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Permit • CITY .TI GARD RESTRICTED ENERGY I� DEVELOPMENT SERVICES PERMIT #: ELR2003 -00146 I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/29/03 SITE ADDRESS: 11847 SW PACIFIC HY PARCEL: 1S135DD -00800 W SUBDIVISION: HOFFARBER TRACTS NO.2 ZONING: C -G BLOCK: LOT: 022 JURISDICTION: TIG • Project Description: Low voltage for sound system. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: X 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: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: SANOKEE BROWNELL SOUND + HI -Fl 375 NW GILMAN BLVD STE C -203 2500 SE HAWTHORNE BLVD ISSAQUAH, WA 98027 PORTLAND, OR 97214 Phone: 425- 391 -0570 Phone: 425- 391 -0570 Reg #: LY(£1- 786673876 ELE 26- 789CEP FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 5/29/03 $75.00 Elect! Final [TAX] 8% State Tax 5/29/03 $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 no started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law r- . i --s you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 010 hrouc Issued by Alio r 1 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day FOR OFh10E USE ONLY Electrical Permit Application Received Electrical t�� 3 _ s�� a - • Date/By: S ; )q -03 s Q?) Permit No .. City of Tigard Planning Approval Sign g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post-Review Land Use Gxn �' � ll;� Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 Name/Method: - °ry & Supplemental Information. TYPE OF WORK PLAN REVIEW (Please check all that apply) El New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location 14 Addition /alteration/replacement ❑ Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in El 1 & 2- Family dwelling Irl Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more El Accessory Building 0 Multi-Family l ti -Famil ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder El Other: ❑ Egress/lighting plan ❑ Other: JOB SITE INFORMATION ama,09.2TION Submit _ sets of plans with any of the above. S � e. � The above are not applicable to temporary construction service. / Job site address: //t1 �✓ FEE* SCHEDULE Suite #: Bldg. /Apt. #: / Number of inspections per permit allowed Project Name: )(S /4W As i .a(I/1b S1►s`tan Description Qty Fee (ea.) Total ` Cross street/Directions to job site: New residential-single giIncludes attached multi-family per i j � dwelling unit. Includes attached garage. Service included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Limited energy, residential 75.00 2 Subdivision: I Lot #: Limited energy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 Services or feeders - installation, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 ❑ PROPERTY OWNER / � TEN T 601 amps to 1000 amps 240.60 2 GrN� .ST/ y Over ect amps or volts 454.65 2 Name: d Reconnect only 66.85 2 Address: /129 3 Ac. j iG A, Temporary services or feeders - installation, City/State /Zip: " / / 9722.1 I alteration, 00 m less relocation: 66.85 I 200 amps or less Phone: Fax: 201 amps to 400 amps 1o0.30 2 ❑ APPLICANT ❑ CONTACT PERSON Branch n to ch h amps 133.75 2 c Bran circuits - new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 6.65 2 City/State /Zip: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit 46.85 2 Phone: I Fax: Each additional branch circuit 6.65 2 E -mail: Misc.(Service or feeder not included): CONTRACTOR Each pump or irrigation circle 53.40 2 9 47 a ? Each sign or ore lighting 53.40 2 Job No: Signal circuitss) ) o or a limited energy panel, Business Name: `w alteration, or extension / Page 2 2 pV Description: I� Address: ,Z $Db SZ A 4RIY1 O — ,7R7fA/►0 0R 912/ y Each additional inspection over the allowable in any of the above: City/State/Zip: Per inspection per hour (min. 1 hour) 62.50 1.1 - Phonesp.?..,23 /.7f4 G I Fax: feu.231.- 74 G Investigation fee: G9 �3 CCB Lie. #: 7t8f 7 4, Lie #: L . , 4 s Other: Electrical Permit Fees* Supervising electricia "_ _...........- _ /o Subtotal $ <ve-,; " si: ature re • uired: ., �� Plan Review (25% of Permit Fee) $ Print Name • • �9 iriAT,! ringskr _ State Surcharge (8% of Permit Fee) $ e„ — TOTAL PERMIT FEE $ q l Authorized / Notice: This permit application expires if a permit is not obtained within Signature: //1f / _ Date j ✓ 180 days after it has been accepted as complete. ast/g....? •Fee methodology set by Tri -County Building Industry Service Board. /• ,2 /i ;fir; - r (Please print name) i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: 0 Audio and Stereo Systems ❑ Burglar Alarm O Garage Door Opener ❑ Heating, Ventilation and Air Conditioning System • Vacuum Systems* • • 0 Other Y • . p t 1 ♦ .. • ` • Y COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918- 260 -260) r heck Type of Work Involved: Audio and Stereo Systems 0 Boiler Controls Clock Systems El Data Telecommunication Installation ❑ Fire Alarm Installation . • ♦ • • • HVAC ' y r - Instrumentation ❑ Intercom and Paging Systems O Landscape Irrigation Control El Medical Nurse Calls n Outdoor Landscape Lighting ♦ ` • El Protective Signaling 1 - .t ` •• I I Other ..,, • . ' • Number of Systems •, e * No licenses are required. Licenses are required for all S • ' other installations ^Nt i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 . INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested AM PM BUP / Location / I g '17 i 2- c-c� Suite MEC Contact Person / t..t Ph ( ) 3/ q - 4134 j PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner � Oi►�- -b.. ELC Footing ELC Foundation Access: // Ftg Drain ELR 3 -" ao / ` '' 7` ' Crawl Drain Slab Inspection Notes: L� / � a 5 a \l 5 S SIT Post & Beam V Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing !/ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 19 7 Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL A() o∎C; e Service Rough -In Lo V Slab i p � S� ∎M � -1r1 l� l Loydolfa9�/ yJ Fir rm v Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS 1? FAIL SIT ❑ Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line / i ADA Date G ` sZO — © Inspector . Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from th ob site. PASS PART FAIL