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Permit CITY OF TIGARD RESTRICTED ENERGY 31j� ELECTRICAL PERMIT - DEVELOPMENT SERVICES PERMIT #: ELR2000 -00228 ref J - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/6/00 SITE ADDRESS: 08048 SW SHAFFER LN NEW DURHAM PARCEL: 2S113B0 -00300 SUBDIVISION: &ORQAM ELEMENTARY SCHOOL ZONING: R -12 BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of irrigation control device. 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: IRRIGATION X TOTAL # OF SYSTEMS: 1 Owner: Contractor: SCHOOL DISTRICT NO 23J DOWN TO EARTH IRRIGATION 13137 SW PACIFIC HWY 13075 SW PACIFIC HWY TIGARD, OR 97123 TIGARD, OR 97223 Phone: Phone: 503 - 684 -3500 Reg #: LIC 5281 ELE 394CPI FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 10/6/00 $75.00 2720000000 Elect'I Final 5PCT CTR 10/6/00 $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 o rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 -0010 through A 52- 001 -0080. You may obtain copies of these rules or direct questions to O1( at (503) 246- 987. Issue by • -' ' Permittee Signature NJQ 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: 4/4 DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day t Electrical Permit Application AN Date received: to -t! -GO Permit no.: 1.4,o2..2, - _LI,l l•iI City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: UU B Receipt no.: Phone: (503) 639 -4171 /���- Fax: (503) 598 -1960 Case file no.: Payment type: ate, - i , Land use approval: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: 80 48 S - SLk icl, v F S Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: +Block: (Subdivision: Project name: l7urZ►gaws socce.t- Fusco I Description and location of work on premises: r, csc..7 Estimated date of completion/inspection: lb . CONTRACTOR APPLICATION FEE SCIIEDU,E Job no: Fee Max Business name Description Qty. (ea.) Total no. insp (x.+ ,c.,1 - .� e.ln.t . - r nf1 Address: I U 7 QA t New residential - single or multi- family per s. « lbw y • dwelling unit. Includes attached garage. City: 'T(.(- a.t. o I State:0 -LCD I ZIP: ct 7 Z. 3 Service included: Phone: 527; - to B ¢- 35 ax--. I E -mail: 1000 sq. ft. or less 4 CCB no.: JQ17 5- 32. .e, I I lec. bus. lic. no: 391-C e L 10•vO1 Each additional 500 sq. ft. or portion thereof Limited energy, res 2 tty /metro lic. no.: / Limited energy, non- residential 2 t o ( b / . -c Each manufactured home or modular dwelling 'Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders- installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): Tt(iA✓t.c3 ;'kwl. Sast>oL DIS1• Z3 J 201 amps to 400 amps 2 Mailing address: 13 l 3 `1 s•t o . Ptac,i a e 14..- 401 amps to 600 amp 2 601 amps to 1000 amps 2 City: - h" o I State:o no I IP: q Z Z.2-3 Over 1000 amps or volts 2 Phone: 4 31 - 4 0 ) se I Fax: I E -mail: Reconnect only I . 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 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 2 City: I 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): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 O 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, O System over 600 volts nominal more residential units in one structure , alteration, or extensions / 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: / t 1, /t7 /D/l-) (?j1 i- )T/ZCIL_. ❑ 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 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 $ 7g . OU O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $ o y State surcharge (8%) U Credit card number: / / within 180 days aft it ha been g ( ) $ to Expires accepted as complete. TOTAL $ 6 / • oU Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00 /COM) • TYPE OF WORK INVOLVED - RESIDENTIAL ONLY 4. Complete Fee Schedule Below: Number of Inspections per permit allowed Restricted Energy Fee $75.00 Service included: Items Cost Total 4- (FOR ALL SYSTEMS) 4a. Residential - per unit Check Type of Work Involved: 1000 sq. ft. or less $147.15 4 Each additional 500 sq. ft. or ❑ Audio and Stereo Systems portion thereof $33.40 1 Limited Energy $75.00 ❑ Burglar Alarm Each Maniifd Home or Modular Dwelling Service or Feeder $90.90 2 Garage Door Opener` 4b. Services or Feeders Installation, alteration, or relocation ❑ Heating, Ventilation and Air Conditioning System` 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 TYPE OF WORK INVOLVED - COMMERCIAL ONLY 4c. Temporary Services or Feeders 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 4d. Branch Circuits New, alteration or extension per panel El Boiler Controls a) The fee for branch circuits with purchase of service or Li Clock Systems feeder fee. Each branch circuit $6.65 2 . b) The fee for branch circuits Data Telecommunication Installation without purchase of service r - I � or feeder fee. - I ' Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 n HVAC . • 4e. Miscellaneous (Service or feeder not included) Instrumentation Each pump or inigation circle $53.40 Each sign or outline lighting • $53.40 • El Intercom and Paging Systems Signal pircuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control` Minor Labels (10) $125.00 4f. Each additional Inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 I 1 In Plant $73.75 I 1 Outdoor Landscape Lighting' 5. Fees: ❑ Protective Signaling 5a. Enter total of above fees $ D /� ^ Q -� ` /�� _f��� 8% Surcharge (.08 X total fees) $ n Other / £ a t 6d / [ d Gv e.„,C� 77-O (_, Subtotal $ 5b. Enter 25% of line 5a for Number of Systems Plan Review if required (Sec. 3) $ Subtotal $ • No licenses are required. Licenses are required for all other installations I El Trust Account # FEES: Total balance Due $ ENTER FEES $ 8% SURCHARGE (.08 X TOTAL ABOVE) $ TOTAL . $ . • CITY OF TIGARD BUILDING INSPECTION DIVISION MST - 24 Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested ": / A M PM BLD Location Uhl d 5 "' ✓ �n Suite MEC Contact Person CSotR► Ph PLM Contractor Ph SWR BUILDING Tenant/Owner IP 4 y �� ELC Retaining Wall ELR Z9t.'L - Uv 2 2,k Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab � f ri f� 7 / 0".1 / 1 3- X -6756-, 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 •ECECTRICAt Service Rough In UG /Slab Alarm Fi -' - ASS 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 /n Other oach /Sidewalk Date /g---f2 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.