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Permit
CITYF TGARD ELECTRICAL RESTRICTED ENERGY PERMIT l i� � DEVELOPMENT SERVICES PERMIT #: ELR2006 -00050 i . DATE ISSUED: 2/10/2006 �`-� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S113AD-01700 SITE ADDRESS: 16920 SW 72ND AVE ZONING: C -G SUBDIVISION: ROSEWOOD ACRE TRACTS LOT: 030 JURISDICTION: TIG Project Description: Data /tele Low voltage. 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: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: BRIDGEPORT LAND LLC MATRIX COMMUNICATIONS 3939 NW ST HELENS RD 4243 SE INTERNATIONAL WY PORTLAND, OR 97210 STE C PORTLAND, OR 97214 Phone: 503- 224 -2676 Contact #: PRI 503 -513 -9152 FAX 503 -513 -9352 FEES Reg #: LIC 74332 ELE 26- 694CLE Description Date Amount [ELPRMT] ELR Permit 2/10/2006 $75.00 [TAX] 8% State Surchari 2/10/2006 $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: //�7 � %: Permittee Signature: 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. Electi;'ical Permit 7„/N!)17,1 : c 'r a i J t FoR i Ic ►. 1 ;tit: t)1'l.N. w Received Ci of Tigard ' I'armit No.: —7W 13125 5W Hall Blvd., Tigard. OR 9 P1nn Rade Phone: 503,639,4171 Pax: 503.598,1r0B 0 2006 A : ', J Datc/By. Other Permit; Inspection Line: 503,639,4175 , l, . -„ note Ready/11y bol RI SMpage 2 fnr Internet: www.ci.tigard.or.us 1, Supplemental �• `v Nnrlfletl/Methea Information U 1 1 i . ' PI New construction � to n /alt / r l a c ement Please check all that apply: ID Demolition El Other ['service over 225 amps, comml pl- lazardous location j]Scrviec over 320 amps – rating ❑Buildng over 10,000 sq. 0,, • CATF.,CsOE-X OP COl't1STR • ' of 1 - and 2 - family dwellings 4 or more new residential ❑ i- and 2- family dwelling Eommcrcial/industrial ❑ Arno . oty building ❑System over 600 volts nominal unite in one structure ❑Building over three stories ❑feeders, 400 amps or more ❑ Multi-family ❑ Master builder ❑ Other: ['Occupant M Occupant load over 99 persons ❑ anufactnrcrl structures or . ,JOR'. S11TT .INl ORMATIO1V AND .LOCATION .. ['Egress/lighting plan RV park Job no,: .lob site address: / ,, CO 01-cart facility ❑o her: �/ /_� ._ � M '! Submit 2 sets of plans with any of the above. ,_ — ...._, ._. City /Stat:eJZIP: / l9 ` d •3 02 e∎ The above are not applicable to temporary construction service. Suite /b ldg. /apt:- no Project name: � � j� nea +: 9✓C)h1ED�y .1E:, .. rf pt inn Olr. pal. Tntnl Cross street/directions to job site: New residential single- or multi- family dwellin}.1 unit. " .. includes attached garage 1,000 sq. ft, or less 145,15 4 _ Subdivision: 1 Lot no.: Ea. ndd'I 500 sq. tt. or portion 33.40 – 1 – Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 . . DESCRIPTION OF WORK . • . Each manufactured or modular • • dwelling, service and/or feeder 90.90 2 Services nr feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER . ❑ TCN1 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name 601 amps to 1,000 amps _ 240 2 _ — Address: Over 1,000 amps or volts 454.65 – 2 -- Reconnect only 66.85 2 C: ity /State /7.rP: Temporary services or feeders installation, alteration, and /or I relocation Phone: ( ) ..J 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 10030 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 -- ❑ APPLICANT , .. © . CONTACT• 010#0N • A. het for branch circuits with _,,,,.__ -- ,_-- -� service or feeder fee, each 6.65 2 Business name: branch circuit B. Fcc for branch circuits Contact name: x'I noul service or feeder lee, 4115 2 Address: each branch circuit --_ Each add'1 branch circuit 6.65 2 City /State/ZTP: Miscellaneous (service or feeder not included) Purnp or irrigation circle 53.40 2 Phone: ( ) Pax: !( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- • CO !TOR energy panel, alteration, or / ( extension. Describe: Page 2 2 Business name: r I �1i11 _ j C / �� ,,� , i 4 Each additional inspection over allo wable in arty of the above � ,' �� Per inspect 6 2.50 �— C itv /State /71F; .. A. Investigation per hour (1 lir min) 62,50 �L / f / G i � /4) 3 • • . industrial plant pct' hour 73 -75 �/ i� i LECTRiCak11 >-1►1LRMn.. .5*-.. .• IrEgIOW .. f° — Electrical ;• : � 6uprv. Lie.'. �...._� c/ ,p r Subtotal • Suprv. Electrician signature, required: • /. Plan review (25% of permit fee) – Print name: I Date: State surcharge (R% nf permit fec) TOTAL PERMIT FFF t f / . IP Authorized signature: Thiv permit appliention expires if n permit not nhraloed within 1511 • days after it hits keen accepted as complete Print name: 1 Date: ^ Fee melhodoloey act by TO-County Building? Industry service [Ionrd °* Number of inspcclitms per permit allowed. ITuildlnprermhs \PLC-Permit Appflon 12/ni . 40- 161 5T(1o/02 /COM/Wrn CITY OF TIGARD EL/ .::, A BUILDING DIVISION PERMIT #: A 666- bbd S 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 4 ,,� Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: ` (p 0 , 6 7,), ,-.771 f CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 - 7-0 (, Pour Time: 4- , m , Th -: - Inspection Description C. (firm # Contact # Message / q .� 1 2o -/3 `f ,...Q ': - ctions/ • - is /Instructions: \■ PASS U PARTIAL APPROVAL CANCEL ❑ NO ACCESS n FAIL I I CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED Inspector: G 1 E3 t- Date: 3 '7"0110 Phone #: (503) 718- 2-4►6• CITY OF TIGARD _ BUILDING DIVISION PERMIT #: 0.90 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: `f in/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 VI -- INSPECTION WORKSHEET FOR DATE: 2 /•it ' 07 a TIME: 1:07Aivi PAGE: 3 SITE ADDRESS: "i6920 j r ;;N AVE CLASS OF WORK: SUBDIVISION: t OSEWO OC) ACRE TRACTS LOT #: 030 • TYPE OF USE: PROJECT NAME: l 1 E HoF DESCRIPTION: Datailele Low voltage. • OWNER: BRIDGEPORT LAND LLC, PHONE #: a:;03, .24..6 - K; CONTRACTOR: MATI-'IX t- ;.OMNialNl NS PHONE #: e;t, :„ i 13• s I Inspection Request Scheduled For: Date: 21.i6i2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 13S Low voltage 021009-01 603-320-1099 I0t.9 N . Corrections /Comments /Instructions: Igi PASS n PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS n FAIL I& CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Kbe l Date: 1 1 44 4r Phone #: (503) 718- Ztilt'•