Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
u� X41 DEVELOPMENT SERVICES PERMIT #: ELR2003 - 00133
611 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 5/13/03
SITE ADDRESS: 14650 SW 76TH AVE OFFICE /COMM.CTR. PARCEL: 2S112BD 00100
SUBDIVISION: TIFFANY COURT APT. ZONING: R -12
BLOCK: LOT: 065 JURISDICTION: TIG
Project Description: Low voltage (protective signaling)
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:
WASHINGTON CO. HOUSING AUTHORITY SONITROL (AKA SOUND SECURITY)
111 NE LINCOLN ST 8220 N. INTERSTATE AVE.
#200 -L, MS63 PORTLAND, OR 97217
HILLSBORO, OR 97124 -3082
Phone: 503- 846 -4794 Phone: 503- 223 -5822
Reg #: LIC 53535
ELE 26- 370CEP
SUP 1812LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/13/03 $75.00 Elect'I Final
[TAX] 8% State Tax 5/13/03 $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 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. t, 1
Issued by .��✓L L4 �(� � �/ v Permittee Signature (f)1 A'11) ,C �YL
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
i,
': ' - :-. • ;. r y'l Kv -'Sr4. e :d fi t4+ .ne ,T , y t
El ectri c a l P eranm t A .pp h cation r ,4 . :. .0 k - t'ii.,;^j {• a .�G {; I" ^ •" r .•. , G i rt
! 1! . . ..' . R-EC E Il V E D • Date received:6 , h'p Permit no.:. _ -..p * _00 3 .- .
�•. ayt''III City of Tiga Project/appl. no - • Expire dater '
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR L j 23 ' •- Date issued` • ` '•' By:� - Receipt no.:
Phone: (503) 639 -4171 I "I UU UU
Fax: (503) 598 -1960 CITY OF TIGARD Case. file no.: -- . Payment type: - . .
Land use approval: BUILDING DIVISION —
d 1 o vs ,6: i t a 4' .' , 7, G - t . r r f - ? 3, s 'R ' liz �,1" 4 4 {' . 1 t"r �' AP zw = �' -.6. d i
) a .z.:„Yr'*_ ,o, s ,, ' n � ' . � ,T W , 'Wo f + ! i T YPE OI' , . k " ,_ F �4 n ,, r f � +sue } E . , r k a ts ' `,: # A'� 5 . r
❑ 1 & 2 family dwelling or accessory $ Cominercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
ORMATIO
_, j ?".( $` � ..7c S ' i s '1 ,� N �4* t p I NFN . ,.. i r 5. i „r �„ c r j k Fn. ;, K.
' ? ' > " �'�'lr " 7 t U' ' - , JUD�SIT'E r,r.. . rt i �� , .: �'S b yi 9 B �.>
Job address: \ l.o5Q, ' `11e"t�"' nV`f' v _ Bldg. no.: Suite no.: Tax map /tax lot/account no.: .
Lot: I Block: I Subdivision: ' (5"0 = 1 - 1....
Project name:w.0 ,,C.6 • \ -v,5 'v1'') scription and location of work an premises:
Estimated date of completion/inspection
, , „. -TONTRACTOR APPLICATIO1V d .
"? i "�° -� � > ��. ; : . „ -� F; �FEEaSCHED1aLE 3 � -.� � �• � 4
.may --� . �,. _ . -• gP "
Job Stn? 1 1 1 5 - \ _.. Fee Max
Description Qty. (ea.) Total iw. insp
Business name: S p,N,CQ\ SQC4(\ w/r New residential- single or multi- family per
' Address: S a. .p 0o-{ Zvvto SA (7),:c dwelling unit Includes attached garage.
City: D y* -V.:L 1C A . Stater ZIP: )- Service included:
t ('
a3 r7 �� Fax: 13 n3 E -mail: 1000 sq. ft. or less 4
Phone: a Each additional 500 sq. ft. or portion thereof
CCB no.: Cj 3c? 5 Elec. bus. lic. no: D (,, _ 3n o cep Limited energy, residential 2
City /metro lic. no.: Limited energy, non- residential 2
Dl Lo 10 r r ~ � / -o Each manufactured home or modular dwelling
6 Service and/or feeder 2
Signature of supervising electrician (required) Date S— -03 Services or feeders — installation,
Su elect. name (prin t 3 clE f'( IV Ew TO A l License no: /i31 a [ fA
Sup. alteration or relocation:
w r: •• •PROPERTY OWNER :;s,i;." 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: I E-mail:
Reconnect only 1
Temporary services or feeders -
Owner installation: The installation is being made on property I own installation, alteration, orrelocation:
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 •
, , . ; i" CP , a r ' ; * ''''Y',6--.';''''
�.;� Branch circuits - new alteration,
s r <;. ENGINE . , , .,..
_ - or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address:
service or feeder fee, each branch circuit 2
City: I Statc :. _ ZIP: B. Fee for branch circruts without purch se
iry. I of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
F - s? pply) _ {e, 7, Misc. Serviceor feeder not included):
P. -LAN R EVIE }'V`(Please < check =:all thaf �a 1 (Service
O Service over 225 amps-commercial Each pump or irrigation circle 2
0 Health-care facility Each sign or outline lighting 2
❑ Service over 320 amps- rating of 1 &2 ❑ Hazardous location Signal
circuit(s) or a limited energy panel, r
family dwellings ❑ Building over 10,000 square feet four or g ` `r\7 2
❑ System over 600 volts nominal more residential units in one structure alteration, or extension*
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection 1 I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other • '
- Permit fee $ 1 ' 00 •
credit Not all jurisdictions accept edit cards, please call jurisdiction for more information. Notice: This permit applicat Plan review (a[ %) $
❑ Visa ❑ MasterCard . . .• : : expires if a permit is not obtained 8% e 00
Credit card number: / / within 180 days after it has been TOTAL State surcharge (8%) ) $ `' d
Expires . accepted as complete.
Name of cardholder as shown on credit card $
Cardholder signature Amount 440-4615 (6/00 /COM)
'Electrical l Permi Fees: ' . - - Limited Energy Fees: - : --
•
. TYPE OF WORK INVOLVED RESIDENTIAL ONLY
Complete Fee Sch Below: Restricted Energy Fee $75.00
" Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total ' sl, Check Type of Work Involved:
Residential - per unit •-
1000 sq. ft. or less . $145.15 4 , n Audio and Stereo Systems
Each additional 500 sq. it or :
portion thereof - $33.40 1 I I Burglar Alarm .:.: "' „ ": • .,
Limited Energy $75.00
Each Manufd Home or Modular...... .. n Garage Door Opener
Dwelling Service or Feeder $90.90 2
i
• . Services or Feeders r7 Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation .
•
200 amps or less $80.30 2 '
201 amps to 400 amps $106.85 2 Vacuum Systems •
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 1 1 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 • • - $75:04
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.
Branch Circuits [ Audio and Stereo Systems
New, alteration or extension per panel
a) The fee for branch circuits I Boiler Controls
with purchase of service or •
feeder fee. I I Clock Systems .
Each branch circuit $6.65 2
b) The fee for branch circuits I Data Telecommunication Installation
without purchase of service .
or feeder fee. I I Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 I I HVAC •
Miscellaneous • • '
(Service or feeder not included) I Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ".
Signal circuit(s) or a limited energy G U n Intercom and Paging Systems -
panel, alteration or extension l $75.00 1 5;
Minor Labels (10) $125.00 • 1 I Landscape Irrigation Control
Each additional inspection over Medical
the allowable in any of the above
Per inspection $62.50
Per hour $62.50 Nurse Calls
In Plant $73.75
- - - — FI r` • -
Outdoor Landscape Lighting! -
Fees: I — - - -
oc Protective Signaling
Enter total of above fees $ 19 i :6 L—
''/l n Other
8% State Surcharge O , �Y +
25% Plan Review Fee l Number of Systems
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:
bt
El Trust Account # Enter total of above fees $ 1 1 5
• 8% State Surcharge $ f , l'U
Total Balance Due $ t • Uo •
•
i:\dsts \forms \elc- fees.doc 10/09/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ' ' AM PM BUP
Location f q 40 D 7 Suite MEC
Contact Person Ph ( ) a 3 8 ZZ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 4—e ELC
r U
Footing � � 6'.7:51 " ELC
Foundation Access:
Ftg Drain ELR 3 - ao X33
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
•
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing •
Firewall &C_-.Z,,/
.
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof 5Jf7
1/ 7t4l / •//
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
�Yw+ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•1: PART FAIL
SITE ❑ Please call for reinspection RE: D Unable to in,pect — no access
Fire Supply Line
ADA Date ! 243 Inspector ' __ . Aair� Ex
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL