspection fee of S— a required before next inspection Cl Unable to inspect Inspector.— Dine:�L�,.I�.__.^ Page _•of CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL I CAL PERMIT 13125 WHO Blvd., 17gard,OR 97223 (503)6394171 PERMIT DATE ISSUED: 02/-0112 02/25/97 PARCEL: IS134AD-06201 S T TES ADDRESS. . . : 1034 SIJ NIMBUS AVE #N 'it!PDIVISION. _ . ZONING: I-P BLOCK. . . . . . . . . . LOT. . Project Description : Installation of of, signal circuit ----------------------------------------- --RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS------ ----•--MISCELLANEOUS----- 1000 SF OR LESS, . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. , : 0 LIMITED ENERGY, , . . . : 0 401 (.j'-Ao amp. . . . . . . : 0 SIGNAL/PANELL. . . . . , . : i MANE. HM/ SVC/FDR. . : 0 601+amps--1000 volts. e 0 MINOR LABEL ( iib) . . . : 0 ------SERV I CE/FEEDER- --- ----DRANCI'. CIRCUITS-. _ - - -ADD' l.. INSPECT IONS..--- q1 - 400 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 I 401 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 (,01 1000 -Imp. , . . . : A _._._.__._. __.___._._.__._.___._pl._AhJ REVIEW 1000+ amp/volt. . . . . : 0 )-4 RES Ut'ITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR > 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: ---____..__.----------_______________.-_-------___-._.-- FEES nCTION TECHN0LOGY type amol_lnt by date rer_pt n35 SE 17TH PRMT f 40. 00 DRA 02/25/97 97-290846 9- PCT $ 2. 00 DRA 02/25/97 97--290848 PORYL_AND OR 97214 Phon.i #: 231-1992 Contractor: ----•---------____._______________ __________.___---•-_--_______.____.._.___ ___ ACTION TECHNOLOGY SYSTEMS $ 42, 00 TOTAL (TELEPHONE & ALARM SUPPLY) 335 SE 17TH AVE - - ---- REQUIRED INSPECTIONS - ----- - f"'ORTI-nND OR 97214 Ceiling Cover Undergrotind Cove Phone #: 503-231-1992 Wall Cover Elect•' l Service 000791 'his perait is isaued subject to the regulations contained in the Tigard Municipal Code, State of Ore, Specialty Codes and all other Permittee S i gnat i.tre ,4 appli^able laws. All work will be done in accordance with approved plans. This perait will expire if work is not started l" Q within 198 days of issuance, or if work is suspended for sore j-K than 180 days. C�L s aed A ' Y F- ___._______________---___----OWNER INSTALLATION ONLY--_-__-____-_-_-__-_-__-__-__-._ N The installation is being made on property I own which is not intended for "ale, lease, or reT;t, !IWNER' S SIGNATURE: r DATE: L7 uu _______._______.____.__.____CONTRACTOR INSTALLATION ONLY-----------__-______-__w_-_ 916NATURE 0;= 13UPR. ELEC' N: DACE: ! .ICENSE NO: Call. for inspection - 639-.4175 CITY OF TIGARD Electricai Permit Application Plan c 1311!5 SW HALL BLVD. fiec'd e ��-'��- TIGARD OR 97223 Dale Rec'd-8 - Dale to P.E. Phone(503)639-4171, x304 Print or Type Date to DST- �J- Inspection (503)639-4175 Incomplete or illegible will not be accepted Permit 0 Fax (503)684-7297 Called 1. Job Address: 4. Complete Fee Schedule Below. Name of Development_ Number of Inspections per permit allowed -- Name(or name of business) G Service included: Items Cost Sum Address J O 3e*0 S 1.J 46. Residential-par unit City/State/zip T1000 sq.It.or lass $110.00 4 TC�t�J1nr.> Qv?- d1-12 2 _ Each additional 500 sq.n.or -- ❑ portion thereof $25.00 Commercial Residential Limited Energy $25.00 Each Manul'd Horne or Modular Dwelling Service or ree(!er _ $68.00 �__ 2 2a. Contractor Installation only: - (Attach copy of all current licenses) 4b.Services or Feeders Electrical ContractorP4C�SOn7 T xNp�,[�p�-� Installation,eneration,or relocation 200 amps or less 2 Addres^ X35 SE t.'1T+1 201 amps l0 4r10 amps -- $80.00 � 2 City rtX I.V1*4t� State_t'D+Z Zip ®l_1?�1 _ 401 amps to 800 amps $120.00 Phone No. 23 t- t OtVk 601 amps to 1000 amps $180.00 2 2 Job No. Over 1000 amps or volts $340.00 _ 2 Elec.Cont. Lice. No. 2fr--1-\ Cit:_Exp.Date_1,d - 1 -�"t nnconnect only $50.00 2 OR State CCB Reg. No._-1 gl'�__Exp.Date I - l S'QI q 4c.Temporary Services or Feeders COT Business Tax or Metro No._ 2 e1O�-Exp.Date W-1-Al Inetalintion,alleratien,or relocation `-��''..,,..,, 200 amps or less $50.00 _ 2 Signature of Supr. Elec'n f;V . 2.01 amps to 400 strips � $75.00 2 401 amps to 600 amps $100.09 -_ 2 Over 600 amps to 1000 volts, License No. S-101 Exp.Date ( - t - �Q see"b"above. Phone No. 231-\ hO%2 ` - 4d.Branch Circuits New,allegation or extension per panel 2b. For owner installations: a) the lee for branch circuits with purchase of service or Print Ownur's Name lveder too. Address Each branch circuit _ $5.00 2 -- b)The lee for branch circuits City State Zip without purchase of Phone NO. _ service or leede-lee. First branch circuit $35.00 _-! 2 The installation is being made on property I own which is not Fach additional branch circuit $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous Owner's Signature (Service or leeder not Included) g - Each pump or Irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required): Sfgnal circult(s)or a limited energy Q panel,alteration or extension _ $40.00 2 Minor Labels(10) - $100.00 Please check appropriate Item and enter fee In section 5B. 4 or more residential units In one structure 41.Each additional Inspection over v Service and feeder 225 amps or more the allowable In any of the abo✓e -- System over 600 volts nominal Per Inspection $35.00 J v,Classified area or structure containing special occupancy Per hour $55.00 m as described In N.E.C.Chapter 5 In Plant _ $55.00 _ J "Submit 2 sets of pLtns with application where any of the above apply. 5. Fe P.s: Not rayulred for ternporat t constructlon services. 5a.Enter total of above teas $ 40'a,:) 5%Surcharge(.05 X total fees) $ --� N_OTI&u Subtotal "t 5b.Enter 25%of line 5a!or PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review ffMidrgL(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 0 Trust Account if ^_ , Total balance Due s taosrsu LC"APP Rev W"