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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 4l DEVELOPMENT SERVICES PERMIT #: ELR2006 -00010 �JI-' 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 1/10/2006 PARCEL: 1S135BA-02800 SITE ADDRESS: 10380 SW CASCADE AVE ZONING: I -P SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Data cabling replacement. 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: LANPHERE ENTERPRISES INC ACCESS ELECTRIC & CONSTRUCTION LLC 12530 SW CANYON RD 2870 SE 75TH AVE. STE. 108 BEAVERTON, OR 97005 BEAVERTON, OR 97123 Phone: Contact #: PRI 503 642 - 4333 FAX 503- 642 -9699 FEES Reg #: ELE 16 -16C LIC 162666 Description Date Amount SUP 4931S [ELPRMT] ELR Permit 1/10/2006 $75.00 [TAX] 8% State Surcharl 1/10/2006 $6.00 REQUIRED ITEMS AND REPORTS 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- 01 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: Permittee Signature: 1,y1 __/ /r`'( 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. Jan 09 06 02:54p James Currie 5036429699 p.1 Permit.; Electrical Permit Au( : 4ti lp � n FOR OFFICE USE ONLY Ct of Tigard Received /� � ri p06 / — I o 0/0 Permit No 13125 SW flail Blvd.. Tigard, OP ?7223 I\10 Re e ive C]�� OQ�p '�t7�o // � ]'tan Review Phone: 503.639.4171 Fax: 503.598.19 i+y, ti p4' " �'\ Date/II : O Permit.; Inspection Line: 503,639,4175 F 1`G ARC ,� , L f'', ',Ate Ready /Hy: m See Page 2 for Internet: www.ci.tigard.or,us co , O , 0 nl`S,O - Notiriad/Mathod: Sepptementat Information . ,��, �� ,, t , r i �.:! .!��' "''�'� 1 `� °� t ' i ' ",f' � I � ' �41�, "amp' " ;.. r � � - - - .k: lip rf�41. .,��,n t' i (p " e 14', ¢ .;.ri ' �Y , t I�fl. Piy!tt ' : I y' °.�fY,h 1 "•.u' : 1'� {� 1 yy .6�rr ��'�y. ;p� �. .. _ .'� .L�...�5, 7R� :�{1'.£� �11L ,. �� � �1. .�,.� I: yr'' M;;tiYa,t ��1 ,� d.�,. -.N � �'ti R��.`.Y .,I�,. 't *'+V�- d4T• ^':.: ❑ New construction ( 1 Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑Other; ['Service over 225 amps, comm'1 ❑Hazardous location ��;;�'} „r tio, ``ti sr t A(itt �lev 't. r ' y :,Y.y4. , +fi e.,,. , : v: 1;� -�'*r ❑Service over 320 amps -• rating ❑ Huildng over 10,000 sq. ft., ..., �;+ ,!t N'' , tw” ;, 0I." -gR��i sit; " :s'! «r: 3�,..:yB ^.i�T M � : C. ; !. �..i (1 dwellings more new residential i ..r •, . ;,�` . 3, ,Z �. !': , n ' of 1- a ll 2-family dwellin 4 or n i;il :" ..�. ''' ,'��, ry , .' Er n..,. .x "'' ...... , r ",..t� +' y ❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ©System over 600 volts nominal units in one structure ❑Building over three stories OFeeders, 400 amps or more ❑Mufti family ❑ Master builder 0 Other Occu ant load over 99 persons ❑Manufactured structures or P ,.R ll t TIM VW. G ti 4M 4 ,1 "( d.' j1' ❑Egress /li plan RV park ❑I•lealth -care facility []Other: Job no.: w -I O.-I , Job site address: /0 3$0 �� r � .� ____ Submit acts of plans with any of the above. City/State/ZIP: -T-, „,A4 . .. 223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no Project name: a fl J 1•a,` A' � 4 l / De scr i pt i on Qty. Kee. 1 Totnl r Cross street/directions to job site; c f r t. t ...,, . '„0c New residential single or multi - family dwelling unit. "� 7 � Includes attached 1,000 sq. ft. or less 145.15 -- 4 Subdivision: l Lot no.: La. add'l 500 sq. ft, or portion 33.40 l Tax map /parcel no Limited energy. residential 75,00 2 !� , n r �: A , Limited energy, non - residential 75.00 2 'T i 1' , Gee �� n t ",�Y r��fa t ��. NTAItiti ! ,r' s14( Each manufactured or modular (� „t... „ K dwellin , service and fee 90.90 2 1� L t ( Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 , 2 •c + - r' .r ' t 4 rr'. 201 amps to 400 amps 106.85 2 1 I + N iY .., q e 3 I , ; : 41t ; .' 1. • ' 1 i f� 1t , r 11 i ; : 1)1( ' „ C t 4L, . , � ?,. . s.: .'n R�; . i �t ;' t � :f� !� ` . si L iir ,r�:tiGA�!' 401 amps to 600 amps 160,60 - 2 - Name: _ 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or vole 454.65 2 - Reconnect only • 66.85 _ 2 City /State /ZIP: Temporary services or feeders installation, alteratioh, and /or relocation Phone: ( ) Fax; ( ) 200 amps or less 66.85 1 Owner lnstallatiwa: 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 O �} wner signature; Date: Branch circuits - new, alteration, or extension, per panel 9,�,:}'ti ' j'sr t�E h A. ;l ” �IS'jY ^ y er t , n��� �� F.,� a�q ���� lL� 0 mm toe ntt� �Trfri`ue; r {� � L`.'LlJ � t ;'�,, 1 a , � �t i a'al 'iti "Yi,�•)fi1Ss',9lCtk,;. A,Fee for branch circuits with Business name: service or feeder fee, each 6.65 2 /gyp / �. C � t- 4 .�� `ri , - branch circuit Contact name: t`�� B, Fee fat branch circuits e n t i rn merman without service or feeder foe, 46,85 2 Address: �1 i each branch circuit g l0 SC '1. A v.( .3 r1 k r e to g Each add'l branch circuit 6.65 2 City /State/ZIP: a t A I S b o r® Q � A / ) /f3 Miscellaneous (service or feeder not_in_c_l_uded) 'R O� Pump or irrigation circle 53.40 2 Phone: (spa) 442 -14 3 Fax" (3o3 ) 642 _G b q 9 Sign or outline lighting 53.40 2 1 - mail: ��l, ��� 1p Signal cireuit(s) or limited- -- ---- - -� - -; i2:t�J it "t1't��t'rign ail ' a �{� 5.' i,1li" o ¢,ti E 7', I; ' "4 a i . ' '.,'Ll", energy panel, alteration, or i i c � M r i .7'l�'�i��,43�:�'ln� sw . il:SL"'irdCl.�'�� r u x.54' , .. Business name: extension. Describe: Page 2 — 2 Address: leach additional inspection over allowable in any of the above -- Per inspection 62.50 City /State/ZlP: O l n Investigation per n (I ) _ -�� -� � h ur 1 Iu mm 62.50 Phone: ( ) ,Q 1 Fax: ( ) 4 , I - Industrial plant per hour 73.75 .. — il!I �'. .:C: .i Ll:� ��II�L:r�idJ��''tu�in 4.'p'. .: .' :.., CCl3 Lie.: 1 koziD(o(p Electrical Lie.: G- ((x, Suprv. Lic.,l.139I $ Subtotal 7 i p Suprv. Electrician signature, required: �" -- Platt review (25% of permit fee) State surcharge (11% of permit fee) . • 0 - Print name: 1�y F 4Z w�,8t.ba__ Date: . 6 — TOTAL PERMIT FEE S 1 . 0 0 Authorized signature: This permit application expires if a permit is not obtained within 180 " - days aster it bee been accepted a>< complete Print name: Date: • Fee methodology it by Tri•Coutty nuildtng Industry Service Hoard Wes " - --- --- ----- •• Number of utxpeetioos per per dot Allowed. is' AuitdinaYermita \zLC•PemvtApp.doc 12/01 440-46%ST(lwoa,com/wPa Jan 09 06 02:54p James Currie 5036429699 p.2 El ectrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Burglar Alarm ❑ Garage Door Opener* ❑ I-Ieating, Ventilation and Air Conditioning • System* O Vacuum Systems* ❑ Other: '`y ' 0 ��� , ' a .A, JY•��'�.' Y, V� � . � +�:�. afJbll .i�'ttC'�!����� "n'1%'�..�o�� Fce for each commercial system $75.00 (SEE OAR 918- 260 -260) • Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ata Telecommunication Installation ❑ Fire Alarm Installation ❑ I VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical O Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling • ❑ Other Total number of commercial systems: No licenses are required. Licenses are required for all other installations