Permit CITY F-TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00335
" '4II DATE ISSUED: 10/11/2005
13125 SW Hall Blvd., Tigard, OR 97 503 - 639 -4171
PARCEL: 2S 101 AD -03100
SITE ADDRESS: 06950 SW HAMPTON ST ZONING: MUE
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Low voltage for 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:
AMERICAN PROPERTY MGMT. REITMEIER MECHANICAL INC
PO BOX 12127 7051 SW SANDBURG #400
PORTLAND, OR 97212
Phone: 503 284 - 6133 Phone: 603 - 0205
Reg #: ELE 244LHR
LIC 153770
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/11 $75.00
[TAX] 8% State Surchar€ 10/11/200E $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 ar- set for in 9AR 952 - 001 -0010
through OAR 952- 01 -0100. You may obtain copies of these rules or direct ques . o ns to/6 C .t 503 - 246 -6699.
Issued By: Permittee Signature
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 A al.e
1 it - _ FOR - OFFICE USE - -
VED
R eceived -� ���G ? 35
City of Tigard Y I II 1 �}, Permit No / avv J ` J
`J g Date/By: 0 ( 0 5 6 I�f L w
13125 SW Hall Blvd., Tigard, OR '` 1 1 2005 Plan Review
Phone: 503.639.4171 Fax: 503.598.19 A N��I Date/By: Other Permit:
Inspection Line: 503.639.4175 i•' Date Ready/By: g . y: r . El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Informa
2UILDINC DIVISION
TYPE OF WORK PLAREVIEW
LI New construction ddition /alteration /replacement Please check all that apply:
❑ Demolition ❑Other: OService over 225 amps, comm'l ['Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling dommercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑Other: ['Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: Job site address: 6 51.4) 671.4 ❑Health - care facility ['Other: 570
p' Submit 2 sets of plans with any of the above.
City /State /ZIP: — 1 - 7.4 r 012, � 722 The above are not applicable to temporary construction service.
� °w FEE* SCHEDULE
Suite/bldg./apt. no.: Project name: PT, J( � ,
Description I Qty. l Fee. Total I `
Cross street/directions job s'te: New residential single- or multi - family dwelling unit.
A Includes attached garage.
19-a) /3 1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 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
r c} IJ ` p /� C.� ,.� Ab L n dwelling, service and/or feeder ' 90.90 2
1 L) � -.9i t> VOLT
O L I ,6 c Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Aeja- Iiik °p(,..OP..P Ma A47. 601 amps to 1,000 amps 240.60 2
Address: ' ), !).- 1-2-7 Over 1,000 amps or volts 454.65 2
n Reconnect only 66.85 2
City /State /ZIP: Pj)- .,)/J ea_ cb - 72. 1 Z Temporary services or feeders installation, alteration, and /or
Phone: ('�"3 ) 4-- E � 3 I Fax: ( ) relocation
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 I ❑ CONTACT' PERSON A. Fee for branch circuits with
� A � service or feeder fee, each
Business name: R .-- r (ek— k{ I ok C- branch circuit 6.65 2
�- B. Fee for branch circuits
Contact name: ' A) tilo t41J5o without service or feeder fee, 46.85 2
Address: 70 s I s A J / 6 u lea Sr 44,t,z) each branch circuit
Each add'1 branch circuit 6.65 2
City/State /ZIP: — 1 - 116 i2 t OP- 97 7`73 Miscellaneous (service or feeder not included)
Phone: 505 0 3 -020c I Fax: : (C) ) 6,03 _0190 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTO R energy panel, alteration, or
extension. Describe: Page 2 2
Business name:
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Az-PI Investigation per hour (1 hr min) 62.50
Phone: ( ) 1? Fax: ( ) / '431f‘7 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: l 53 ? ? 0 Elect ical Lic.•,:, .4_4 - � Suprv. Lie.: Subtotal --- 5
� Suprv. Electrician signature, requir.� . Plan review (25% of permit fee)
r
Print name: _, y D ate . 0/� �s." State surcharge (8% of permit fee)
I ' �^' 1' TOTAL PERMIT FEE CC `� e
Authorized signature' q7 , , � This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building 'Permits\EL.C- PermitApp doe 12/03 440- 4615T( I0 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELR2005 -00335
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 N �' juyp�@� li
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 55
SITE ADDRESS: 05950 SW HAMPTON ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HA PTON BUILDING
DESCRIPTION: Low v■ tage for HVAC.
OWNER: AMERICA PROPERTY MGMT., PHONE #: 503-284 -5133
CONTRACTOR: REITMEIER '-ECHANICAL INC PHONE #: 603.0205
Inspection Request Scheduled For: Date: 1/17/2005 Pour Time:
Code # Inspection Description Confirm # . Contact # Message
13 Low volts 020431 -01 503577 -83. N
Correc Co - 4 ients /Ins ctions:
•
iZ PASS n PARTIAL APPROVAL CANCEL n NO ACCESS
FA I > ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: L/ _;i✓ A// Date: I I '1 ' u.1 Phone #: (503) 718- 2'1g