Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
�� i rc DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00129
F��I DATE ISSUED: 5/23/2005
"^'� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AB -02201
SITE ADDRESS: 07117 SW BEVELAND RD # 00 ZONING: MUE
SUBDIVISION: BEVELAND LOT: 2 - JURISDICTION: TIG
Project Description: 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:
ZIMMLER DEVELOPMENT LLC AMERICAN HEATING
7115 SW BEVELAND ST 1339 SW GIDEON ST
TIGARD, OR 97223 PORTLAND, OR 97202
Phone: 503 -598 -3440 Phone: 239 -4600
Reg #: LIC 33135
• ELE 26- 993CRE
FEES SUP 2640LEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/23/2005 $75.00
[TAX] 8% State Surcha 5/23/2005 $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 52- 1 -0100. You ay obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699. r
Issued By: Permittee Signature: y �� /1
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.
Electrical Permit Ap tMn: V ED F OFFICE- USE:ONLY . - -
City of Tigard Received i - 1 Pernut N o . : #( r i
13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
503.639.4171 Fax: 503.598.1960 . r' - Plan Review 9 p v
MAY 2. 3 200 ' l h l Da teB : Other Pen : j t��.L Oa y---60, � / 7
Inspection Line: 503.639.4175 Ti t ` W Date Ready/By: El See Page 2 for
Internet: www.ci ttgard.ocus CITY OF Notified/Method Supplemental Information
.. .. Est
nl�r c
i L, . " _ t Y t - „ „i- N ” "� a .W.;c O..,: 1. v `'. -,� gx. PLAN =,R IEW «.eta .{
❑ New construction Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑Other ['Service over 225 amps, comm'l ❑Hazardous location
�
4 Mfer� x � ['Service over 320 amps— rating ❑ Buildng over 10,000 sq. ft.,
.. d 4.,.,,,- O CONSTRi7 rf” fir #_
..m ., of 1- and 2- family dwellings 4 or more new residential
.aez r.. s u-'a , _,, , a4 .x °H -::,,,? .- raaf.;. * ._, ,, . _ - ; 1 _ . - .: iaA ,
❑ 1- and 2- family dwelling P Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
111 Multi - family 1=1 Master builder 111 Other:
❑Occupant load over 99 persons ['Manufactured structures or
1 JUB STTE INFOI2MATI0N� LO AT•O_N�. t ' S ❑Egress/lighting plan RV park
Job no.: I Job site addressgh 7 ' Bevs 4 t O ❑Health -care facility ['Other: t✓ �%f �# �t�.� Submit 2 sets of plans with any of the above.
City /State /ZIP: .--ribi !� (rZ The above are not applicable to temporary construction service.
� =Wi 1 NFL j FEE*, SCHDULE: pi
E>.` t
Suite/bldg. /apt. no.: Project name: _ °': - - - - -
1 1 Description - � I „ Qty. I Fee. .s I Total I '
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: „,, Limited energy, non - residential 75.00 2
, DESGRIPTICON O ' * 94 . r ; : � .
_ ��. ' �. � � - . �. a_ ,. _ � �aa �, � .�.. :� � � „� a; _ = Each manufactured or modular
\ / 1._- tAi e N1. ee Sic service and /or feeder 90.90 2
1 tt1 � � Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
r g rp �° <' s s x= 201 amps to 400 amps 106.85 2
. _ OP O ERF . � I '- . ,:N, & - Y . .,” 4
" 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: . Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) i Fax: ( ) - 200 amps or less 66.85 • 1
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 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
P7 IC�NT
`?��1~ °;� �'' ;� �APe.,�.���..�"itg; 111414COITA41PER5M:A 4 A. Fee for branch circuits with
service or feeder fee, each
Business name: 1 1 32U H -Oe 1 I s branch circuit 6.65 2
Contact name: ' ye .. l ! B without for service circuits
�'*^r! H ' ry 1 without service or feeder fee, 46.85 2
Address: i ;.+. each branch circuit
e Each add'l branch circuit 6.65 2
City /State /ZIP: ./i - ,' r. , I. Miscellaneous (service or feeder not included)
(, )6 00 I ( Pump or irrigation circle 53.40 2
Phone: V(J�J Fax: :
Sign or outline lighting 53.40 2
E Signal circuit(s) or limited -
- , ° ' .q i COAT TORT " energy panel, alteration, or
� E 1 Q� extension. Describe: Page 2 2
Business name: S S
Address: l GE 4/ s ., y ° Each additional inspection over allowable in any of the above
' ��' ` Per inspection 62.50
City/State /ZIP: Texfairi Cit. ci? Investigation per hour (1 hr into) 62.50
f
Phone: ( ) ' i... t AO Fax: ( ' vv Vv j ° ... 8 Industrial plant per hour 73.75
6 X ,,, EI ECTR`CC�A7~_ _ Rill ... ` , ;FE "
CCB Lic. t Electrical Li 60 ` _ ' Suprv. Lic. - ;. ,, ,'. 0 Subtotal
Suprv. Electrician signature, required: i . , tf Plan review (25% of permit fee)
ce State surcharge (8% of permit fee)
Print name: 4 f ' II ate: - 1 1
` TOTAL PERMIT FEE
Authorized signature: ,i
7 r I This permit application expires if a permit is not obtained within 180
t / days after it has been accepted as complete
`
Print name: \ r"y`AL Date: 5 / * Fee methodology set by Tri- County Building Industry Service Board
'`' �► �!°'* I ** Number of inspections per pemut allowed.
is \Buitding\Pennits\ELC- PermitApp doe 12/03 440 - 461ST( IO /02/COM/WEB
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00129
1125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/23/2005
Phone: (503) 639 -4171 ,e,441111‘11'\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/7 /2005 TIME: 7:17AM PAGE: 68
SITE ADDRESS: 07117 SW BEVELAND RD 200 CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 2 -3 TYPE OF USE:
PROJECT NAME: EWING FOLEY
DESCRIPTION: HVAC.
OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: 503- 590 -3440
CONTRACTOR: AMERICAN HEATING PHONE #: 239 -4600
Inspection Request Scheduled For: Date: 6/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voitag 008609-01 503.793 -4001 Y t d5
Corrections /Comments /Instructions:
•
•
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 6 Date: / ® Phone #: (503) 718-