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Permit CITY OF TIGARD ELECTRICALPERIVII- RESTRICTED ENERGY k'r, DEVELOPMENT SERVICES PERMIT #: ELR2004 -00135 s --" 13125 SW Hall d., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/26/2004 SITE ADDRESS:428 -SW GRANT ST SITE 2S102C6 -00100 SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R -12 BLOCK: LOT: 041 JURISDICTION: TIG Project Description: Low voltage for irrigation 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: X OTHER: • HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: TIGARD - TUALATIN SCHOOL DISTRICT #23 CEDAR LANDSCAPE 6960 SW SANDBURG RD 14145 SW GALBREATH DR TIGARD, OR 97223 SHERWOOD, OR 97140 Phone: Phone: 625 - 3700 Reg #: LIC 75535 ELE 5843 FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 5/26/2004 $75.00 Elect'I Final [TAX] 8% State Surchart 5/26/2004 $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 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. Issued by .I, � .. �L �1 _ Permittee Signature /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 I May 25 04 03:07p Cedar Landscape 5036258623 p.2 . \1 Electrical 'Permit A 0 k r i et G v ED FOR OFFICE USE ONLY City of Tigard Y 2 5 2004 Da1e By Flo /ff, i� Pemnt r,o �, - ©c) / 13125 SW Hall Blvd., Tigard, OR 97223 � N Plan Relic Phone: 503 639.4171 Fax • 503.598.1960 ( Date /By. Other Permn Inspection fine: 503.639.4175 Permit: R s , �. Date Ready /By. t Ed See Page 2 for C�T'( of TIGA ; PLAN REVIEW ^' Notified/Method' Read /By �'` (�� Ed mental Information See Internet. www.ci.tigard.or.us ING DI'J%S ! l ` �1 • TYPE TYPE OF WORK ❑ New construction ❑ Addition /alteration /replacement Please check all that apply: Service over 225 amps, comm'l ❑Hazardous location [] Demolition ❑ Other: Service over 320 amps - rating DBuildng over 10,000 sq. ft., • CATEGORY OF CONSTRUCTION of l- and 2- family dwellings 4 or more new residential ESystem over 600 volts nominal units in one structure ❑ I and 2 family dwelling ❑ Commercial/Industrial ❑Accessory building ❑Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other: DOccupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ` ❑Egress /lighting plan RV park ❑l'lealth - care facility ['Other: no.: Job site address: (S s Lk) rG�,� { S4 Submit 2 sets of plans with any of the above. City /State /ZIP: — r --- 5Ct Ird, / 7223 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite /bldg. /apt. no.: Project name: G. F. - 1 - i ,. e �I ere et1TA ✓/ Description I Qty. I Fee. j Total l '+ Cross street/directions to job site: NO i . vY. t� tr0.� 4 S-f• New residential single- or multi - family dwelling unit. Includes attached garage. T Y ZiV 5 w W e ,, 5+. 1,000 sq. ft. or less 145.15 4 Subdivision: U Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: - Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and /or feeder 90.90 2 T. fC � �'h U . Q � -'�(" l ,l.er Services or feeders installation, alteration, and/or relocation J 200 amps or less 80.30 2 20,1 amps to 400 amps 106.85 2 ❑ PROPERTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Over 1,000 amps or volts 454.65 2 Address: Reconnect only 66.85 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee 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 citcic 53.40 - 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53 40 2 E - mail: Signal circurt(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 i 50 0 2 Business nam 4ro Layasc 1 �n SRR- COn (. 'e'l 1 Each additional inspection over allowable in any of the above Address: 1 4 ��j S 6..(t-)Y PA �� Per inspection 62 50 City /State /ZIP: <3 ex � -6ct f 6(Z Investigation per hour (I hr m 62 50 Industrial plant per hour 73.75 Phone: (co3) 6, ZS — 3 7 b Fax' ( 503) 6 Z5 — S6 2 2 ELECTRICAL PERMIT FEES* CCB Lie.: C gy 3 Electrical Lie.: Suprv. Lie.: Subtotal '7 S •6a Plan review (25% of permit fee) Suprv. Electrician signature, required: - - / State surcharge (8% of permit fee) 6' • &?) Print name: �, �. U c l Date: � (a S(Q y TOTAL PERMIT FEE '(, 00 c � Authorized signature v "_ , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Date: :. Fee methodology set by Tri- County Building Industry Service Board Print name: - « Number of inspections per permit allowed. ,. \Build■g',Prnuos \ELC- PertnitApp doe 12'03 440- 4615T( ia,s2/cosvWEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received `a 5 Date Requested Co AM PM BUP Location 1" 7 Suite MEC Contact Person Ph ( ) 9l j ' off' 7 --- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner P T– ELC Footing Foundation ELC Ftg Drain Access: ELR a On l Crawl Drain �� / Slab Inspection Notes: SIT Post & Beam / I 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 �� 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 _ ota e -ire Alarm � Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Li� PART FAIL ❑ Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA C( 7 , Approach/Sidewalk Dat � O Inspector : ''G ■ / Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL