Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00353
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2008
PARCEL: 2S 101 AB - 02000
SITE ADDRESS: 07175 SW BEVELAND RD 100 ZONING: MUE
SUBDIVISION: BEVELAND LOT: 004 JURISDICTION: TIG
PROJECT: NETBIZ INC
Project Description: Install voice /data cabling. Job No. 639868
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: • INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BERMAN, JOHN M + COCHRAN ELECTRIC
SUMMERS, MICHAEL L BROADWAY ELECTRIC
7175 SW BEVELAND RD #210 626 SE MAIN
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: PRI 503- 234 -6564
FAX 503- 238 -2098
FEES Reg #: ELE 37 -546C
LIC 72942
Description Date Amount SUP 3447S
[ELPRMT] ELR Permit 12/19/200E $75.00
[TAX] 12% State Surcha; 12/19/200E $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 -s are se • h in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.2• •.6699 or 1.800. .2
Iss ed By: , l / Permittee Si W
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: , / awl prop?, - 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.
•
,FROM COCHRAN— BROADWAY (4E0)0E0 17 2008 13: 14 /ST. 13: 13 /NO. 7500000820 P 1
Electrical Permit Applcatio EC IV ' I - FOR OFFICE f SE ONLY •
City of Tigard Received / A /,' OG dui Permit No.: Ei. -/ ?J 66 5 53
Date/By: It D 'rF
13125 SW Hall Blvd., Tigard, OR 97223 DEC 17 2008 Plan Review
It . Phone: 503.639.4171 Fax: 503.598.1960 Date/Bv: Other Permit:
+16. \ I i Inspection Line: 503.639.4175 CITY �A®{� Date Ready/By: �rud ' 0 See Page 2 for
-- Internet: www.tigard- or.gov ROB OF Notified/Method: ` / (� Supplemental Information
TYPE OF `� u {.. ' s ND DIVISION SION ' . . - • PLAN REVIEW .• .. •
❑ New construction Addition/alteration/replacement .. Please check all that apply (submit 2 sets of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
•
less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - and 2-family dwelling mmercial /industrial Accessory building amps for all oilier installations, buildings.
❑ Multi- family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
JOB SITE INFORMATION AND LOCATION ' ' ❑ Addition of new motor load of •
Job no.: (.0 ✓ I U Job site address: -7 J'-7 S 5 (4) m..(a 100HPor more. occupancy.
G{ ❑ Six or mote residential units. ❑ Recreational vehicle parks.
City/State /ZIP: t f v { D 2 q - Z 3 ❑ Health -case facilities.
13 Supply voltage for more than
-p. n , ❑ Hazardous locations. 600 volts nominal.
Suite/bldg/apt. 110.:51e 110.:51e l 00 Project name: K --b 7, Ali CP ��ErtJ (J ❑ Servic or feeder 600 amps or more.
J : FEE. SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee I Tow I •
' New residential single- or multi- family dwelling unit.
, Includes attached garage.
Subdivision: Lot no.: 1,000 sq, ft. or less 145.15 ' 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential
DESCRIPTION OF WORK :. .. , (with above sq. ft.) 75.00 2
Limited energy, multi - family 7500 2
�L(' 9 1 aU (.(;�� tYne residential (with above sq. fr.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
D PROPERTY OWNER ' • - I or TENANT 201 amps to 400 amps 106.85 2
Name: • 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 F 2
City/State./ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
• A. Fee for branch circuits with
' . ❑ APPLICANT.:'' • S CONTACT' PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: COC-� ail v.\ B. Fee for branch circuits
Contact name: 1/4.(-
f\ � (� ■ trilhou( service or feeder fee,
1. .-- "'^ e {\ 1 C' . C I first branch circuit 46.85 2
Address: 1O 3(4U S �t �� S Each add'l branch circuit 6.65 12
�cY��lJt \
Miscellaneous (service or feeder not included)
City /State /ZIP: '" a O 9_ cl 7 2....2., - . Each manufactured or modular • 90.90 2
( dwelling, service and/or feeder
Phone: (q1( ) ao - q- .(� "'f Fax: : ( ) Reconnect only 66.85 2
E -mail: Puntp or irrigation circle 53.40 2
. CONTRACTOR . " Sign or outline lighting 53.40 2
Business name: Signal circuit {s) or limited -
Signal
tM — - - , ,energy panel. alteration, or
Address: � 2 ��� .L 5±- I extension. Des e � Page 2 I 2
City/State /ZIP: TEiv.1.--y4,4.1A 23 4 Each additional inspection over allowable in any of the above
�/ Per inspection 62.50
Phone: (5 = w) 'L 3C.4 = ( a Lsc1 Fax: ( 5 o3) 2_ 3y - O....) / Investigation per hour (I he rain) 62.50
CCB Lic.: 7MC{t'tdl Electrical Lie.: 31- 5y(oC., Suprv. Lic.: l__" c industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: \C \\\`�. �\ Subtotal: 75,00
I Plan review (25% of permit fee):
Print name: �L��.�� Date: State surcharge (12 %ofpermit fee): q —
Authorized signature: 'TOTAL PERMIT FEE:
4
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I tnuilding1PermitstELC- PermitApp dos 05/23/06 440 -461 ST( I I /OS /COM/WEB
, FROM COCHRAN - BROADWAY (WED)DEC 17 2008 13: 141ST. 13: 13 /No. 7500000820 P 2
03/18(2004 17:13 FAX 5035981960 CITI OF TIG.ARD 2002
Electrical Permit Application - City of Tigard
Page 2 • Supplemental Information
LIMITED ENERGY PERMIT FEES:
m wow OM X:: . • -
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
Li Burglar _Alarm
(� Garage Door Opener*
fl Heating, Ventilation and Air Conditioning
System"
• Vacuum Systems*
7 Other;
:CO '.q ' o CZA`L, VORX:QNLY:
Fee for each commercial system 575.00
(SEE OAR 918 -260 -260)
Check Trove of Work Involved:
l Boiler Ct nrrols
• Clock Systems
f5ata Telecommunication Installation
II Fire Alarm Installation
• HVAC
• Instrumentation
0 Intercom and Paging Systems
• Landscape Irrigation Control*
Li Medical
7 Nurse Calls
7 Outdoor Landscape Lighting*
• Protective Signaling
E Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
SI�.i g➢r•.r.•:.�E1.C- Scr'rftA c., 0.✓33
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI R2O08 -( }0353
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1W 19p000
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 ��
INSPECTION WORKSHEET FOR DATE: 1/14/2009 TIME: 7:01Am PAGE: 47
SITE ADDRESS: 07175 SW DFVELAND RD 100 CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 004 TYPE OF USE:
PROJECT NAME: NETBIZ INC
DESCRIPTION: Install voice/data cabling. Job No. 639868
OWNER: BERMAN JOHN M +, PHONE #:
CONTRACTOR: COCHRAN ELECTRIC PHONE #: 503-234 -6504
Inspection Request Scheduled For: Date: 1/14/ 2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message N\N 135 Low voltage 079659-01 971.219.9278 V
Corrections /Comments /Instructions:
I
v PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION [l ADDITIONAL FEES ASSESSED
Inspector: \T ' NS ( Date: [ Phone #: (503) 718- lik6