Permit il ` �;: �COTY TIGARD
l c�ryr. ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00016
DATE ISSUED: 1/23/2008
�TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 340 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: MERIDIAN TECH GROUP
Project Description: Voice and data.
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:
PACIFIC REALTY ASSOCIATES STEELHEAD TECHNOLOGIES INC
15350 SW SEQUOIA PKWY #300 -WMI 11600 SE HAWTHORNE ST
PORTLAND, OR 97224 PORTLAND, OR 97216
Phone: Contact #: PRI 503- 255 -0364
FAX 503- 255 -3947
FEES Reg #: ELE 26- 1205CLE
LIC 168965
Description Date Amount
[ELPRMT] ELR Permit 1/23/2008 $75.00
[TAX] 12% State Surch 1/23/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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. Y may ob n copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ViiALIAAL., idi i iejt, Permittee Signature: ,,f� 0
4 '
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.
Electrical Permit Applicati E GEIVE� FOR oFFlCl USE ONLY
City of Tigard Received 491 ♦ Permit No
�' g IAN 2 2008 Date /B : l '2i" .��� _ /��
° 1 3125 S W Hall Blvd., Tigard, OR 9722 Plan Revie
' C • Phone: 503.639.4171 Fax: 503.598. 1 ®F tIG Date /B : Other Permit:
Inspection Line: 503.639.4175 Date Ready /By: See Page 2 for
F I G A R D Internet: www.tigard- or.gov BUILDINO�lI /iSIOi� Notified/Method: �� ®
Supplemental Information
TYPE OF WORK PLAN REVIEW
-a ew construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling O'COmmercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system,
❑ Addition of new motor load of ❑ "A", "E ", "l -2 ". "I -3 ",
2q q� p or more. occupancy.
Job no.: Job site address:
/ / / Sly (OD�h 0. t7 ►/C 1A' �� 0 or more residential units. ❑ Recreational vehicle parks.
-
Ci /State/ZIP: ` A ❑ Health -care facilities. ❑ Supply voltage for more than
ty / G tr ! / r T/1 /� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.`3 0 Project name: p) f , to a n t GP cJ ❑Servi or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'i 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
V 6 / . r .1)+T-or residential (with above sq. ft.) I
Services or feeders installation,_ alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ( ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
0 APPLICANT ' ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: .�.,o E e ye � (k (a ( �f � 1 l
5 t, G B. Fee for branch circuits
/ 1 "" without service or feeder fee, 46.85 2
Contact name:
l e1^ (? c C Q t a: ) f4.t_, first branch circuit
Each add'i branch circuit 6.65 2
D
Address: 1 ((_ i , S t co 41,0 '�/'jl r j F r
Miscellaneous (service or feeder not included)
City/State /ZIP: 1 f ' le �� 2-1 b Each manufactured or modular 90.90 2
t' n dwelling, service and/or feeder
Phone: (� �) .-7 Fax:: � ) a te_ (f Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: 5/ if Signal at(s) or limited-
panel, energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50 '
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic./(7 9f Electrical Lic.la L Sup 3,,,,,,_,., Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
�i��
Suprv. Electrician signature, required: /C 4 , Subtotal: -y S
l \ / Plan review (25% of permit fee): t9
Print name: j ✓J< 5 � ✓ / Z" Date:
7� State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit. 1. "
l: \Building \Permits \ELC- PermitApp.doc 05/23/06 440 -4615T(t I /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008.00010
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/23/2(.10:1
Phone: (503) 639 -4171 '�� ic:,i' th
Inspection Requests (24 Hrs.): (503) 639 -4175 �'!L ' P,� I
INSPECTION WORKSHEET FOR DATE: 2/1/2000 TIME: 7:02AM PAGE:
SITE ADDRESS: 129013 SW E =I TH PKWY 340 CLASS OF WORK:
SUBDIVISION: TIGARD 1 TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN TECH GROUP
DESCRIPTION: Voice and data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: STEELHEAD TECHNOLOGIES INC PHONE #: 503
Inspection Request Scheduled For: Date: 2J1 /2008 Pour Time:
Code # Inspection Description Confirm #., Contact # Message
I g
Elan ical final (0E4352-01\ 503 -761 -2510 N
Corrections /Comments /Instructions:
G-GZ,o orJ-CD ►. P►ts 6 11kCi t \Ki • 80o .10 0 -
PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
gJ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N D4 L.6 Date: 2 -"1 01) Phone #: (503) 718- 2-4/412
CITY OF TIGARD _k
BUILDING DIVISION PERMIT #: ELR2O0 {-OOO16
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 103/2009
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '. "'I _ I I
INSPECTION WORKSHEET FOR DATE: 1/2812008 TIME: 7 :00AM PAGE: 14
SITE ADDRESS: 12909 SW 68TH WM' 31() CLASS OF WORK:
SUBDIVISION: T TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN TECH GROUP
DESCRIPTION: Voice and data.
OWNER: f :1C REALTY A 3SOClATE S, PHONE #:
CONTRACTOR: STEELHEAD TECHNOLOGIES INC PHONE #: 503-255-03m
Inspection Request Scheduled For: Date: ,'1 /20013 Pour Time:
/ �-
Code # Inspection Description Confirm* ` Contact # Message
135 1.cw voltage t) , 01&01 603 - 956 -5386 N
Corrections/Comments/Instructions:
® C ►k.. i ca cz ► 5 pNOi R ADAL Cif AFL
�l
uN c A6t>z ,( c�it --rN
1
X PASS fl PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL fl CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G V (W)1.-6 Date: ' Z L . V V Phone #: (503) 718