Permit 1
Ir CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00371
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/25/2007
PARCEL: 25101 DB -00100
SITE ADDRESS: 07320 SW HUNZIKER RD 102 ZONING: C -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TRILOGY HOMES
Project Description: 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: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ROBINSON DEVELOPMENT AF TECHNOLOGIES
PO BOX 91305 1418 HEMLOCK ST. NW
PORTLAND, OR 97291 SALEM, OR 97304
Phone: Contact #: PRI 503- 362 -2364
FAX 503- 362 -2382
FEES Reg #: ELE CLEI0
LIC 167061
Description Date Amount
[ELPRMT] ELR Permit 9/25/2007 $75.00
[TAX] 8% State Surcha 9/25/2007 $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 or 1.800.332.2344.
Issued By: ‘ j Permittee Signature: —as
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.
t o
Electrical Permit Applicati,t EC 19A E FOR OFFICE USE ONLY '
City Received l' / —7 Permit N
`J of Tigard g Date/By: p� /O / �� e h7 — d U 3 '/
1 14 ° 13125 SW Hall Blvd., Tigard, OR 972234;.;! <, 5 --- Plan Review Other Permit:
_ ' Phone: 503.639.4171 Fax: 503.598.1960' L 11 D ateBy:
T I G A R D Inspection Line: 503 C ITY OF TIGARD
Internet: www.tigard- or.gov Date Ready/By: Juris 7 ' ® See Page 2 for
Notified/Method: Supplemental Information
TYPE OF. WORK . '- • , , . PLAN REVIEW n ' •
CI New construction Addition /alteration /replacement Please check all that apply (submit 2 of plans w /items checked below):
❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards.
' c, F CONSTRUCTION .. exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
CATEGORY O
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ['Fire pump ❑ Installation of 75 KVA or
' JOB INFORMATION AND LOCATION ^ ❑Emergency system. larger separately derived system. ■ . ['Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
#1.4. Ad u
/_•• 100HP or more. occupancy.
Job no.: Job site address: 9 3 vc D 5 trt`l / t2D ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: l �� 2 �� (� ❑ Health -care facilities.
❑ Hazard locations. ❑ Supply voltage for more than
L6 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ' ' , L p ❑ Service or feeder 600 amps or more.
��� j �`I - FEE SCHEDULE `
Cross street/directions to job site: Description I Qty. I Fee. I Total I *
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft, or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK , (with sq. ft.)
75.00 2
with above s ft.
Limited energy, multi - family 75.00 2
LID L. * Dte....74 GA— residential (with above sq. ft.)
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
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 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 _ I - ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
. CON TRACTOR ' • = Sign or outline lighting 53.40 2
Business name: /�G// /' Signal circuit(s) or limited -
41 ? AI G�7, c—s energy panel, alteration, or 7.64:2—L92 Address: `(./ / 1,/,,,i9 L�c!< .. j /�� extension. Describe: Page 2
City/State /ZIP: �, / 2 2 Each additional inspection over allowable in any of the above
" ��� % Per inspection 62.50
Phone: ,(b 3) ?6,. _ r93 62 y I Fax: 6 .34,4,...a, 3 g y Investigation per hour (1 hr min) 62.50
CCB Lie.: / ' / Electrical Lie.: el../.1,,/ 0 Suprv. c.: ar ,3 Industrial plant per hour 73.75
ELECTRICAL' PERMIT FEES
Suprv. Electrician signature, required: , �j' Subtotal:
Plan review (25% of permit fee):
Print name: Date: G
62 #_ !'� / "� ® 7 ___ s-_a State surcharge (8% of permit fee):
Authorized signature_ //_ TOTAL PERMIT FEE: I .p
Print name: (2.&./,,,/ O/ff/.r/f_c Date: This permit application expires if a permit is not obtained within 180
Z��7 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I: \Building\Permits\ELC- PermitApp doc 05/23/06 440- 4615T/I 1/05 /COM/WEB
A
Electrical Permit Application - City of Tigard ,
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIALWORK:ONLY: ' "_ . ,
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
I I Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n 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
n Boiler Controls
n Clock Systems
Data Telecommunication Installation
❑ \ Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
PI Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \ BuildingPermits \ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION ., .
PERMIT #: ELR2007•00371
•
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9.
Phone: (503) 639-4171 , :/or 1 p
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/26/2007 TIME: 7:01Alvl PAGE: 36
SITE ADDRESS: 07320 SW HUNZIKER RD 102 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TRILOGY HOMES
DESCRIPTION: Voice and data.
OWNER: ROBINSON DEVELOPMENT, PHONE #:
CONTRACTOR: AF TECHNOLOGIES PHONE #: 503-362-2364
Inspection Request Scheduled For: Date: 9/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Low voltage
056376-01 603-932-6657 N
Corrections/Comments/Instructions:
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N
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IV I .
iN
1 V \
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PASS I I PARTIAL APPROVAL n CANCEL fl NO ACCESS
FAIL I I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: ----• N b02:4 LC Dat e: 4 °1—
Phone #: (503) 718- I
A-2-