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Permit
i CITY OF T I GA R D ELECTRICAL PERMIT - RESTRICTED ENERGY I! DEVELOPMENT SERVICES PERMIT #: ELR2003 -00210 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/22/03 SITE ADDRESS: 13535 SW 72ND AVE 140 PARCEL: 2S101 DC -00200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P BLOCK: LOT: JURISDICTION: TIG Project Description: JOB NO. 2339 -175 Tenant Improvement 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: PACIFIC NW PROPERTIES LTD PTNSHP SONITROL PACIFIC 9665 SW ALLEN BLVD STE 115 8220 N. INTERSTATE AVE. BEAVERTON, OR 97005 PORTLAND, OR 97217 Phone: Phone: 223 - 5822 Reg #: LIC 53535 ELE 26- 370CLE FEES Required Inspections Description Date Amount Ceiling Cover [ELPRMT] ELR Permit 7/22/03 $75.00 Wall Cover Elect'I Final [TAX] 8% State Tax 7/22/03 $6.00 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 pen 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 throuc Issued by i 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day . J • Electrical Permit Application - . . O ±.. . . . Date received: f j Permit no.: , , ....,ft, , p . �;';_��! • gc • of Tiger _ wE Projecdappl.no.: Expire date: o , ar Vkddress: 13125 SW I tl OR 97223 Date issued: By: Receipt no.: • = tH ahone: (503) 639 -4171 • �u3 U.1 �a l,. cam- ~ (503) 598 -1960 ti / t , Case file no.: Payment type: • 0 51 O ,_ and use approval: cvc of TI'-. ISI '1 - 1 y - ''-3 - TYPE OF PERMIT . - �U 1 & 2 family dwelling or accessory XCommercial/industrial 0 Multi- family 0 Tenant improvement . 0 New construction 0 Addition/alteration/replacement 0 Other: 0 Partial JOB SITE INFORMATION . Job address: .135 35 atkp 41 a ' t - Bld no.: Suite no.: 140 Tax map /tax lot/account no.: Lot: I Block: 'Subdivision: Project name t hcJ je-L- , [Description and location of work on premises: -r , d1,Qc4C ( ,Q cull A Estimated date of completion/inspection: . . CONTRACTOR APPLICATION FEE SCIIEDULE - • Job um a. • - 19 b.. Fee Max Description Qty. (ea.) Total no. insp Business name:) Q R � c � � p _ New residential - single or multi-family per Address: g ?...c.,., oar '1 J �-`Lk dwelling unit. Includes attached garage. City: pa [ CUr\C‘ I State ZIP: q' 1 e2 1 '1 Seniceincluded: Phone: - 5 2 al..' Fax: I E-mail: I 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: '6 %j rj I Elec. bus. lic. no: a - 31 (o - � (jCkQ E red energy, residential 2 City /metro lic. �l> ✓ Limited energy, non- residential '' 2 l Each manufactured home or modular dwelling 7 �7 D Service and/or feeder 2 Signature of supervising electrician (required) Date Services or feeders - installation, Sup. elect. name (print): -Se0 - License no :22 c:404 alteration or relocation: : . . . . . . . . --- .._... PROPERTY OW7 ER - .....__ .... .... 200 amps or less ... 2 201 amps to 400 amps 2 Name (print): 401 amps to 600 amps • 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: 1E-mail: Reconnect only 1 Owner installation: The installation is being made on property services or feeders - - y I own installation, altemtion, or relocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 4. -: `:_'- -..'------7.---" _- ° --- --- v -=" <.•.- Branch circuits- new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 'State: I ZIP: B. Fee for branch circuits without purch se City: of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): Each pump or irrigation circle 2 O Service over m 225 amps - comercial • O Health-care facility Each sign or outline lighting 2 0 Service over ac 320 amps - rating of I &2 0 Hazardous location E� family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, r l� / 2 0 System over 600 volts nominal more residential units in one structure alteration, or extension* ` 0 Building over time stories 0 Feeders, 400 amps or more *Description: 0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: 0 Egress/lighting plan 0 Other Per inspection 1 1 1 1 Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other . - Permit fee $ n Not all jurisdictions accept credit cards, please call jurisdiction for ati more infonnoo. Notice: This permit applicat Plan review (at _ %) $ O Visa 0 MasterCard expires if a permit is not obtained 0 / / within 180 days after it has been State surcharge (8 %) .... $ ` n Q Credit card number Expires . TOTAL $ • accepted as complete. Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees: • TYPE OF WORK INVOLVED- [RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: - • Items Cost Total si, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less . . . $145.15 4 Audio and Stereo Systems • Each additional 500 sq. , ft. or portion thereof $33.40 1 0 Burglar Alarm : Limited Energy $75.00 Each Manufd Home or M Garage Door Opener` - - Dwelling Service or Feeder $90.90 2 i Services or Feeders 0 Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation . 200 amps or less $80.30 2 Vacuum Systems' • 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 — Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation 200 amps or less $66.85 . 2 . ' Fee for each system $75:00 201 amps to 400 amps $100.30 2 (SEE OAR 918 -260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see "b" above. ❑ Audio and Stereo Systems Branch Circuits New, alteration or extension per panel I I Boiler Controls a) Vhe fee for branch circuits with purchase of service or ❑ feeder fee. Clock Systems Each branch circuit $6.65 2 b) The fee for branch circuits 1 Data Telecommunication Installation without purchase of service or feeder fee. ❑ Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy i panel, alteration or extension 1 $75.00 ❑ Minor Labels (10) $125.00 Landscape Irrigation Control Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 n Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting` • Fees: C r OO Z Protective Signaling 11 Enter total of above fees $ J 8% State Surcharge $ Ill . 6 n Other 1 Number of Systems 25% Plan Review Fee • See "Plan Review" section on $ • front of application. ` No licenses are required. Licenses are required for all other installations Total Balance Due $ 8\ .00 Fees: Enter total of above fees $ 1 6 ' 3 ❑ Trust Account # 8% State Surcharge $ L ` C) O Total Balance Due $ U t ' ©° i:\dsts \forms \elc- fees.doc 10/09/00