12725 SW 66TH AVENUE STE 207 c
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12725 SW 66"' Avenue #207
ELECTRICAL -
ERMIT
CIT ®F TIGARD RESTRICTEDP
li " ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2002-00150
13125 SW Hall Blvd., Ti-iard, OR 97223 (503) 639-4171 DATE ISSUED: 8/7/02
SITE ADDRE`1S: 12725 SW 66TH AVE 207 PARCEL: 2S101A.D-00100
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 034 JURISDICTION: TIG
Proiect Descriction: Installation of data/telecommunication system.
A. RESIDENTIAL _ _ B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATlJTELE COMM: X NURSE CALLS.
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
L___ ___�---- — ---- ---- -------TOTAI_# OF SYSTEP;IS: --- - —�
Owner: Cuntractor:
PARROTT, VIAL LL(; CABLE RUNNERS
12725 5W 66TH AV"-- #202 ;x,500 SW BOONES FERkY RD
PORTLAND, OR 9722,1 PORTLAND,OR 97219
Phone: Phone: 503-245-3669
Reg #: LIC 1:2854
ELE 26-Ml CLE
FEES _ — Required Inspections
_Type By Date Amount Receipt Low Voltage Inspection I
PRMT CTR 8/7/02 $75.00 2720020004 Elect'I Final
5PCT CTR 8/7/02 $6.00 2720020000
Total $81.03
This Permit Is issueh sut;iect to the regulations containeu in this ?igard Mu;�elpol 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 1,10 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon lavr
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR
952-00i-00I0-through OAR-Q52-001-0080. You may obtain copies of these rules or direc!questions to OUNC at (503)
24P-1987. �
..<
Is ed by Permittee Signature X
OWNER INSTALLATION ONLY
'Tt.,- installation is being made on property I own which Is not intended for sale. lease, or rent.
OWNER'S SIGNATI)RE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELFC'N ,— _— _ _— DATE: _
LICENSE NO: —-- -- -- - — ---- — _ -- ---- ---
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
lRecei ea / ry elcctricaiate/ /��iJ 7 Gs Permit No.:�L�s'�G 91�
ax'd
Itj' f)f j 1g Planning Approval Sign
Test l�orm Date/By: PcrmitNo.:
13125 SW Ifall Blvd. Plan Review Other
Tigard,Oregon 97223 DatcBy: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use
Date/By: Case No.:
Internet: w•ww.ci.tigard.or.us c.ortact Juris.: See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information.
TYPE OF WORK - PLAN REVIEW Please check all that apply)P E _
CW construction - Demolition ❑Service over 225 amps- health-care facility
commercial ❑Hazardous location
Additi�_n/alteration/rcplacci Other: ❑Service ovc�320 amps-rating of ❑Building over 10,000 square feet,
CATEGORY OF CO TRUCTION 1&2 family dwellings four or more residential units in
El 1 &2-family dwelling _Commercial/Industrial ❑System over 600 volts nominal one structure
Lj ❑Building over three stories ❑Feeders,400 amps or more
ACCCSSO Buildi—�, t] Multi-Family ❑Occupant load over 99 persons ❑Manufactured structures or RV park
Master Builder Other: ❑Egress/lighting plan ❑Other: -
JOB SITE INFORMATION and L CATIONSubmit.�sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job �-7 LS'�✓
_ site address:1 �v _FEE*SCiIEDULE _
Suite#: Zo7 - _B1d�4/sJCOKL�-g.//A/pt.#�_ -� Number of Ins ections per 1) mit allowed
m
Pro'ect Nac: (�Q .�SMS' Description Qty Fee(ea.) Tulal
New residentlal-single or multl-family per
Cross street/Directions to Job site: dwelling unli.Includes attached garage.
Service Included:
1000 64.It.or less 145.15 4
Each additional 500 sq.11.or portion thereof 33.40 1
Subdivision: Lot#: Limited energy,residential 75.00 2
Limited energynon residential 1 75.00 2
Tax map/parcel M Each manufactured home or modular dwelling
DESCRIPTION OF WORK service andlor feeder 90.90 2
- -�Q_ r{GG A -T acerates or feeders-Installation.
T,rQ alteration or relocation:
200 am s or Icss __ _ 80.30 2
-_ --�-�_._-_---- 201 ams to 40(1 strips _ 106.85 2
401 amps to 600 amps 160.60 2
PROPERTY OWNERTENANmps t
T 601 ao 100)am ps — 240.60 2
---�--- Over I WO amps or volts 454.65 2
Nanle_-- _ Reconnect only 66.95 �_ 2
Address: Temporary services or feeders-Installation,
--- - alteration,or relocation:
City/State/Zi 200 amps or less __ 66.85 1
Phone: Fax: 201 amps to 400 amp,_ 100.30 2
APPLICANT CONTACT PERSON 401 to 600 ams 133.75 _ 2
Branch circuits-new,alteration,or
Name: _ _ extension per panel:
Address: Y A.Fee for branch L:-cuits with purchase of 6.65 12
�- — service or feeder fee each branch circuit
City/State/7 _ R.Fee for branch circuits +tthout purchase of
service or feeder fee,fit at branch circuit 46.85 _ t 2
Phone: FaX: Each addiii na!branch circuit _6.65 2
E-mail: v- --- ---_��- ----_ \±iac.(Service.,b ff,eder not included):
CONTRACTOR Each pump or it igation circle $3.40 2
---'-- -`- Each sign or outl ne lighting 5340 2
Job No: _ Signal circuit(s)o,a limited energy panel,
Business Name: GAdtf alteration,orextensim,* 75.00 2
•Description:
Address: /as ao , &J o .e f «r��
City/State/Zip: - 7 21 S Poch additional Inspectlon over the allowable Ind of the above:
--,---� Per inspection r hour•min, I hu�r 62.50
S R - _
Phone: - tvi�;'t f Fax: U 1-ZVI-S77d Investi alio
CCB Lic. #: ��- Lic.#: Z G- j'/C L1 Other. "- - -
Electrical Permit Fees*
Supervising electrician s--� — "" - Subtotal
signature required: / _ �- planRcvicw 25a/a of Permit Fee) S _
Print Name:^4 t%M42V I Lic. #: ; ,9Z7 SLf _ State Surcharge(8%of Permit Fee) $
_ TOTAL PERMIT FEM S U
Authori-:rd `�� "Notice: This permit application expires If a perndt 1_nolo lamed within
ignature: -- ---_ Dat
�Q 180 days after It has been accepted as complete.
_ •Fac methodology set by Tri-County Building Industry 5eiwlee Board.
---------- (Please print name) v --- ___.
CITY OF TIGAR") 24-rio. -
BUILDING Inspec.lon Line: (503) 639-4175
MST -----------�_,._.__
INSPECTION DIVISION Business Line: (503)639-4171
BUP .
Received .— Dite Requested 1�__ AM— — PM -- _ ______ SUP
—— 01 7 S' >f:l>' z i
Location
Suite =-`�_�. -� _ MEC - --- ----
Contact
-Contact Person _-- Ph(-- __ _- __ PLM
Contractor Ph(_____ -) ____ SWR
BUILDING Tenant/Owner __ ---_ _ ELC
Footing r ELC _
Foundation Access:
Ftg Drain U A W PQ ELR
Crawl Drain
Slab Inspection Notes: ' _,C SIT
Post&Beam -_ - ' -�� 1�-�6�- - t
Shear Anchors l
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation r-�r`1���ON �D Sl S r t`l 6T Q�I/��ll 'AHe-P00 P1 Y� ()'rL
Drywall Nailing
Firewall �� �5- `Y�1��S W � �SUY 1✓� � If�1�' ��r�� ! }V
Fire Sprinkler
Fire Alarm 1�1 S ) ON c'`'V
Susp'd Ceiling _
Roof
Other._ ------- _ -
Final
PASS PART FAiL �
PLUMBINr,I_ ----_ JJ -- ,—
Post&Beam
Under flab -- ---- -- - ---
Rough-In
Water Service - -- -
Sanitary Se ier
Pain Drair s - - - -
Catch Beic,ir,.'Manhole
Storm Grain - --'-- -J`--
Shower Par
Final
_PASS PART FAIL -----
ME_C_HAN_ICAL ---
Post&'Beam
Rough-In --- ----------- --- -_ -
Gas Line
Smoke Dampers --- --- -- --- -- -- -
Final
P4sS PAP r FAIL -- -- '----- ------
ELEC_TRIC%1L
Service
Rough-In --- ----- -- - - --
Low Voltage ----__-._- -- ---- - ----
Fi a-AWrrr
Ina PART FAIL Reinspectien!se of$___-_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
SiT - F] Please call for reinspection RE: _ _-_-- E] Unable to inspect-no access
Fire Supply Line
ADA
rxt
App•narch/Sidewalk / O� Insp r__��^''4%�L h/ .•c ----
Other:_
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL