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Permit CITY OF TIGARD ELECTRICAL E N E - ENE RESTRICTED RGGY ��11I DEVELOPMENT SERVICES PERMIT #: ELR2004 -00266 �£ --' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/19/2004 SITE ADDRESS: 15750 SW 98TH AVE ADM. BLDG. PARCEL: 2S111CD -00300 SUBDIVISION: ALDERBROOK FARM ZONING: R -7 BLOCK: LOT: JURISDICTION: TIG Project Description: Limited energy for HVAC wiring. Job No. 010427 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: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: TIGARD CHURCH OF GOD HUGHES ELECTRICAL CONTRACTORS 15670 SW 98TH AVENUE 10490 NW JACKSON QUARRY TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: 503- 639 -4000 Phone: 647 -2205 Reg #: L60-22049850 SUP 2347S ELE 34 -281C FEES Required Inspections — Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 8/19/2004 $75.00 Elect Final [TAX] 8% State Surchart 8/19/2004 $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 fol . ru es -.opted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throus ° OAR 952 -001 -6 00. Yop: y •bt- copies of these rules or direct questions to OUNC at (503) 246 -6699. Issu =d by , A Permittee Signat re y 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 088/t . r D 1543 FAX 5036 iV7 tp HUGHES ELECTRICAL �!� 00 3 .cfdCC za WEg milt • C4 ' of Tigard Received c/ � 1)etdv g Pennit No.. 2 _ooh( 13125 SW . ,1-tall givd., Tigard. OR 97223 Q Ilan Review �� Phone: 5'03.639.4171 Fax: 503.598.196AUG 1 2004 , A ( + DatcIBy: to Other Permit: Inspect Line: 503.639.4175 ,..4_1411,- _ I pets ReadyfBv. Inns Iii Ste P2gc for Internet: www,ei,tigard.or.us F PR D Notified/Method: fa, _ Supplemental Information 11TIG G6TY • S101V PLAN ~:R' • LEw ❑ New construction ❑ Addition /alteration /replacement Please check all that apply: ❑Service over 225 amps, comtn'I ❑liazardous location ❑ Demolition Q Outer: ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., t:;; >; :: :•, CATEGORY. OF CONS'FRIUCTION .. • of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling 'commercial /industrial ❑ Accessory huilding ©System over 600 volts nominal units in one structure ❑Building over three stories El Feeders, 400 amps or more 0 Multi - famil 0 Master builder ❑ Other; []Occupant load over 99 persons ❑Manufactured structures or JOB •SITE INFORMATION' •AND LOCATION ' ❑Fgress/lighting plan RV park • Job no.; 01 0 427 ' Job site address: 1 5 b S w eiglIT any of the above. City/State/ZIP ;1/ 6 0 , '7'7 223 The above are not applicable to temporary construction service. .FEE* .SCHEDILE' • Suite/bldg. /apt. no Project name: � o j g aF�� • `��''�� u escrlMim i i Qty. I Fee Tolxl Cross street/directions to job site: New residential single- or multi - family dwelling Unit. - — - Includes attached garage - 1,000 sq. R. or less 145.15 4 Subdivision: Lot no.: �Ea earn 500 sq. ft. or portion • 33.40 Limited energy, residential 75.00 • 2 Tax map /parcel no.: Limited energy, non - residential 1 75.00 75'60 2 :, . . •. • . DESCRIPTION'OF, WORK • .. '' ' Each manufactured or modular /fit / ,- q r e t ` f dwelling. service and /or feeder 90.90 2 T�J U t }J(p Services or feeders installation, alterat and /or relocation 200 amps or less 80.30 2 - 1 201 amps to 400 amps 106.85 • 2 . .•❑..'PROPERW.OWI R :. ❑ TENANT ... • . 401 amps to 600 amps 160.60 2 • Name: 69 4 . 0 - - 1 & , 601 amps to 1 .000 amps 240,60 2 Address: / • J V IA "Fib L - Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 _ City /State /ZIP: /4 t9/2. q7223 Temporar services or feeders installation, alteration, and /or relocation Phone: ( 93) 439- e O Fax: ( ) 200 amps or less 66.85 1 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 ' 2 intended for sale, lease, rem. 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 A. Fcc for brunch circuits with .. . . . i„ ...:APPLICANT ID CONTACT PER50F�i. • :: service or feeder fee, each Business name: branch circuit 6'6� 2 - B. Fcc for branch circuits Contact name: without service or feeder fee. 46.85 2 - each branch circuit _ - Address: each add'I branch circuit_ 6.65 _ 2 City /State /ZIP: Miscellaneous (service or feeder not included). Pump or irrigation circle 5140 • 2 Phone; ( ) Fax: ( ) - . - sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- • CONTRACTOR. energy panel. alteration, or • • - extension. Describe: Page 2 2 Business name: HjiG ELECTRLCAL. CONTRACTQRS - - - - EaCh additional inspection over allowable in any of the above Address; 9640 SW SUNSHINE CT STE 600 Per inspection 62.50 City /State /ZIP: B EAVERTON , . OR. 97005 Investigation per hour ii hr tail) , 62.50 _ Industrial plant per hour Phone: 626 -3344 Fax: (503) 626 -3377 T _ 'EL'ELECTRICAL PI;RNfIT FEES!' _ CCB Lie,: 49850 Electrical Lie.: 34-281c Suprv. Lie.: 2347s Subtotal 75% co Suprv. Electrician signature. required; - Plan review (25% of permit flee) ) K ' State surcharge (8% of permit fee) (0. 00 Print name: WILLIAM E„ HUGHES 1 1)atC: S ) — TOTAL, PERMIT FEE '5 r „ Authorized signature: . This permit application expires it a permit is not obtained within ISO dyes after it has been accepted as complete Print name: Date: • Fee methodology .get by Tri- County Building Industry Service Board •• Number of'inxpectionu per aeI11i1 allowed. - I:\ BUildingTennitx1ELC- PemiitAVV.d00 I agn S40.4n 15T( I 0/W./COM/WE B CITY OF TIGARD 24 -Hour BUILDING Inspection Lift: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested oZ — Zer AM PM BUP Location ,6 Suite MEC Contact Person Ph ( ) PLM Contractor nn Ph ( ) SWR BUILDING Tenant/Owner e.4,,,,Lza-- / ELC d . -Dd j <r.D-- Footing ELC Foundation Access: Drain ELR �� as `'.4 Crawl Drain Slab Inspection Notes: Post & Beam ' / - P _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam ) (i Under Slab / Rough -In Water Service Sanitary Sewer ‚4 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 na ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Date /;-- ! Inspecto Ext Other: Final D • NOT REMOVE this inspection record from the b site. PASS PART FAIL