Permit TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00219
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/27/2007
y PARCEL: 1 S 126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 455 ZONING: C - G
SUBDIVISION: ONE EMBASSY CENTER LOT: JURISDICTION: TIG
PROJECT: WEYERHAEUSER
Project Description: Low voltage vocie and data cabling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PORTLAND OFFICE ASSOCIATES NETVERSANT CASCADES INC
BY TC PORTLAND, INC 9740 SW NIMBUS
8930 SW GEMINI DR BEAVERTON, OR 97008
BEAVERTON, OR 97008
Phone: Contact #: PRI 503- 646 -0533
FAX 503- 641 -6613
FEES Reg #: ELE 34- 589CLE
LIC 150328
Description Date Amount SUP 710LEA
[ELPRMT] ELR Permit 6/27/2007 $75.00
[TAX] 8% State Surcha 6/27/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issu = =y: Permittee Signature: �� �� / � ('a1i 0—r)
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
N- 26- 2007(TUE) 22:28 NETVERSANT CASCADES INC P. 002 /003
ectrical Permit Applicatio _ a �' � � rFOR OFFICE US ONLY " y ;
, � �- CI:'iy'of Tigard l! �6�� Rec+:+t�
eh,tart� - CO /z (51: S Penult Na... EL : ZOO �
° 1 3125 SW 1laII Blvd., Tigard, Olt 97227 U N 2 7 ZOO/ • nRi,Iew
-4� i. , Phone: 503.639.4171 Fax: 403,5%1.1960 OaIr4y: other Permit:
– * 14 '..' Inspeetfon Llnc: 503,639.$ 175 ° � paw It444yruy Fa Ste Pear 2 for kTIGAILD; C IT`� CF 'r f .BAR® mini x .. r l litternet: www.ligttrd•ur•atu� BI IIE rump (p @i�Fa;1r .. Natifled Supplrmrnial Informal inn
TYPE; OF 'WORK .' . PLAN ; REVIEW
[j New const RI Add(tion /IIIlenu ion /replttecment Mauve cllrck all that apply tutaalta j gala �d w /Ilaltm c lun4, d hcluw) :
0 Demolition E] Other" .from Cl where the ovallahle 0 salvo
1 current ❑ M nitp arinas and boowe flaws stones-
0 Marinas /anis,
' CATEGORY OF'CONSTRi1CI1 c coeds Iona omit al 13U volts or 0 Flatting bulldiuy.
lava to ground, or exceeds 14.000 ❑ Cnumtateial-ttsa sartcullurul
0 1- and 2 -family dwelling LContmercial /industrial ❑ Accessory huI Idin; amps fbr all other Installations. buildings,
❑ Multi- family Master builder 0 Other: 1:IFire 0lnstalallonof75KVAor
Q t:nturgaltcy ayalem, Imo sepanttaly darivad system,
dOB SPl IN FOItINJI'!'10N'AN D t ION.;i;, ; f, ❑AdditInn new motor load af CI "A ".•E". "L: "1.1`.
• I OaHP or awn occupancy, no.: Qla doh exile address: Q �C f�
I:1 Sh. or mum ruatdatlual wtils. CI Recreational vehicle parks,
Cfty /Stalt/Z1I' : 400Qr I CI la suplclyvulla11efarnwta thwt
al / a. r. �� r i !a $1uranlnso loccmlons ma vn imamai,
uite Idg. /apt. no.: q • proict:Cnantc: � e` t 1z _k me p t � 0ServiceorfeederWOamp ► ormole.
s: Fl red /directions lo ola site: , C�Jr_t_ 1 G av -- i.: IEEE — SCHEDULE
Cross tT..r111NM1M oil.' R •e. Tpt
New residential single. or multl•ram)ly dwclllnc unit.
hlclndes attached enrage.
Subdivision: Lot no.; 1.000 ay. R. or Icon 145,15 4
`Cox map/parcel nu,: En. :WWI 500 ail. I t, ur portion 33.40 1
Limited clergy, rcttldentlal 75.00 ?
, ' . , 'DE.SC1uMTON +,oFi'. SVORK'' , I ". , d1;!, ' ' 1:. : , :` I Jwlthabo.ca
�
r I � I I Limited ntia multi•farnity I. � J -1 A — residential energy. m above ay. n.1 7S,On 2
Services ur feederxlurtaltutlun alterntlon. and/or relocation
200 amps ur Irvt 0030 2
' Hp. 'PROPERTY 'OWNER ,': `.'" ".',I. ZI •• „ a
'j' 201 ampto40Qa1npg ~ 106.85 2
Mimic: 401 amps lu 600 amps 160,60 2
601 amps to (.000 amps 240.60 2
Address: over 1.000 amps or volts 454.65 2
City/State/ZIP: Temporary servtectcor feeders installation, alteration, and/or
r relocation
!'hone; ( ) _j_
( ) 200 amps or loss 66.85 1
Owner Installation: This installation is being made on properly that I own which is not 201 utttpI 10 400 amps 100.30 2
intcndcd for stilt. Icasc, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 umpu 133.75 2
Branch circuits— new alteration, or rattca:atm. per aunet
Owner signature: - Date: A. lrce for branch circuits with
;I ArE!i.lrnN r ;i, ,■,'; dl G+ lVJFAC Y1;.1LC1N.'..i A i...,1 above service or feeder fee. 2
each branch circuit
Business name: B. Fee for branch circuits --
--
' � first Contact name: 's' thOlit service ur feeder fee.
lid lirirst branch circuit 40.$$ 2
_ --,
Address: 1 �"` - [ I:aeh WWI branch circuit 6.65 w
� O Mlscc1tuttcuurjseevlcc or feeder not included)
City/Suite/71P: 2uch manufactured or modular
00.90 2
dwclllnp. service and/or feeder
Phone: ( ) Fax:: ( - ) Reconnect only 66,85
E -mail: Pump or Irrigation circle 53.40 - 2
CONTRACTiOR ; ; 1 , 1 Sign or outline 'fabliau 53,40 2
1 Rignal circutt(s) or !Intl -
Buses name: U_ n •. �, 1 f� A ,(�,>� r _ I - n e , energy panel. alteration, or
Address: 1 S{/
Y 0 v A/ I Yl1 b LI S P I1 Cli e, _ extenaton. eacrlbe: ' Page 2 �s 2
City /State/ZIP: 3e ve i r
t'r Gl 0 R / oQ Each additional Inspection over u llowsbly In unxurltce ubovc
Per (nupectian 62.50
phone: (51$ log ip rp,S 33 Fax: ( sue ) CF yr • (p (i) 13 investigation per hour (t hr min) 62.58 — _
CCI3 Lir.: (so $ Electrical Lic.:3y CLE Suprv. Lic.: 7�aL industrial phut! per hour 73.75
• Suprv. Electrician signa Subtotal: X15. 0
ture. required: t:t r:Crlu,t~wt, rgw►irn FEF :
! . „
Pm, name: L�/�P � � Dalc: Plum review (25% of permit fee): 0
1
' � _eulC 1 ' �Z S . MAW Outdo: mile (@t% of emit fee): — Th . 0 0
Authorized signature: TOTAL PERMIT FEE: Si, 0
This permit applIcatlnn espIrrs it a permit Is not altalncl *Milli 11111
Print name: I Date: days prier 11 has stria ant Iusd as camphor,
Number of iospeedous allowed per omit.
I :tnuthtmatertmos\hi_oer m isapdnc ux2i,ur, 4411 13111 utrurDMrwltu