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Permit ti CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY .�L'�I�;� DEVELOPMENT H BMENT Tigard, SERVICES 639 -4171 DATE ISSUED: ED: 7/9 2004 SITE ADDRESS: 12240 SW SCHOLLS FERRY RD PARCEL: 1S134BC -00300 SUBDIVISION: GREENWAY TOWN CENTER ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Tenant Improvement A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: 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: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: BPP RETAIL LLC VISION SECURITY SERVICE BY BURNHAM PACIFIC PROPERTIES 10874 SW ROLAND CT ATTN: JOHN WATERS WILSONVILLE, OR 97070 SAN DIEGO, CA 92101 Phone: Phone: 503 682 - 6713 Reg #: LIC 152497 ELE 3- 544CLE FEES Required Inspections Description Date Amount Ceiling Cover [TAX] 8% State Surchar€ 7/9/2004 $6.00 Ceiling Cover Wall Cover [ELPRMT] ELR Permit 7/9/2004 $75.00 Wall Cover Total Elect'l Final otal $81.00 Elect! Final 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 p 2 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: CO k TRACT LLATION ONLY SIGNATURE OF SUPR. ELEC'N � ,, DATE: 1 1 LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day w El'ctrical Permit Application FOR OFFICE USE ONLY City of Tigard Dar ed Permit No. • / .22x) 01 aOO 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /a'" l Date/B : Other Permit: Inspection Line: 503.639.4175 e. Date Ready/By: Jug: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK . •- .4,:'' .�,..:. •; PLAN REVIEW. ❑ New construction 3ddition/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 1 - and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling 2ommercialJindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑Other: ['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: ) q D 5w �,4-i3LLS �� ❑Health raze facility ❑Other: Submit 2 sets of plans with any of the above. City/State /ZIP: l) 6 ty2p Cr_. / £")aa) i The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: FEE* SCIIEDi1LE Description I Qty. I Fee. Total 1 '' Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: 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 75.00 2 DESCRIPTION OF WORK Each manufactured or modular �� - Ct _ (' ¶ dwelling, service and /or feeder 90.90 2 t tJL SI OTff�il �['e,(1�J \ Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER .+TENANT. , - 201 amps to 400 amps 106.85 2 • 401 amps to 600 amps 160.60 2 Name: V `-' -ff__,-- 4).C.■, 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 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 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT I ONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: s V15) CO . 51;T__,) it)--)I'tJt S �v) atz- branch circuit Contact name: .3 f?3 - > n _ l B Fee ou service circuits feeder without service or feeder fee, 46.85 2 Address: 1 ((c 4 �OJ,i0 � - each branch a branch it 1 Each add'I branch circuit 6.65 2 City/State/ZIP: l tk', lc_ot,1vl �, q/0 ) 0 Miscellaneous (service or feeder not included) Phone: (p3) brig. , ( I sob) 5 , , ) i 53 Pump or irrigation circle 53.40 2 Fax: Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- *.... • CONTRACTOR , . . - energy panel, alteration, or O \ � C 1 O 1 5 t-- . o , i2 �� n extension. Describe: I Page 2 ( 2 Business name: v J �S `� { �/ l� l , ` O Address: P-�jj�� Each additional inspection over allowable in any of the above I O�� �� t` r�� Per inspection 62.50 City /State /ZIP: 1)GOOV ILL,F, cya. q Investigation per hour (1 hr min) 62.50 1'- Industrial plant per hour 73.75 Phone: ( )3 ) LI,3,(D7 Fax: (933) .113 ELECTRICAL PERMIT FEES* CCB Lic.: 1 17 Electrical Lie.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: ,// Plan review (25% of permit fee) Print name: LE �D �' Date: State surcharge (8% of permit fee) 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: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Building \Permits\ELC- PennitApp.doc 12/03 440.4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL 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* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: - • Fee for each commercial system $75.00 (SEE OAR 918 - 260 - 260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls El Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls • El Outdoor Landscape Lighting* Protective Signaling El Other Total number of commercial systems: I *No licenses are required. Licenses are required for all other installations is\ Building \Pemiits\ELC- PennitApp.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Lim* (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested . 8— _ O AM PM BUP Location /1-- L© 5c-ii tSu Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner y,fr 4 ELC • Footing Foundation ELC Access: Ftg Drain ELR Z ' y— 00 Zee. Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear W Int Sheath/Shear Framing Insulation /kW n y& V t j � f r /iY Drywall Nailing �-CJ C/-Y v' ` r Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 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 Service Rough -In UG/Slab Low Voltage • Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL 0 Please call for reinspection RE: 0 Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date e t �y� - Inspector 1� wB ? Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL