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Permit • ` CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY pl'� DEVELOPMENT SERVICES PERMIT #: ELR2004 -00249 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/5/2004 SITE ADDRESS: 14650 SW 97TH AVE PARCEL: 2S111AC 02700 SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5 BLOCK: LOT: 037 JURISDICTION: TIG Project Description: Low voltage for upgrades to HVAC. 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 TUALATIN SCHOOL DISTRICT ROBERT LLOYD SHEET METAL 6960 SW SANDBURG ST 4485 INDEPENDENCE HWY. 51 TIGARD, OR 97223 INDEPENDENCE, OR 97351 Phone: Phone: 503 838 - 3863 Reg #: LIC 62476 ELE 27 -70CRE SUP 3951LEB FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 8/5/2004 $75.00 Elect'I Final [TAX] 8% State Surcharl 8/5/2004 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 - 001 -0010 through OAR 952-011-0100. You may obtain copies of these rules or direct questions to OUNC at (503 46 -6699. i Issued by 4i1e_ Permittee Signature e OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day V1, GV/ GV VY 11,.. it a /La. vvUV V Vavvv . ... .,,..,�+w. -... r� RECEIVED /.. .�4'rd•� -�!.,$ r';r."3r�t tai'5.''.,3''1"a '13 -'.y vra :..F�ri3�,4 •t -,q•r •il.,'r3a'`�,Y f Electrical Fermat A lleatl ®n rcli clr F lee U4C �>.��t�-,� �f r 3 fitiwz ,. 10,1 ;.ss.- ..,1. ,,i,.; c as . :. F n yNErt ez� 12 rs. `„s`Im- * r . Received � permit No.! 1 = �• /� I a City of Tigard AUG 0 5 2 t DeteB o r �— / 'DD 1312$ SW Hall Blvd,. Tigard, OR 97223 Plan Review Other rermin Phone: 503.639,4171 Fax: 503.598.1960 " ''1 ; ' '} D &Iera : C ITY OF TI 64,1411P Ds R see rage z for j inspection Line: 503.639.4175 65 lem 2 fo rormadnn . inter-net: www.ci.tiprd.or•us BUILDING D r • 1 Notified/MO.:AL pp i _ _ _ _:•,. ;,,.I,; ;:;1'1 c; PLAN: :REV :IEW. A ' '' l I� ; :•� �,, �Ia ,........... _.... .... ft' `oF' :vs �gxtK, . ❑ New construction i Addition/alteration/replacement Please check all that apply: • ❑Service over 225 amps, comm'I ❑Hazal'dous location ❑ Demolition ❑ Other: . ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., i ' ,' ';'1 1 =r!''" '' 4 or more new residential :il;ia is', l!;::' 1�1Y;:: CiSEf">1W- ' OF.. ;COTriti q : .. .. :i'iC: of1•and2- f�milydwellings ❑ 1- and 2- family dwelling `Commercial /industrial ❑Accessory building ... over 600 volts nominal units in one structure ❑Building over three stories OFeeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other. QOccupani load over 99 persons ❑Manufactured structures or i , . a :a:,l:1h , . ;1 , 6i� ' �� �!. 1 .10 .1,v,�. i a 1q• I € '• 1; : 'ii. ❑ /ti hting plan RV park ; .•fi 11 ; I.I : ; :a416'; i' • :� : : :,�yB�i4El? , :,�1!'t . "!�`� "�1�H,1!' :5 ' ; : .T>OA.'�OfY :' :' : �,..' . : !i, F ; l Egress g ',_, - 1 � :. 1 "• ❑Health -care facility ❑Other: Job no.: Job site address: ( C3 ��1� , l �—\ Vi I_ - Subm 2 sets of plans w any o the above. Clry /State /rte, T 1 AA ^ 6 ,e mil C . C. 1 ci -i '7 2 . �1 the above are not applicable so temporary conerruotion service. Rs) • •i' ,•:,,,I . " SC•HEDUCE i • 1 Suite/bldg./apt. no.: rroject name: ( 03 A Ci -FL? 1A 1 D t-I• • Daatrlpaon I Qtr• I Po. I rata J .. - Cross street/directions to job site: ljj 1 S- • (2_00 ST New residential single- or multi - family dwelling unit. _ Includes attached garage. ,l)' , 0 I u 2De5C r- S) 1,000 s ft. or less 145.15 - 4 Subdivision: Lot no.: 2.e. odd'] 500 sq. R. or portion 33.40 1 - Limited energy, residential 75.00 2 Tax map/ parcel no.: energy, non - residential 75.00 2 p Limited energy i :i,lr. 1 ,; ' d! 1111 � 041 1." {�1 .. • ' :i: ; :'i� I''1i; 101 '! : Each manufactured or modular r l::;::'.i. r ,: r. :,� : ., >' : :.: n :.. : : : :� :,>�"P''• . ..,,..' t 1 I,di 111 : : •r • i ` Pl � /- �� v 1 ' C dwelling, service and/or feeder , 9090 V J R-r T ' U c ` 7��� Services or feeders installation, alteration. And/or relocation 2 200 amps or less 80.30 2 . 201 am a to 400 snips 106.85 _ 2 _ 1 � ��: ' ©e' 1 awriE ' i; I`ua i''; ...... ai. _, it 401 amps to 600 amp — 160.60 Name: ( 6 4Z D �l /4 A N �C •r ./Q _ 601 amps to 1,000 amps 240.60 2 lS // -� Over 1,000 amps or volts 454.65 2 Address: 9 CDtI L Reconnect only 66.85 2 i City/State/ZIP: 77 G/9RD C - S 7 Z7 -3 Temporary services or feeders installation, alteration, and /or Phone: O V Fax: ( ` — ; f - 4-i Oy relocation 66.85 1 3 — ( 200 amps or less 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, rent, or exchange, according to ORS 447, 449, 670, and 701 401 amps to 600 amps 1 33.75 2 Owner signature: Date: Branch circuits— new, alteration, or extension, per panel : 1111111111: , :�: ii l : ". i CON pd 4'71 PERSON :I:i A. Fee for branch circuits with 1 ; ; 1� 1 : � . ,1 :.: , r. ,o: a� .. � .. � c .r' , ' . service or feeder fee, each , Business name: 1-1-0 , 7' 0 5 NT E - branch circuit 6.65 2 B. Fee for branch circuits Contact name: C,tC2- C .: .1'-A U 1 S without service or feeder fee. 46.85 2 �� U 5 \ Z2fPD N, ft U "� L chcllbra circuit Address: j`1, ` \ W� J ( Each add'1 branch circuit 6.65 2 City /State /ZIP: 1 K 3MD IV E �Q ,¢ q 2 3 1 Miscellaneous (service or feeder not included) e� ['amp or irrigation circle 53.40 _. 2 Phone: � 4:2, ''� _ ( 'Fax: (i5 Q)3 - �3 / 674 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - i• ; • c• : "Ai .' i / r ; s':, zt .�',!il rte..'.'... '' , . :cl I :I.�• .. 1 ' : . 1, .. energy panel, alteration, or .6 i.s. .•'� �. . �; . : � .. � . . extension. Describe: Page 2 2 Business name: R(:) -1 Lth Y 0 (�� 4EFT i V l E-CP L Address: q LI 9 I NO E ►) 1-0 1J EN CE 14 `-1 J k Each additional Inspection over allowable in any o the above (� Per inspection 62.50 City /Stale/ZIP: OD 1�7 � � �C ©1� , • 7 Investigation per hour (I Iv nun) 62.50 s m 3e - Ml i� " — 7 l); Industrial plant per hour 73,75 Mimic ( r (v r '� -1i ;II fir,: '.,.. cl., I:EQrItic %"it$RMIT'IYEES ":'l ,. ; ; :... CCB Lk.: 107 ci 7 ( Electrical "Li: v ?/! 2GZul � . , . Lic .3 s I L. Subtotal 75, OO Suprv. Electrician signature, required: a � Plan review (25% of permit fee) _ (r State surcharge (8% of permit ice) 6, .. 2O .� 1��� ►-1i , / i , D :, e: C7 TOTAL PERMIT FEE F i , oc, Authorized signature: 1 � � This permit appllcanun expires It a pc Milt Is nut obutuce within 180 days alter It has been actepced as complete Print name: 19.w r Date: S e • Pee methodology set by Tri- County Building Industry Service Hoard •• Nu+rirerof inspections perpemtit allowed. i:WDuildieat +itsIBLGPmiiTApr.mc 12/03 440.ddisttlooatco /wta CITY OF TIGARD 24 -Hour :BUI *.DING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Busi ss Li e: (503) 639 -4171 l BUP — e6 4-�( Received _ Date Requested l `" AM PM BUP Location (4c'7° G60 Suite MEC Contact Person Ph ( ) PLM Contractor !!� ee Ph ( ) SWR BUILDING Tenant/Owner lX-5 . ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear • Int Sheath/Shear Framing Insulation Drywall Nailing Fire all prinlcler Fire�At3Pf"r"' Susp'd Ceiling Roof Oth: • • 4_, 'ASS PART FAIL df •L ING okr 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 Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS • PART FAIL SITE Please call f• reinspec '. n RE: ❑ Unable to inspect — no access Fire ADA 7 Supply Line 1 0 . Approach /Sidewalk Date Inspector A 1 Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUFZDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP L ( —06 -A l _ a Received Date Requested j `�� j AM BUP Location 9 7 Suite MEC Contact Person � �� — Ph ( ) 6 S7.3 4 O / Z PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner �' - ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing ` Firewall S'P ° I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof n� (p /� _ Other Fi ASS FAIL L U ING Post & Beam Under Slab Rough -1n Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -1n • Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE. ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line 1-& ► _ N ADA �e� Approach/Sidewalk Date Inspect I�� Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL