Permit u CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00215
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/20/2007
PARCEL: 2S 101 AC - 01900
SITE ADDRESS: 12615 SW 72ND AVE ZONING: C -
SUBDIVISION: LOWE'S HIW, INC LOT: JURISDICTION: TIG
PROJECT: LOWES
Project Description: Replace EAS alarm boxes.
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:
INSTRUMENTATION: OTHER: BURGLAR AL X
TOTAL # OF SYSTEMS:
Owner: Contractor:
WASHINGTON COUNTY SCHOOL BROADWAY ELECTRIC - COCHRAN INC
DISTRICT NO. 23 626 SE MAIN
12615 SW 72ND AVE PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Contact #: PRI 503- 234 -6564
FAX 503- 238 -2098
FEES Reg #: ELE 37 -546C
LIC 72942
Description Date Amount SUP 3447S
[ELPRMT] ELR Permit 6/20/2007 $75.00
[TAX] 8% State Surcha 6/20/2007 $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 or 1.800.332.2344.
Issued B � , / � � ' Permittee Signature: c �Cajtii
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.
06/20/2007 11:09 COCHRAN BROADWAY 9 5035981960 NO. 433 D02
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Electrical Permit Application r- • rop.orncE. l'Slr_ ONIN
City of Tigard - ,- iii, - ' lucel, , "ed. (p f • ot-- All Po.: ra Ad -002/5
13125 SW Hall Blvd., 7igani, OR 97223 MG E , Pim Review
Phone: 503.639.4171 Fax: 503.598.1960 . Oaten:4=1r
Inspection Line: S03.639.405 111ki .4 ' '' 1 1 Dea 1 .._ 1100 Ea See Pass I for
m
la= www.ei.tigartar.us J 0 ri ..' . ' .1 " . - - - 01Y Netillerlfteniort Suppiensantil Information
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0 New congzuction ISU )
. Plena cha c an duu apply:
CIService over 225 amps. conun'l Okiazanious location
e
0 Dmoon D Oral ,-;‘' w- ' , 1:1Scrvice over 320 amps - rating OBuildng over 10,000 sq. ft.,
l!ii, . - -,: '"" 44 •'' ' %. : z'il' I ; f . ..i;‘j .. .4 , ....).4.7y•4•0:•!..:::•TAI.:: of 1- and 2-farniiy dwellings 4 or mac new residential
0 1 - and 2 dwelling C Commercial/industrial 0 Accessory building 13SVstees over 600 volts nominal units in one
0 strucoire
OBuilding over three stories CIFeeders, 40 amps or more
El Multi-family 0 Master builder 0 Other,
- „ .. Cl Occupant load over 99 /sessions CIManufactmed structures or
Tp::) ,..4... it in Egress ili ght i ng o ar RV park
Li Co - 0 plIcalth-care thaity
Job no.:. m 00 3 4 Job site address r2.401.5 SW 72r4 Apt, mid, 2., sea ofplans with any of the above.
City/Stare/21P: - TVA a . Theabove are not applicable to temporary construction service.
_
tiafiltV.F.Z.: ' ktintie*•.' - ..*: '''
Suite/bldgiapt.no.: 443 Project name.: Lou, -e
Dmertettes _IQ* 1 ft. I ' rmi ..
Cross street/direcdons to job site: New residential single- or multi dwelling unit.
Includes attached garage.
1,000 aq. ft. or less ' 145.15 4
Subdivision: J Lot no.: Ca. aderl 500 so. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: .
Limited tunny, nun-residential 75.00 1 2
-
.-.9.iir.:?..:i.';'•.:. .......143 Eaelt manufacrured or modular
• ,IL I
Ai0.- t .. t a " 4 )S dwelling. service tataVor feeder 90.90 _2
Services or feeders lastalladon, alteration. end/or relocation
200 amps or less . 80.30 2
giCUr AMEriaa=a1liaffig
. - 201 amps to 400 amps . 106.85 2
. . 40L amps m 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 _ 2
• • ---,
Address: Over 1,000 Grips or volts 454.65 2
- Reconnect only 66.85 2
City/State/ZW: Temporary services or feeders nstallation, alteration, and/or
Phone: ( ) t Fax: ( ) relocation
200 amps or less 66.85 1
Owner bratalladon: This installation is being nude on proptory that I own which is not 203 to 400 100.30 2
intended for sige. lease, runt, Or exchange, according to OM 447, 449, 670, mid 701. 401 amps to 600 amps 133.75 2
_.....
Owner signature: . Data: Breach circuits - sow, alteration, or extension, per • anel
V rffigNitTS) 24 ' , 4 ,..','''' 'Ilfri .17 A *'' "":* -: • ''' V ... 111 .-1 " . 4. ' S ...' /:■;i: V'..: A. Pee for branch circuits with
• service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee far brancircurti
Contact name: Ki V w I •
without service or feeder fee. 46.85 2
Address: - _
each branch circuit
s:
Each adds brunch circuit 6.65 2
City/State/ZEP: . •
Miscellaneous (service or feeder not Included) _
Phone: 6 ) 5=-13 I Fax: : ( ) Pump or irrigation circle 53.40 2
• Sign or mediae lighojag--_ 53.40 2
E-rnail:
Si. cireuit(s) <Lind )ted
Meartift424: ,;.?: : :.:..;../..'e:... :. -4:::',..1 • 7. .:"... , .: ...:4:,t ; .4=4: ' ;ial
v , I Page 2 lc -.•+ 2
.
Business name. 'Q.
-e. •
Address: C 2 c 5 e 0,. ./.., • Each additional inspection over allowable in any of the above
' ' ' Per inspection I 62.50
City/Slate/ZIP'. 4- . .. 09... c ‘l 2-t4s Inienigarion per hour (I la nem 62.50
Phone: (Tea ) 23c.v.-cos-cot.4, Pax! (503) 2. g.
3% -*Loci/ Industrial plant per hour 73.7S
1; :c".Feti- t .*.K 3 ` 74 agffgt 1 LOAV. • :Ma. : . ,-. . 4 .7....:."?.::
CCB Lie.: / 2. I Electrical Lic.: 3 t,c. I Suprv. Lie.: 3 ii(ri-5 ; . Subtotal 7 s
Suprv. Electrician Signature. required: . . • Plan review (25% of permit fee) • '
Print name: - ICat■V• k- Cs... . ... Date: • . , ...*." State =Mune (8% of rack foe) 6
__ _
. TOTAL PERMIT PEE / ,..
Authorized signature:
This permit application expires It a permit a net Obtained vdento tea
days after Ulm been accepted , compete .
Print name: Date • Pee inettusdology set by Tri-Cotmty Building industry Service Baud
' Number of inposetiesh per permit allowed.
06/20/200? 11: 09 COCHRAN BROADWAY 4 5035981960 NO.433 D03
A3,412004 17:13 F FAX 5035981960 CITY OF TI•GARD Q3002
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
l 'SI t1iV C•isi .tr • -- • .: •
Fee for all residential systems combined........ $15.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
Vacuum Systems*
❑ Other:
OM w ;t . ITN ' 1.- '. :NOB IOQNLY:
Fee for each commercial system 575.00
(SEE OAR 918-260-260)
Check Type of Work Involved: • A',H±Lo lnd Ster.c 6yste►ns -
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
t ❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
• Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting'
❑ Protective Signaling 1j1
[2
ther _aZiltifri --
Total number of commercial systems: 4. .
No licenses are required. Licenses art required
for all other installations
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