Permit i,
CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
rifa DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00087
DATE ISSUED: 4/19/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AD -03100
SITE ADDRESS: 06950 SW HAMPTON ST 308 ZONING: MUE
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Low voltage: Voice and Data
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: : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
AMERICAN PROPERTY MANAGEMENT HASTINGS COMMUNICATIONS INC
2510 NE MULTNOMAH 14994 SW EMERALD CT
BEAVERTON, OR 97007
Phone: 503- 284 -6133 Contact #: PRI 503 -524 -5678
FEES Reg #: ELE 34- 602CLE
LIC 131979
Description Date Amount
[ELPRMT] ELR Permit 4/19/2006 $75.00
[TAX] 8% State Surcha 4/19/2006 $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 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503-246-6699.
Issued By: l Permittee Signature. / / / �A
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.
EF
Electrical Permit ApplicationE ; FOR OFFICE USE ONLY Received
NI V
City of Tigard° Date/By. 11 ' Q Permit No.: 4 J _ _•, , —00:0
13125 SW Hall Blvd., Tigard, OR 97223A pR { 2006 Review
Revw
0 ' ' Phone: 503.639.4171 Fax: 503.598.19SO . Date/By. Other Permit:
T1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Buds: ® See Page 2 for
Internet: www.tigard- or.gov CITY G 1 � � - 1 Notified/Method: Supplemental Information
TYPEr 1 ', l INI -: � �' PLAN REVIEW - ,
❑ New construction j]' 7Cddition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential .
❑ 1- and 2- family dwelling ommercial /industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑Other: ['Building 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: (' ❑Health -care facility ❑Other:
Ej $ � .Slit) /7 ,c7:: 2 sets of plans with any of the above.
City / State/ZIP: T 4 �-72._ 5, ,h 3� 8 The above are not applicable to temporary construction service. •
Suite/bldg. /apt. no.: ` f 306 I Project name:
FEE* SCHEDULE .
t Description I Qty. I Fee. I Total I
Cross street/directions to job site: 74 ! _d2 /_ �
! 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 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 1 75.00 '7S_° 2
' - DESCRIPTION OF WORK Each manufactured or modular
! ,, ' / dwelling, service and/or feeder 90.90 2
t 69'LL/ 1/0 ( - ems Ih (�P �' GF' G _ Services or feeders installation, alteration, and /or relocation
0 200 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: 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
Phone: ( ) 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
. ita I WeONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: - r 7 S ts,vn * ' C S Ve. branch circuit
Contact name: pA�r'c " � / L _ - _ ' 5 B without ou service circuits
/r7 without service or feeder fee, 46.85 2
Address:
� first branch circuit
',fig ( (jr,) Each add'I branch circuit 6.65 2
� �
City / State/ZIP: t JL " L I �' ?�7 Miscellaneous (service or feeder not included)
53 ) S ® Fax : : 0503 s Z n� 7S
Pump or irrigation
tl i ne ti g t i ng e 53.40 2
Phone: (
vl �T� I � Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
• . CONTRACTOR energy panel, alteration, or
/ extension. Describe: Page 2 2
Business name: n s [ rn r �+.., 2�C .
Address: / i/ [[ � �� C � l ��� S+� w � Each additional inspection over allowable in any of the above
T Per inspection 62.50
City / State/Z1P: .3.--7 . _3L 0/e— 9 `h 7 Investigation per hour (1 hr min) 62.50
I ndustrial plant per hour 73.75
Phone: ( j1 - -1 cZ Fax ( 5-1 `( �Sk' E LE CT RICAL PERMIT FEES*
/ ' y 6 �' . CCB Lic.: Electrical Lic.: 3t./_ Suprv. Lic.: (_m_ 30 Subtotal: *
Suprv. Electrician signature, requiired: /4. - Plan review (25 °/a of permit fee): l , Print name: , 47 _ , , , , ,, k � L ,, _ i ci - / 7 _ o / State surcharge (8% of permit fee): I, Tit J Da e: / QC t n
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: " r t S ' Date: 9_ (57 o 6 * Fee methodology set by Tri- County Building Industry Service Board
1 ** Number of inspections per permit allowed.
l:\ Building \Permits\ELC- PermitApp.doc 03/23/06 440- 4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
ItESIDENTIAI WORK ONLY
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
❑ Other:
COMMERCIAL' WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation -
El HVAC •
❑ Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling •
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PemitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00087
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2006
Phone: (503) 639-4171 440 0i (
Inspection Requests (24 Hrs.): (503) 639-4175 AA 1.
INSPECTION WORKSHEET FOR DATE: 4/28/2006 TIME: 7:02AM PAGE: 14
SITE ADDRESS: 06950 SW HAMPTON ST 308 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FORTY POUND SALMON
DESCRIPTION: Low voltage: Voice and Data
OWNER: AMERICAN PROPERTY MANAGEMENT, PHONE #: 503-284-6133
CONTRACTOR: HASTINGS COMMUNICATIONS INC PHONE #: 503-5245678
Inspection Request Scheduled For: Date: 4/28/2006 Pour Time:
Inspection 1 cription Confirm # Contact # Message
,c)9 • Electrical final 028969-01 503-789-6862
Corrections /Comments / Instructions:
74.. PASS El PARTIAL APPROVAL I CANCEL fl NO ACCESS
El FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CY - W - 6- AJ .6e Date: 4 4 t 'tb Phone #: (503) 718- to)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006.00687
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '!. �..
INSPECTION WORKSHEET FOR DATE: 412712001; TIME: 7:04AM PAGE: 73
SITE ADDRESS: 05951 SW HAMPTON ST 308 CLASS OF WORK: •
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FORTY POUND SALMON
DESCRIPTION: Low voltage: Voice and Data
OWNER: AMERICAN PROPERTY MANAGEMENT, PHONE #: 503 -284-6133
CONTRACTOR: HASTINGS COMMUNICATIONS INC PHONE #: 503- 524 -5678
Inspection Request Scheduled For: Date: 4127/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 028824 -01 503 - 789.5852 N
Corrections /Comments /Instructions:
Low 7c,,D,
q; 32_ 4
�► '? ' b n NC-- 0- LeS6 A & D
kr\bu
PASS PARTIAL APPROVAL ❑ CANCEL A10 ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: C5'N2-' 4 " ( S" Date: Phone #: (503) 718- 1--0