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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY ;��� DEVELOPMENT SERVICES PERMIT #: ELR2000 -00253 _` 13125 SW Hall Blvd., Tigard, OR 97223 (5031 639 -4171 DATE ISSUED: 10/31/00 SITE ADDRESS: 12286 SW SCHOLLS FERRY RD. PARCEL: 1S134BC -00300 SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of audio /stereo systems. 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: BURNHAM PACIFIC MUZAK LLC 10135 SE SUNNYSIDE RD 12402 NE MARX SUITE 250 PORTLAND, OR 97230 CLACKAMAS, OR 97015 Phone: Phone: 254 -7400 Reg #: LIC 142760 ELE 26- 1055CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 10/31/00 $75.00 2720000000 . Elect'l Final 5PCT CTR 10/31/00 $6.00 2720000000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are :.et forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or di i q 1 stion- o OUNC at (503) - 246 -1987. - - Issued by Permittee Signatu e ra Ii OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: - Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day t Electrical Permit Application Datereceived: /d /3 Permit no.:EL,QZpoO -OOZ 3 ..Yj■ City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: • TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ..lCommercial/industrial 0 Multi- family 0 Tenant improvement ❑ New construction 0 Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: j2.Z$b Sy-) 541-‘01-A-5 F�ea`1 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: 'Subdivision: Project name: BAAA FO-E514 I Description and location of work on premises: 5oJ.)o s y5 'r Al Estimated date of completion/inspection: I I i i I ZIL CONTRACTOR APPLICATION FEE SCIIEDU.E Job no: Fee Max Business name: 64 J SAIL. Description Qty. (ea) Total no. insp New residential -single or multi-family per Address: I 7_4-o 7- ivi= M a- a X dwelling unit Includes attached garage. City: Paa -Tt. t I State: 0e_ IZIP: c}"7 Z 30 Service included: Phone: 2-64 /400 I Fax: I E -mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: (4-2_160 I Elec. bus. lie. no: 'Z-lo - 10 65 C L E f Limited energy, residential 2 City /m ro 'c. no. Limited energy, non- residential 2 i 0 I Z ZI . Each manufactured home or modular dwelling / Signature of s pervising el trician (required) Date Service and/or feeder 2 Sup. elect. name (print): lbAJaD P rri License no: 3l ioter Services or Feeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps • 2 City: I State: I 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 200 ORS 447, 455, 479, 670, 701. 201 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 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: I State: • I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: • 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW' (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps- commercial . ❑ Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 1&2 0 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 0 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 I I 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 $ 2-5 rr ❑ Visa ❑ 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 $ . f n Name of cardholder as shown on credit card r $ Cardholder signature Amount 440-4615 (6N0 /COM) i Electrical Permit Fees: Limited Energy Fees: :r 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 `, 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 ❑ Burglar Alarm • Limited Energy $75.00 • Each Manuf'd Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 1=1 Vacuum Systems' 201 amps to 400 amps $106.85 2 401 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. ao Audio and Stereo Systems 1 • Branch Circuits ❑ B o i ler Controls New, alteration or extension per panel a) The fee for branch circuits ' with purchase of service or ❑ Clock Systems feeder fee. pi Each branch circuit $6.65 2 I Data Telecommunication Installation b) The fee for branch circuits • without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 . El HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ • Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control • Minor Labels (10) - $125.00' ❑ Medical Each additional inspection over the allowable in any of the above El Nurse Calls Per inspection $62.50 • Per hour $62.50 • ❑ In Plant $73.75 Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ I I 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 • $ - 7,C. 67) • El Trust Account # 8% State Surcharge $ 6 , -z) • Total Balance Due $ e/ b 070 i:\dsts\forms \elc- fees.doc 10/09/00 - CITY'OF TIGARD BUILDING INSPECTION DIVISION ' - - 24 - Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 MST BUP Date Requested //- L AM • PM BLD Location .5 SGT` //S (e" Suite MEC Contact Person m Ph PLM Contractor t )Z 4 Ph SWR BUILDING Tenant/Owner ELC 0 02 ; ,Sr 3 Retaining Wall ELR ZGw Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes:/� �� Slab (��4.0 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 ,ELEC - - b 1 Rough In UG /Slab $ U sy5/ ir_ Low Voltage- - Fire Alarm Fin AS PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date /// Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.