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ELECTRICAL PERMIT-
CITY OF T I G A R.D
RESTRICTED ENERGY
DEVELOPMENT SERVICE'S PERMIT#: ELR1999-00108
13".25 SW Hall Blvd , Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/30/99
PARCEL: 2S 112AB-00800
SITE ADDRE=SS: 14255 SW 72ND AVE
SUBDIVISIOW ZONING: I-H
B'_OCK: LOT: JURISDICTION: TIG
Proiect Description: Repaid & upgrade of existing burglar alarm
A. RESIDENTIAL B.COMMERCIAL
AUDIO & STFREO: AUDIO & STEREO: — IN1 ERCOM & PAGING.
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM. OUTDOOR I_ANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: : X
TOTAL# OF SYSTEMS:__
Owner: Contractor:
ANDERSEN, H A ET AL MAS TECHNOLOGIES
BY CHARLES L KOBIN 16285 SW 85TH STE 104
610 SW AIDER STC 1200 TIGARD, OR 97224
PORTLAND, OR 97205
Phone: Phone: 306-0958
Reg #: LIC 125921
ELE 26-945CLE
_ FEES _ _Required Inspections
Type By Date Amount Receipt AElect'I Final
5PCT BON 4/30/99 $2.00 99-314975
PRMT BON 4/30/99 $40.00 99-314975
Total $42.00
ORIGINAL.
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 wiihin 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
a Issued by � ) ( t l ( i Permittee Signature 61z" _
> 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:
w
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ Ih,_ — DATE:
LICENSE NO: --- — -__-- - - -- -__-._--
Call 639-4175 by 7:00 P M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
13125 SW HALL BLVD Date Recd: Ll —7t-''J
TIGARD
'' -
TIGARD OR 97223 PRINT OR TYPE
V-503-639-4171 X304 Permit
F - 503-08A-72Q.7 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Deve . .ient Project TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee........................................ $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste#
ADDRESS Check Type of Work Involved
C (State Z� Phone# ❑ Audio and Stereo Systems
Nam /r ❑ Burglar Alarm
T, u `f �D -�N�' ❑ Garage Door Opener'
OWNER Mailing Address
CityWState ip Phone# [:] Heating,Ventilation and Air Conditioning System'
Narfie El Vacuum Systems'
❑ Other
CONTRACTOR Mailing Address
TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to Issuance a C /Statei£ Phone# Fee for each system.............................................. $40.00
copy of all license3 (t / ' (SEE OAR 918-260-260)
are required if Ore on Cont?. Bird Lic. ExpPate
expired in C.O.T. 'Z 1 Check Type of Work Involved:
data base). Electrical Contr.Lic.# Exp.Date
56 /0-Ig' ❑ Audio and Stereo Systems
C.O.T.or Metro Lic.# xp Dale
�t� ' ' ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State Zip Phone# ❑
Fire Alarm Installation
This permit is issued under GAE 918-320-370.This applicant agrees to
make only restricted energy installations(100 volt amps or less)under this ❑ HVAC
permit and to do the following:
❑ instrumentation
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 licensing;
2. Call for Inspections when installation under this permit are ready for F-1 Landscape Irrigation Control'
inspection at 603.639.4176; ❑ MPdir,,l
3 Purchase separate permits for all installations that are not ready 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 ❑ Outdoor Landscape Lighting'
a inspector are done,and, ❑
Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the on
N corrections are completed Other ,2�Y �Oc�/�U� 2 tS`Ik VA.
t ' Permits are non-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
CIO
The person signing for this permit must be the applicant or a person No licensee are regodred Licenses are required for all other Installations
t,l authorized to bind the applicant.
FEES: 'f
/_119-19 nature
ENTER FEF3
5%SURCHARGE(.06 X TOTAL ABOVE)
Authority it other than Applicant. TOTAL_ 11 g2lo O
I clstslresele doc 7197
' CELECTRICAL PERMIT
CITY OF TIG�RD _
/ PERMIT #� ELC1999-00617
DEVELOPMENT SERVICES DATE ISSUED. 10/19/1999
13125 SW Hall Blvd., Tipard, OR 97223 (503) 639-4171
PARCEL: 2S112AB-00800
SITE ADDRESS: 14255 SW 72NC AVE
SUBDIVISION: ZONING: I-H
BLOCK: LOT : JURISDICTION: TIC
Project Description: Install (1) 200 amp service/feeder and (4) branch circuits.
RESIDENTIAL UNITTEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 5rOSF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+amus - 1000 volts: MINOR LABEL (10):
_ SERVICE/FEEDER BRANCH CIRCUITS
— ---� ADD'L INSPECTIONS
0 200 3mn: 1 W/SERVICE OR FEEDER: 4 PER INSPECTION:
201 400 amp: 1st W/O SP VC OR FDR: PER HOUR:
401 - 600 arrrp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR — 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ANDERSEN, H A ET AL FRAHI_ER ELECTRIC CO
BY CHARLES L KOBIN 11860 SW GREENBURG RD
610 SW ALDER STE 1200 TIGARD, OR 97223
PORTLAND, OR 97205
Phone: Phone: 639-4627 ORIGINAL
Reg #: LIC 00037410
SUP 1816S
ELE 34-13C
FEES Required Inspections_
Type By Date Amount Receipt —
Elect'I Service
PRMT KJP 10/19/199E $85.65 99-319166 Elect'I Final
5PCT KJP 10/19/199 $6.85 99-319166
Total - $92.50
This Permit is issued subject to the regulations contained in the TigarJ Municipal Code, State of OR Specialty Codes and all othar applicable laws.
All work will be done in accordance with approved plans This permit will expire if work is not starred 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 ordirect questions to OUNC at(503)
246-1987
v~ PERMITTEE'S SIGNATUREISSUED BY: /
OWNER INSTALLATION ONLY
m
The installation is being made on property I own which is nct intended for sale, lease, or rent.
LD OWNER'S SIGNATURE: —_ _ DA'.c:_
J
_ CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �a DATE: �' ��:� �Jr1
LICENSE NO: _ --� 2) 3 V S _
Call 639-4175 by 7:00pm for an inspection the next business day
CITY;F TIGARD lectricai Permit Application PlaCheck#
•i 3125 SW HALL BLVD. RECEIVE[
Date Rec'd
TIGARD OR 97223 Date to P.E._
Phone 503 639-4171, x304 ' 1999
( ) Date to DST
Inspection (503)639-4175
COMMUNITY 11LVELUPMLIVT Print of Type Permit#'rLG 1999-[A-,1,
Fax (503) 598-1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name(or name of business) FUUGHT & COMPANY Service included: Items Cost Sum
Address 14255 SW 72nd AVENUE 4a. Residential-per unit
Cit /State/Zi TIGARD, OR 97224 Each
ad it or less $ 117.75 a
Y P Each additional 500 sqftor
portion thereof $ 26.25 _ 1
Commercial ® Residential ❑ Limited Energy _ $ 60.00
Each Manurd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder _ $ 72.75 _ 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
information for COT data base). Installation,alteration,or relocation
Electrical Contractor_ I'POHLER ELECTRIC CUAMNY 200 amps or less 1 $ 64.25 $64.25 _ 2
Address 11860 5W GRE01BURG RUAU 201 amps to 400 amps $ 85.50 2
Ci TIGARD State Uk Zi 91223 401 amps to 600 amps $ 128.50 2
City -Zip 601 amps to 1000 amps $ 192.50 _ 2
Phone No. M3) o39-4621 Over 1000 amps or volts $ 363.75 2
Job No. 59574 Reconnect only $ 53.50 2
Elec, Cont. Lice, No. 34-13C Exp.Date 10/01/00 4c.Temporary Services or Feeders
OR State CCB Reg. No._37410 EXp.Date 07/02/01 Installation,alteration,or relocation
COT Business Tax or Metro No. 1987 Exr,.Date 12/01/99 200 amps or less $ 53.50 2
201 amps to 400 amps $ 8025 2
Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2
9 Over 600 amps to 1000 volts,
see"b"above.
License No. 23345 Exp.Date 10/01/U1
Phone No. (503) 339-4627 4d.Branch Circuits
New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name _ Each branch circuit _ 4 $ 5.35 $21,40 2
Address b)The fee for branch circuits
without purchase of service
City State_ Zip or feeder fee.
Phone No. First branch circuit _ _ $ 37.50
Each additional branch circuit _ S 5.35
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75 _
Owner's Signature Each sign or outline lighting _ $ 42.75
Signal circuit(s)or a limited energy
panel,alteration or extension $ 60.00
3. Plan Review section (if required):* Minor Labels(10) $ 107.00
CL Please check appropriate Item and enter fee In section 58. 4f.Each additional Inspection over
4 or more residential units in one structure the allowable In any of the above
Per inspection $ 50.1.0
t•- Service and feeder 225 amps or more
cn Per hour $ 5000
System over 600 volts nominal In Plant _ $ 5,J00
~ Classified area or structure containing special occupancy as
-� described in N.E C Chapter 5 5. Fees:
co Be.Enter total of above fees $ x5.65
Lo * Submit 2 sets of plans with application where any of the above apply. 5%Surcharge(05 X total fees)
r•`t Not required for temporary construction services. Subtotal E _
8b.Enter 25%of line Be for
NOTICE Plan Review If required(Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS El 1 rust Account#
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 92.5U
i\dstsll'orms\cicctric doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
c Date Requested / j �-- AM PM BLD
Location Suite _ MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS
Ftg Dain SGN
Crawl Drain Inspection Notes: -
Slab —__ _�_.__ _ SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing - —_ -- --
Insulation
Drywall Nailing -_-
Firewall
Fire Sprinkler -_—
Fire Alarm
Susp'd Ceiling -- - - --
Roof _
Misc: -
Final
PASS PART FAIL -
PLUMBING_
Post& Beam — -- - - -- -- _
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains _ _. _..._,_
Final
PASS PART FAIL
MECHANICAL
[lost& Beam ___..-------------_-_ -- -.--
Rough In
Gas Line
Smoke Dampers
Final --
PASS PART FAIL
ELECTRICAL — ----�
Service
Rough In
.� UG/Slab -- - - —--
�- Low Voltage
c~n
Fir_rAfsrrn __ _-- --- --
~ PASS PART F, IL
J
Back fill/Gredirig
Sanitary Sewer
- Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Ha.', 13125 SW Hall 13111d
Catch Basin [ j Please call for reinspection RE. Unable to inspect- no access
Fire Supply -ine
ADA
AOpperoach/Sidewalk Date Inspector_ _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY" OF TIGARD BUILDING INSF ACTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-1171 — --
BUP _-
Date Requested_ AM _PM ___ BLD
Location__ `� 1`'—`1—__ Suite _ MEC
Contact Person Ph PLM
Contractor Ph _ SWR
BUILDING errant/Owner { - �� ELC
Retaining Wali Et_R
Footing Access'
Fcundation � �/ FP.S
Ftg Drain SGh
Crawl Drain Inspection Notes: —
Slab — SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing ✓_�_ �2 r_ ! CcT-� -
Insulation
Drywall Nailing
Firewall
Fire Sprinkles `���s /`/E'141_S'
Fire Alarm J �� r �
Susp'd Ceiling / --- ------ -_ -- - -- -
Roof
Mise - —
Final
PASS PART FAIL ---------- ------ ._ --
PLUMBING
Post&Beam ---- -. .. -----
Under Slab
Top Out - -- -- - - - - - -
Water Service
Sanitary Sewer - - -- -
Rain Diains
Final -- - -- --
PASS PART FAIL
MECHANICAL
Post& Beam --
Rough In
Gas Line
Smoke Dampers
Final
FAIL
ELECTRICAL-
L6 L
Rough In
ow age --
Fir
PASS ART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I J Please call for reinspection RE:, [ J Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date - _Z __Inspector Ext
-
Final
PASS PAR t' FAIL j DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD SITE WORK
PERMIT
DEVELOPMENT SERV!DES PERMIT #. . . . . . . . SIT97-002,_>
13125 SW Hall Blvd., Tigard,OR 97223 (5(3)639.4171 DATE ISSUED: 07/03/97
PARCEL: 2S 1 1.2AE.--00800
SITE: ADDRESS. . . : 14255 SW '72ND AVE
SUBDIVISION. . . . : ZONING: I -N
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG
CLASS OF WORK. . :ALT PIA VING?. . . . . . . . . . Y RESO. HO.
TYPE OF USE. . . . :COM GRADING ). . . . . . . . Y VALUE— $ : 33951
EXCV VOLUME: 410 cy LANDSCAPING?. . . . : N
FILL VOLUME: 230 cy SITE PREP"?. . . . . . Y
ENG FILL ). . . . . . : N STORM DRAINS?_ Y
SOJLF) RPT RECD? : N IMPERV SURFACE: 9036 s-f
Re m ar-k s : Excavate organic 6 excess soil, install pipe, catch basins, compact
fill, 8" b•.se rock, and 3" asphalt.
Owner.: ----------------------------------------------------__..-- FEES - -----_---__ ____
FOUGHT & COMPANY type amor.int by date r^ecpt
PO BOX 23759 PLCK �, 0. 00 JD 0Ea/19/97 97--29(;2'10
TIGARD OR 97201 SWM $ 354. 55 JSD 07/03/97 97--2:96756
PRMr $ 211. 00 JSD 07/03/':37 97--296756-
Phone
7-296756Phone #: PLCF, 4 j.37. t75
5F'CT $ 10. 55 JSD 07/03/97 97-296756
Contrar..tor,a ___-_._-_____._______.----_____---EROS $ 80. OA JSD 0"7/03/97 9'7-29675(:1
BOB CARTER EXCAVATION & GRADIN ERF'C $ 2:6. OiI.i JSD 07/03/97 97-296756
ROBEPT ANDERSON CARTER ERP'C $ 26. O0 JSD 07/03/97 97-296756
PO 13OX `30493
TIGARD OR 97261 ------ ------- ------______.._-•----__._____
Phone #. 768--4967 $ 845. 25 TOTAL
Re, #. . : 012141
. ----- - REDUIRED INSPECTIONS -This permit is issued subject to the regulations contained in the F_rosian Control
Tigard Municipal Code, State of Ore. Specialty Coles and all other Excavation Insp
applicable laws. All work will be done in accordance with Fill Inspect icin
approved plans. This permit will expire if work is not started Grading Insp -------
within 180 days of issuance, or if work is suspended for more Pp..ving Insp
than 180 days. ATTENTION: Oregon law requi-es you to follow rules St rm Dra i.n Insp
.._...._..__-----
adopted by the Oregon Utility Notification Center. Those ruler are Final Inspection
set forth in OAR 952-001-0010 through OAR 952-001-0080. Your may
obtain copies of these rifles or direct questions to Off. by calling
(503)?46-9187,
I d b y: _._ --r Permittee S i g n O-i e
+rt+++}t+++•i-+++t++++t+++++++++t+++++t+++i++++4+++4+++++++++++++++++++++++=r++f+++
Call 6313-4175 by 6:00 p. m. fat- an inspection needed the next bi-isiness day
+++++++ '-++++i++++++++++++++++-F+++++++++++++++++++++-f++++++i•+++i+++ .++++++++++++-r
4T
CITY-OF TIGARD Site Permit Application Plan check C�(O
13125 SPIV HALL BLVD. Private Grading, Paving, Site Accessibility D e Red
TIGARD, OR 97223 Retaining Strictures, Utilities and Related Work D: to to P E.
(503) 639-4171 x394 0,rte to DST
Pi,rmd 0 a ELIL(7.;-L
C,fled
Print or Type
Incomplete or illegibl6 applicatiows will not be accepted
Project Name
Utilities(Complete all that a ply)
Job 5���4_o'af, A10101T_ION
Address Address Siorm Sewer
Oi�►c� } _O . T N C, Z Linear Ft.
� Namec.o w,i,ca FvSandary Sewer� �
Owner -Mailing AdCress '-_I ___ Linear F!
Fresh v+r'ater
0. Dix a3 _ �r
_ LinearFt.
C,ty/swe �� DR, Zip , Phone Caldi Basins r/
NameClean Outs
General (� Co.tRt P R L x a�a�I'o H 14
Contractor Mauling Address Ne-!scnbe work to be done:
tPrXX to Pd. �30X 3 O y�
fs WHIG a -� L\`rl f'rh 1 Newo Addition Alteration[) Repairo
I
soorraint must City/State Zip Phrne ,Additional Descnption of work:
proIntle sa
I kv og. 7LajJ_.Zk pXra�aEc oQ �..w„ t 2>< rF�s sct(._
asrnntraaors StatCe Const. Cont. Board Lrc. tR Exa. Date g ,..s}aiil orafr C0,4C t^ QtLs;yl�
iKense as LL
'nR3rrn&tOn in COT Business Tax or Metro u Exp.D F; rr I34 s e I�ocl�/ 3 rA +,�1fa( �'-
COT aataoa$%)
I ame Project s D
_ Valuation
Architect Mailing Address Plan Submittal: (3)seh containing each of t
followin , must accompany this application:
City/State Zip Phone Site plan with Vicinity Map Perking(including
Showing ADA romplian_c_e ADA;b Lighting Plan
Name Grading Plan and details Landscaping Plan
Engineer Mailing Address Erosion Con',rol Plan and Retaining Structures
de!ails I inducing calcWabons
city/state Zip Phone S-te Utility Plan and details Soils Report
(showing connection to (if required)
approved s'stemr
E_icavahon Volume n r� r hereoy acknowledge that 1 have read this application.that the
(Sails report required for ,,5.000 cu. Yards rr nformabon grven is Correct,that 1 am the owner nr authorised
kcu. yds. agent of the cowner.and that plans submitted are in comprrance
Fill plume
_ v.3h 0 on'hate laws
, � Signature of Owner/Agent Date
-� Sols repon required for>5.000 cu. Yds.)
Lr' bO cu vr:sv�/�T v, .��C , I 61i9�g 7
"All the All support a structure Contact'Person Name � Phone
r - Erigireer required if answers yes) YESCI N /9(JSL��
J
639-3/4/
Retaining structure1i(cneck one) _ r--Rock � FOR OFFICE USE ONLY
L— CMU Notes:
[Concrete�Q�Qt �1 [Other
—�
I
Total new impervious area including allnil Use Cast as Mal t.N
buildings. sidewalks. and paving_ 6Q So. Ft
cstsVrteapp doc j
1l/96 � y���. �Ir�,•�h I t�r� �F r ct.),11 D. (�-t3 `��