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8680 SW DURHAM RD xh1. Swtm
OF
T! ELECTRICAL PERMIT-
CITY O F 1 I GAR,D RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2004-00038
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 2/18/04
SITE ADDRESS: 08680 SV'J DURHAM RD
PARCEL: 2S114A0-00100
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of limited energy for security system. Job No. 082
A.RESIDENTIAL _ B.COMMERCIAL
AUDIO & STEREO. AUDIO& STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/iRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NUPSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION- OTHER: SECURITY X
TOTAL# OF SYSTEMS:
Owner: Contractor:
SCHOOL DISTRICT 23J ELECTRIX LLC
13137 .3W PACIFIC HWY 115 V STREET
TIGARD, OR 97223 VANCOUVER, WA 98661
Phone: Phone: 360-694-5094
Reg#: L.360-6954( B5
EI,E 37-9300
SUE' 4398S
FEES Required Inspections
Description Date Amount Low Voltage Inspection
I r:LPRMTj ELIC Permit 2/18/04 $75.00 Elect'I Final
j 1'AXI 81;o State Surchari 2/18/04 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
al!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 w ru dopted by the Oregon Utility Notification C,3nter. Those rules are set forth in OAR 952-001-0010 throuc
Issue er4yL 2% _ Permittee Signature -<4eo—r GQ�
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
Feb 18 04 09: 55a ELECTRIX 360 6950670 p- 1
Electrilat Permit >I ' �� • '
City of Tigard Ot�iy pa elead / Ner,nit NI��Q �g
13125 SW Ball Blvd.,Tigard,OR 972 2 '
C, Plan Review Other Permit
Phone: 503.639.4171 Fax: 503.598.1 D
Inspection Line' 503.639 4175 `/ F �GPP a vale Ready/ey: )unr fd See Page 2 for
Internet: www.ci.tigard.or.us G,T j U \0 Neli6ad/Ivtediod _ Supplemental Infermntiun —
[] New construction /{7Additiuo/alteration/t,�placcmenl Please check all that apply:
[]Service❑ Other: Service over 225 amps,comm'I ❑Hazardous location
Dernolitit.n
_ ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft.,
CAT'FCORY"OF.CONS'!*VCTV.N' of I-and 2-family dwelli::gs 4 or more new residential
[] l-and 2-family dwelling ('Commercial/industrial ❑Accessory building ❑System over volts nominal units in one structure
❑Huilding overr three stories ❑Ftxders,400 amps or more
(] Multi-family ❑Master builder []Other: []Occupant load over 99 persons ❑Manufactured structures u;
—,—
30B Sri 7�'1Nl O1M�ITION.ANI).LOCATION ❑EgroRVark
park
plan
Jab na.: Tob site address:�l Ci �i{/�'UL(- — Submit
facplan ❑Other:
�'l gt �] Suhmu sets of plates with any of the nhovc.
City/StateZIP: 1 ,/ C�►� 17,7 7 ']'he shave are not applicable to temporary constructinn service.
Suite/bldg./apt,no.; t ktl Project name: 141
(e C�
pettripnmt Qq. I Fee `T°,al��
Cross street/directions to Job site: New residential single-or multi-family dwelling unit.
- Includes attached garage,
1,000 sq.ft.ar Icss 145.15
Subdivision: Lot no.. Ea.add'I 500 sq ft.or portion 33,10 I
Limited energy,residential 75.00 2
Tax map/parcel no.: Limited energy,non-residential _ 75.00 2
ttGbCt t71r WORK Each manufactured or mnduiw
—` —� dwelling,service and/or feeder 90.90 _ 2
Services or feeders Installatinn,alteration,and/or relocation_
a 200 amps or less _ 80.30- 2
201 amps to 400 amps _ 106.85 2
❑ PBOPLRTY OWNF,� d TEN4NT 401 amps l0 600 amps (60,6(1 2
Name ►u�d � �L C� } ��j�� 601 amps to 1,000 amps _ .240.60 2
J Over 1,000 amps or volts 454.65 2
Address: i �� ? ("Ll L bt1/� _ --
-I _ Reconnect only 66.85 2
City/State!ZIP: %.�6t ck O �.-- - Temporary services or feeders installation,alteration,and/or
---- relocationPhone:( ) Fax'( ) 200 amps or less b6.85 1
Owner installation:•Phis installation 1s being made on property that I own which is not 201 amps to 400 amps 100.3 0 2
intended for sale.,tease,rent,or exchange,according to ORS 447,449,610,and 70). 401 amps to 600 amps 133.75 2
Owner signature: _ _Date: Brunch circuits-new,alteratton,c_extension,per panel
7 I.ICAIVT ) CONTACT PERSON A.Fee for branch circuits with
service or feeder fee,each
'Business name: '1.4 L (� branch circuit ��GS 2
__— (` '�--i — — -- -- - B Fee for hranch circuits
Contact name: ;�(,hl�;o�/1 each branch
service or feeder fee, 46.85 2
___�_____�L_� !,.. __ ___— `� each hranch circuit T�
Address: rj � Each add'1 branch circuit 6.65 2
City/State/ZIP: VbLvi(l Miscellaneous(service or feeder not included)
Pump or irrigation circle 53.40 2
Phone:( G) l — ax:_(JC�(�) fair S, -7 y�
`JlJ � � f-SU ��`'J' FSign or outline lighting 53.40 2
E-mail I P,F�LMS 1<,U tyi y _tDi 7r• _ Signal circuit(s)or limited-
a7 CONTICACTORenergy panel,alteration,or
extension Describe: Page 2 2
Address: .` Each additional inspection over allowable In tiny of the above
Per inspection 62 SU
city/Stale/ZIP.(" IJP A ev "`L1lGUi Investigation pr*hour(I hr min) 62.50
( 1) Fax: t ) W L}(a C Industrial plant er hour 13.75
Phone:
' CAL PERN13'f M&A
CCB Lic.: pt(i1J Electrical Lic.:?j �f) Suprv.Lie.: "3�1�5 +^ �Subtotal 7 S
Suprv.Electrician signature,required i Plan review(25%of permit fee) _
�� State surcharge(8%of permit fee) _
Print name: Nl4�L L j � Date: ( -it — TOTAL PERMIT MF. X
Authorized signature: This permit appliesilan espira if a ptrwrili It not obtained wltbin 190
days after it has been accepted as complete
Print name: Date: 4 Fee methodology set by Tri-County Building Industry Serme Board
---- •e Number of inspections per permit allowed
I�buildinq`.PemiUtFLC.permlt.�ppdo@ 1210) 440-1a13T(1Q1U2R'0MAVEU
CITY OF TIG'iARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business line: (503) 63)-4171 MST _
_ SUP - --
Received _. 7. 2 !0 4—Date equestgd_7 AM -----_PM_— SUP
Location ___ 6 kt/) Suite. _ MEC --- -
Contact Person Ph O � � �1�� PLM
Contractor --- —. --- Ph( ) - SWR
BUILDING TenanU0wner � �.�1i J,I�A� 1J�t�.f�i1 - ELC
Footing ELC
Foundation, Access: r
Ftg Drain ELR„ %v �p3
Crawl Drlin
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Shf ath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler -- - -- -- -- - ---- --- -----
Fire Alarm
Susp'd Ceiling ----
Roof
Other:
Final
PASS PART FAIL -`~— - -
PLUidBING
Post&Bearn ---------_------- ------------
Under Slab
Rough-In
Water Service --- - -
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain ---- —
Shower pan
Other:_ -
Pinel
_PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers — - ---- _ - ----- ---- --
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In ----
UG/Sla
W Volta a -`
i�§�SART
— � ----- - —
CJ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
FAIL
-,� Please call for reinspection RE Unable to inspect-no access
Fire Supply Line, /-
ADA Date __7 - ! Inspeator
Approach/Sidewalk ---�
Other:
Final DO NOT REMOVE this Inspection record) from the job site.
PASS PART FAIL