Permit ' ^'
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Allik, CITY OF TIGARD
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DEVELOPMENT SERVICES `
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' ` ��/ ELECTRICAL PERMIT -
' ' A.41- :- ����/�� Blvd, 7�oi
m���7���U����/7Y C.
�-`'�-- '- RESTRICTED ENERGY, � :
. PERMIT #: ELR97-0326
DATE ISSUED; 11/12/97
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, PARCEL: 1S136AD-04000
SITE ADDRESS...:11533 SW PACIFIC HWY
SUBDI'V7SION....:VILLA RIDGE Z8NINGtC-G
BLOCK. ......... z �~ ~.~ ..... LnT '. . . :007. JURI8DICTN: TIG '
Project Description: installing u dea telecnmoonica ima systpa .
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A. RESIDENTIAL--------- B. COMMERCIAL--- ------�-r----�---�----------
AUDIO & STEREO...': AUDIO & STEREO..; INTERCOM 1 PASING.. .;
BURGLAR ALARM. . . . : B8ILER. . . ... . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. ... : CLOCK.. . . ..... . . : MEDICAL. .. ... . . .... :
NV�AC. . . . . . .'. . . . ..; DATA/TELE CnMM. . :X ' NURSE CALLS. , .'„. . . . :
VACUUM SYSTEM..'.".: FIRE ALARM.. �. .. : OUTDOOR LANDSC LITE: • .
OTHER: ' :: HVAC..... . .. .. . . : PROTECTIVE SIGNAL. . :
INSTRUMENTATION.; OTHER..: ;:
TOTAL # OF SYSTEMS: 1
Owner: -------- -------------- ----- ----- FEES -----------^-----
BENEFICIAL REAL ESTATE • type amount . by date recpt
11533 SW PACIFIC HWY • PRMT $ _ 40.00 B .. 11/12/97 97-300871
' TIGARD OR 97223 _—'' ^_— — _ ' ' � —' � ��PCT'—$ — 2. 0N—��� 1 1 /�1�/97 97 ;-�
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Contractor: --------------------�--�------------�------------------------------
• SATES 'ELECTRONICS & SECURITY • $ 42. @Q TOTAL
�� � � � ' . � ETER N GATE �
' 6818 S CAP HWY ' ` ----�- REQUlRED �NS --�----
� INSP
PORTLAND OR 97219 Ceiling' Cover Low' Voltage "Insp. •
Phone #: 246-9951 Wall Cover Elect'l Final
Reg it..: 007687
This peroit is issued subject to the regulations contained in the Tigard Nunicipal Code, State of Ore Specialty Codes and all other
applicable laws. All work will be done in accordance with approved p\ans. This peroit will expire if work is not started within �
days of issuance, or if work b suspended for apre then 18� days. ATTENTION: Oregon law requires, you to follow rule Adopted the
0rpgoo.itility Notification Center. Thhse rules are set forth in OAR 9•21Z1-0010 through OR0 952-001-0088 Y U oay:'obtain:',of.. of
these rules or direct questions to OUNC at (503)246-:987.
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issued by, ' __ '__ t.... Pe'mittee Signatur
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• ----�--------------�-------OWNER INSTALLATION ONLY--------�---------�-----�----
The installation is being made on property I own which is not intended f
sale, lease, or rent. .' - • . • , .: ,' . '. .
OWNER'S � SIGNATUR��: ___ _________ DATE: '
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------------------------CONTRACTO TION ONLf-------------� ---------�
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SIGNATURE OF SUPR. ELEC' N: V DATE:
/..N, -_ � __' __-_-_- / . _____-
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LICENSE NO
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��a l 639-4175 by 7:00 P.M. for 'an inspection . needed the next business day,
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CITY OF TIGARD Electrical Permit Application Plan Chec
13125 SW HALL BLVD. Rec'd By , V
TIGARD OR 97223 Date Rec'd 11 -1 Z 7
Date to P.E.
Phone (503) 639 -4171, x304
Print or Type Date to DST ���`_
Inspection (503) 639 -4175 permit
Incomplete or illegible will not be accepted
Fax (503) 684 -7297 R07-65(21 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) .. . _ ,/ ��, . ,&_ , _m.. i i Serv included: Items Cost Sum •
Address /15 , jr 4a. Residential - per unit
aa
� J 1000 sq. ft. or less
Each additional 500 sq. ft. or $110.00 4
City /State /Zip "7
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Commercia' Residential ❑ Limited thereof $25.00 1
Llmded Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all curre t licenses 4b. Services or Feeders
Electrical Contractor . P'= - /Ls . , , Installation, alteration, or relocation
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itra
200 amps or less $60.00 2
Address _ i_i �
llf . 201 amps to 400 amps $80.00 2
City �/?� �iptA t �h� Zip � �1 401 amps to 600 amps $120.00 2
Phone o. . _ Y S 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. Ti/' i xp.Date , j , Reconnect only $50.00 2
OR State CCB Reg. No. 7 Exp.DateT /fl.74?I' 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp. P at - Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 201 amps to 400 amps $75.00 2
5 401 amps to 600 amps $100.00 2
,g Over 600 amps to 1000 volts,
License No le; / Exp.Date JO/01 see "b" above.
Phone No g�
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circ $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy /
$4 T r / ,'p
panel, alteration or extension 2
Minor Labels (10) $ •0.10
Please check appropriate item and enter fee in section 5B. ^,,,, -
4 or more residential units in one structure 4f. Each additional inspection over / Ww"
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY 14'� f�/]
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # loll/
Total balance Due
I \DSTS \ELC96 APP Roy 9/96
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
D a t e Requested: / - / 0 ^ Q 7 P.M. MST:
Location: _ A_ / ` ... ►L _A J BUP:
Tenant: 1 V . L. L_ Suite: Bldg: MEC:
Contractor. Phone: PLM:
Owner R,_ JJJ . J Phone: 2 L-1-G -q -( 5 I ELC:
ELR: 7 -0326
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL LE C TRI CAL, SITE
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Site Post/Beam Post/Beam Post/Bea Loveriservice Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump s w Volt
Approved Approved Approved • Troy:. Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not • pproved Not Approved
FINAL FINAL FINAL INAL) FINAL
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/4-T C' A- a AL-' /NSTi9 -k i19- 7 /e(1/- Ph-5 5
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O Call for reinspection Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: 6_,Q / Date: ! ,2 — ! b - L 7 Page of