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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY A DEVELOPMENT BM SO R 9 OR 97223 -00297 (503) 639 -4171 'DATE ISSUED: E %20/00 - 13125 SW SITE ADDRESS: 06825 SW SANDBURG ST PARCEL: 2S101 DD -00400 SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: C -P BLOCK: LOT: 001 JURISDICTION: TIG Project Description: Tenant Improvement - HVAC 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: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: TOC MANAGEMENT SERVICES AMERICAN HEATING 6825 SW SANDBURG STREET 1339 SW GIDEON ST TIGARD, OR 97223 PORTLAND, OR 97202 Phone: 620 -1710 Phone: 239 -4600 Reg #: LIC 00033135 ELE 26- 683CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 12/20/00 $75.00 2720000000 Elect'l Final 5PCT CTR 12/20/00 $6.00 2720000000 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Issued by / �Q /rn Permittee Signature INSTALLATION 0 ' 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 Electrical Permit Application Datereceived: 1 $ Permit no.: ADD � DD 2 l u,Fr�. .' � ti ` 1 ,.� I City of Tigard Project/appl. no.: Expire date: . City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory XCommercial/industrial ❑ Multi - family ❑ Tenant improvement 1$(New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: �.S 5&.&) i i bi t ...pl_ s+ Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: � I Block: I Subdivision: U Project name: -n .C. ma, & n '.t44-Description and location of work on premises: Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: 2 - 00 Fee Max Business name: r 1 ,-, �� V Description Qty. (en.) Total no. insp " x New residential - single or multi- family per Address: 133'1 S.... 6 la Q tM dwellingunit. Includes attached garage. ' City: 1>'-4 I State MI Z1P:g1202 Sersiceincluded: Phone QN -4t0 I Faxt3 -'A 381 E -mail: 1000 sq. ft. or less 4 CCB no.: 33 I3G I Elec. bus. lic. no: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 Cit me tic. no.: iD Limited energy, non- residential 2 ��(�� 0---'49 Each manufactured home or modular dwelling a fore of supervising electr inn ( Date Service and/or feeder 2 Sup. elect. name (print) a,ra t1 i ,,, & License no: , 1'i2v( Services or Feeders — installation, " t' O \1'NER alteration or relocation: PRVPER7 200 amps or less 2 Name (print): 201 amps to 400 amps 2 Mailing address: 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: I State: 1 ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to Installation, alteration,orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to600am.s 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 2 City: . 1 State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2 Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps- commercial O Health -care facility Each pump or irrigation circle 2 U Service over 320 amps- rating of 1&2 Cl Hazardous location Each sign or outline lighting 2 family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure - alteration, or extension* I 2 O Building over three stories O Feeders, 400 amps or more *Description: O Occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection over the allowable in any of the above: O Egress/lighting plan O Other. Per inspection I 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 $ O Visa 0 MasterCard expires if a permit is not obtained' Plan review (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) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY P 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 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40. • 1 Limited Energy $75.00 ❑ Burglar Alarm Each Manufd Home or Modular ❑ Dwelling Service or Feeder $90.90 2 Garage Door Opener* Services or Feeders ❑ 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 ❑ Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ 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 Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ or feeder fee. Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ 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 Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting* Fees: ❑ Protective Signaling Enter total of above fees $ r7 Other 8% State Surcharge $ 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. Fees:• • Total Balance Due $ Enter total of above fees $ 9 5 ❑ Trust Account # 8% State Surcharge $ 4 .• �7 Total Balance Due $ I . Ot i:\dsts\forms\elc- fees.doc 10/09/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 - _ BUP Date Requested � AM PM BLD Location 6g Zc 5 -' -54 d 64 3T Suite MEC Contact Person 647 Ph Z 3 y 7/ PLM Contractor ' / Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR ZUe U 3 9 7 Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm V P Susp'd Ceiling C _ G1 � s — Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL p lf( Post & Beam f Rough In Gas Line Smoke Dampers ' Final PASS PART FAIL / Service Rough In UG /Slab _ CAN.MEW Fire Alarm PART 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 ADA Othe oach /Sidewalk Date a L" - v - 0 / Inspector � Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 3,14P CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 - ham I:, spection Line: 639 - 4175 Business Line: 639 - 4171 2 BUS " - Qate Requested .. ' / AM PM BLD Location 33 .SL✓ SG-,- d Suite MEC Contact Person / Ph 572-5 PLM Contractor 7/ -e-ri 'i-7 ' /fir- Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR 7�ivv —GO 2 jF 7 Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: ,[_j I / Slab / 1 V �"� 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 PLUMBING 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 Rough In UG /Slab ire Alarm Fi SS PART 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 ADA Approach /Sidewalk D 3 // c9 / I _L - — Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. / zyZP CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 7' 7. G AM PM BLD Location pe. £OJ'Z s Suite MEC Contact Person Ph 70/ Z/ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC oo� Retaining Wall ELR c!/! >G -6O Z97 Footing Access: Foundation F'PS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear �� �j Ina Sheath /Shear Framing C. , 7_00 Insulation ^ ,., Drywall Nailing CC) / —0C) 0 Fire wall i% — O / a l Fire Sprinkler Fire Alarm Susp'd Ceiling / /� G / d [.(i v — a1/45- Roof Misc: Final PASS PART FAIL PLUMBING � P G7 1 [ 11 - Post & Beam Under Slab Top Out Water Service � e Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL - Service Rough In UG /Slab roVC Fire Alarm F• 'ART FAIL S 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 ADA Approach /Sidewalk Other Date ' - �6 — o / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.