Permit 4 .
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Electrical Perinit, Application - ., - • FOR OFFIC:E,VSE ONLY - ..
' . City of Tigard RECEIVED Received
mr lc - 63
503
Line: ,, Permit No: Leaki
• :: 4 - " 13125 SW Hall Dlvd., Tigard, OR 97223 0 P D I:a i L i:i ia i R R ev : ' iew
Ol
- Phone: 503.639 Fax: 503598
: 1 - .• .4171 6
4
hOr Peribit
pion ine: .9.4175 U 0- 2 8 2008 Date Ready/Ry: iiiris lil see rage . ,„ ._
TitGAR.D Inspection
Internet: www.tigard-orgov Notified/Method; T7-, Supplemental Information
' • ' :, .. r: .: : : ' ' ' ::■: .!' 4 V#0, .' la ...40ii5iAlliieP!.'::::'i/,n Oit .' ' •
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0
Now CenStreetien [2] Addition a teration/replacernent Please check all that apply (submit 2 sets of plans w/items checked below).
0 Service or feeder 400 amps Or more 0 building over clime stones.
El Demolition ill Other: 'where the available teak ciirrent l: Marinas and boatyards.
(t060N:Aqi70.„*,•;.0':*Wft1:::!C;P1l'..:::.::'':l!!.;:i. exceeds 10000 amps at ISO volts or 0 F10£11.1q thilldiNO,
iconic/ ground, or exceeds 14,000 0 Commercial.use asricoitunti
LI 1- and 2-family dwelling 0 Commercial/industrial D Accessory building amps for all other installations, buildings.
0 multi-famil 0 Master builder El Other: ['Fire pump, 0 Insialiarien Or75 KVA or
:: r,,,,,,,.::. `,,,l, 0 , 0 Emergency system. 'Urger separately iv sys
. r idii '' 0 0$00 . 1.iO'VSti'YXR*OrOCE:T : •k::; : ;.V;;6: 0 Addition of new motor load of der ed tem
Job no.: 1 Job site address: 1 2A 0 SkAl _6, mc, 0 s l O x 01 0 - 1 , P ,
1 units. 0 ocebpancy
Recreational vehicle parks.
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City/State/ZIP: \r \ t CI, Of\ - C \ I" Qa 0 Health-care facilities. 0 Supply voltage for more than
1 0 Hazardous location. 600 volts nominal
• Suite/bIdg./apt. rio.CA TA ,I 1 Project name, --. I i
1 k b p l 0 SerViOB Or feeder 600 amps or more. . . _
. . , . ..FEE SCHthuLE
Cross street/directions to job site' Ductiotiolt I City:1 Pct. I Toi,a I .
New residential single- or multi-family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. adc1 500 sq, it. or portion 33.40 1
Tax map/parcel no.:
, Limited energy, resident tal
. " . :i.."':'' . 10 , '00i'#. 4 06§ i :6iiwattiv !,:' ( above se,,(t,) 75.00 2
, •
Limited energy, multi-family 75.00 2
1 7±tilifili: -.D‘I'c'i r 4 itttlt=rk±:rtf a__ iesidential (with above sq. 11.)
Services or feeders installation, alteration, a nd/o • relocation
, ..
• . ,..
'12' ,';':;':.1:'E!'::.:1. 200 amps or less 80.30 .'s'§: 201 amps to 400 amps 106,8 2 2
401 amps to 600 amps 160.60 - 2
Name: _, \ ,. s -\ . cly _
601 amps to 1 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: (%9. aa3 I 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 10 400 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: OM: A. Fce for branch circuits with
, . ._. .
APPLICANT . '..,. in poNTAciregtz9N ,. . : • above service or feeder fee,
6.65 2
each branch circuit
Business name! ft \cxe,) . ' vIc e..) illa 7
. - ,. B, Fee for branch circuits
), r k .
without service or feeder fee.
Contact name: .., ■k„
first branch circuit 46.85 2
1 _ i
Address: . '_...j . \ I e 1 -
• Each adc1 branch circuit 6 65 2
' ...in • 41 .'
Miscellaneous (service or feeder not included)
City/State/ZIP: 5 . • Each manufactured or modular
... 90 90 2
dwelling, service
Phone: (,.., 01- °s / Fax: : (50,3) g - and/or feeder ,,,
Jr.ennneet 'only ..
66.85 2
E _ Pump or irrigation circle 53.40 2
€.0.I • ''T'll: :l : ' '';: Sign or outline lighting 53A0 2
Signal circuit(s) or limited-
Business name; American Security Alarms, Inc,
energy panel, alteration, or
- - I 75.00
Address: 5411 SE McLougblin Blvd. extension. Describe: Page 2 2
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City/State/ZIP: Portland, OR. 97202 Each additional inspection over allowable in any of the above
Per inspection 62.50
PliOne: (503) 231 Fax! (503) 230
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Investigation per hour (1 hr min)
62.50
CCB Lie.. 58640 Electrical Lic.:34. a Suprv. pc. , D , 42auti IndustriDi plant per hour . _ 73.75
-- c---- OF • : : - '• •• 'ELECTRICAL PERMIT PEES
StiprV. Electrician signature, required: . • - A CJ Subtotal; 75.00
C Pl f permit fee): N/A
an review (25% o
Print name: 1 --- & i. 5 10 rite.:
,
State surcharge (12% of permit fee): 9.00
Authorized signature; TOTAL PERMIT FEE: 84.00
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- This permit application expires if Ft permit it not Obtained within ISO
Print name: Sara Patterson Date: days After it hue been accepted as complete.
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4 ' Number of inspections allowed per permit.
I. \lhuaivPc.,•mttal - ' 'tApo.cl■ ---- - - 440-4615TO 1 (05/COM/WEB
'd LE2 A AVE15 190H V ';,0
CITY OF TIGARD
BUILDING DIVISION PERMIT #: F(_1 ?00€ l3Q04
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 028/2001.1
Phone: (503) 639 -4171 / µ'govp l� l� �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/30/2008 TIME: 7,QOAM PAGE:
SITE ADDRESS: 07360 SW HUNZIKER RD 102 CLASS OF WORK:
SUBDIVISION: HILLTOP BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: RGIS LLC
DESCRIPTION: Loaf voltage for fire alarm panel.
OWNER: ROBINSON DEVELOPMENT, PHONE #:
CONTRACTOR: AMERICAN SECURITY ALARMS PHONE #: 503 - 231 -0303
Inspection Request Scheduled For: Date: . i0130/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 077393-01 503 - 231 -0303 N
Corrections /Comments /Instructions: 1
\zE c`� b ALA w i6 - c�N�,,
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL [1 NO ACCESS
I I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: V • u `r 06 LC Date: 10 1 0 Phone #: (503) 718- Wit