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Permit . CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00670 V DEVELOPMENT SERVICES DATE ISSUED: 12/5/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S126DC -04900 SITE ADDRESS: 09445' SW LOCUST ST SUBDIVISION: L EHMANN ACRE TRACT ZONING: C -P BLOCK: • LOT : 003 JURISDICTION: TIG Project Description: Installation of two branch circuits. RESIDENTIAL UNIT - TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: . 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: BBH INVESTMENTS THREE DOG ELECTRIC 9445 SW LOCUST 5250 SW CAMERON RD TIGARD, OR 97223 PORTLAND, OR 97221 Phone: Phone: Reg #: SUP 4613S LIC 138509 ELE 26 -1046C • FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 12/5/00 $53.50 2720000000( Elect'I Final 5PCT CTR 12/5/00 $4.28 2720000000( Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 rulesad. opted the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0080. You may obtain pies of these ru - or direct questions to OUNC at (503) • 246 -1987. PERMITTEE'S SIGNATURE � ISS D BY: \ , �j, ,C / /" 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: /� c-f1,7 DATE: -S _ ZC�6 • LICENSE NO: /&6 Call 639 -4175 by 7:00pm for an inspection the next business day gt Electrical Permit Appl Date received: li ' Permit no.: giz - pa 6 O ,.SIl City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: By: Receipt no.: Phone: (503) 639 - 4171 Fax: (503) 598 -1960 Case file no.: Payment type: • Land use approv . TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 6 (ygs 5 W 1 -- 0' ( t Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: Project name: I Description and location of work on premises C67RC'uiiS \tSiJw1A9t 2./1INS 414 Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name: 1 Qty. (ea.) Total no. insp TI IQrriC .- t oc, F a it .. ' . L New residential Address: (a la tM 003 dwelling unit. Includes attached garage. City PO C L flivid I State ZIP:q ZZ 1 Service included: Phone j 3 -Zq ,_y7zio I Fax: �- I E -mail: 111 sq. ft. or less 4 Each CCB no.: t 3 a $Q q I Elec. bus. lic. no: " 11 . . '. • . __ _— Limited energy, residential 2 City /metro lic. no.: Limited energy, non-residential 2 . ∎•- . C> 1Z rj- 2 .000 -� -. .. dwelling Signature of-supervising electrician (required) Date Service and/or feede • Services or feeders installation, Sup. elect. name (print): r (V License no:4 ( 3 5 alteration or relocation: PROPERTY OWNER 11 amps or 401 amps o 600 amps MIMI _ 2 Mailing .•• w .1 . 100 . 111. . __ 2 •'1 ► Y e ° P Over 111 amps or . ___ 2 Phone: Fax: • E-mail: ' Reconnect only 1 • Owner installation: The installation is being made on property I own Temporary services or feeders - installation, alteration, or relocation: which is not intended for sale, lease, rent,.or exchange according to 200 amps or less 2 201 amps to • 11 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit City: I State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail: of service or feeder fee, first branch circuit: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): U. Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320'amps- rating of 1&2 ❑ Hazardous location ' Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ • . 110 ❑ Visa ❑ MasterCard expires if a permit is not obtained' Plan review (at _ %) $ at-' Credit card number: / / within 180 days after it has been State surcharge (8 %) $ Expires accepted as complete. TOTAL $ • Name-of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6 /00 /COM) . it Electrical Permit Fees: Limited Energy Fees: Complete .Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4 Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 IT Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 . 1 n Burglar Alarm • Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 U Garage Door Opener Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106:85 2 I I Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 n Other Over 1000 amps or volts $454.65 2 Reconnect only • $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) • 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. ❑ Audio and Stereo Systems Branch Circuits • New, alteration or extension per panel n Boiler Controls • a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ or feeder fee. Fire Alarm In First branch circuit {i $46.85 4( $ Each additional branch circuit $6.65 C C,S ❑ HVAC Miscellaneous n Instrumentation (Service or feeder not included)' Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 n Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable in any of the above I � 1 Per inspection $62.50 l l Nurse Calls Per hour $62.50 In Plant - $73.75 n Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ 5� n Other 8% State Surcharge $ 'V• Number of Systems • 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. 7 e Fees: - Total Balance Due $,j • Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ i:\dsts \forms \etc- fees.doc 10/09/00 • - — CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour 10peetion Line: 639-4175 Business Line: 639-4171 MST BUP Date. Requested / Z—( 4 AM PM BLD Location got( Coce, 5 Suite MEC Contact Person Ph "Z.,- -4 6P 7/ PLM Contractor o 6— Ph SWR BIM-PKO :„ Tenant/Owner ELC -006 7 0 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab — SIT Post & Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ,----- Susp'd Ceiling Roof Misc: Final PASS - PART FAIL PtunABING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line • Smoke Dampers Final PASS PART FAIL „LEPT, Service Rough In UG/Slab Low Voltage Fire Alarm - ART FAIL Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Ay -- ADA Approach/Sidewalk Date 7 2 - 6°17 Inspector d ir Ext Other — Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.