Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
r DEVELOPMENT SERVICES PERMIT #: ELR2005 -00292
�11" DATE ISSUED: 9/19/2005
'_'-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S113AD - 01900
SITE ADDRESS: 16600 SW 72ND AVE B10 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 009 JURISDICTION: TIG
Project Description: Central Vacuum.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: VACUUM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES GARY'S VACUFLO INC
15350 SW SEQUOIA PKWY #300 -WMI 9015 SE FLAVEL
PORTLAND, OR 97224 PORTLAND, OR 97266
Phone: Phone: 503- 775 -2042
•
Reg #: LIC 69047
ELE 26- 728CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/19/2005 $75.00
[TAX] 8% State Surcha 9/19/2005 $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 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.
Issued By: �� �[i Permittee Signature: -L QJ .,P
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.
Sep 16 05 04:30p Alicia Molina 5037725446 p.l
1 .
Electrical Permit 0?ttitin.
r vED , -'l OR' 9FFIc E`.SEONl ti City of Tigard �� VV`` Received Epp _ _ _
Date/13 : ! A Permit No.: -' / /
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598. c *i 0thcr Permit:
Inspection Line: 503.639.4175 fp 1 2005 r * L j ,; ai , D B y.
,, ,, Date RcadylBy; lots: la See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified /Method: "S) ( Supplemental Information
BUILDING*IVISION PLAN REVIEW
f ,New construction ❑ Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps- rating ❑Buildng 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 -and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling 0 Commercial /industrial ❑ Accessory building El System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders. 400 amps or more
El Multi family ❑Master builder ❑Other:
JOB SITE INFORAL \TION AND LOCATION ['Occupant load over 99 persons ❑ Manufactured structures or
❑ Egress/lighting plan park
/ b
Job no.: 1 Job site address' l,I / �� i� s� C d r n ❑ Healthcare facility ❑Other:
` t 1 "r `� It Submit 2 sets of plans with any of the above.
City/State/ZIP: poi d e R q -7 r?C r7 4 �` r7 The above are not applicable to temporary construction service.
�
Suite/bldg./apt. no.: 7 Project name: . _ FEE* SCHEDULE
'p ( `- f �• •� Description I Qty. J Fcc. i Total I •'
Cross street/directions to job site: a l -Icg nc�1 v c - New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no_:
Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
CO .ir1+ naS tin Ci,t _!4 1111 1 1)1A) -0I fags Services or feeders installation, alteration, and/or relocation
200 amps or Tess 80.30 2
Ar
PROPERTY OWNER ❑ TENANT 20 I amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: �..r. i' 4 �� `1 'C/` t l C ( ' t r i S (7 //�� 1,..,-1- �.,1 Y - , t CC, 601 •amps to 1,000 amps 240.60 2
Address' /� � Over 1,000 amps or volts 454.65 2
l z.. 01) _S i : ` , 1 1l 6 (� i Re onnect only 66.85 2
City /State/Z1P: pD (A- -1 -C\ t2 i J3) 'r ---) :t� q Temporary services or feeders installation, alteration, and/or
Phone: ( -J J
) - id -7c 2 1 Fax: (� 4U ? - 3 � 6-7) 200 amps or less 66.85 1
�
Owner installation: This installation is being made on property that 1 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 600 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
A. Fee for branch circuits with 1
APPLI('aNT ❑ CONTACT PERSON service or feeder fee, each
1 6.65 2
Business name: C - ) C� t -' I S l /( A J _c ! C branch circuit
}�, B. Fee for branch circuits
Contact name: � 1 C a. I '� U , i i'k,' without service or feeder fee, 46.85 2
t '. each branch circuit
Address:
/ t - E r) • - 17 � ()'P . L. Each add'I branch circuit 6.65 _ 2
City /StateIZlP: 0 4 f. o I` q -- 7c Lab Miscellaneous (service or feeder not included)
_ Pump or irrigation circle 53.40 2
L7p
Phone: _ ) / 7 ..- q 3V Fax: :( .5L)) 7T _,s g41 _, Sign or outline lighting 53.40 2
E - mail: i 3 rn C L i - N . 1. � p✓I.t S j f % Z . � ' 1 . l - P) t-. : (' C�ry - � + c Signal circuit(s) or limited
(X TRACT R energy panel, alteration, or
extension. Describe: Page 2 2
e-�!i /U, ` v - / p &-1'
Business name' , 1
P/ Each additional inspection over allowable in any of the above
Address: CIO c -
(. -� , 1 ) .4Ge_ L Per inspection 62.50
City /State/ZIP: ? G., 4-64 -)(` Cn,R 49 -) La (, Investigation per hour (1 hr min) 62.50
Phone: ( 3 ) ) - 7,.".."2 . `i `T • )(`) Fax: (S0 3) '77 702 - ." Industrial plant per hour 73.75
ELEC.TRIC:4L PERMIT FEES*
CCB Lic.ipe9 Electrical Lie.: 2 • ;� - Z` Suprv. Lic.: z j4, Subtotal /�1 S Cr) Suprv. Electrician signature. required: Plan review (25% of permit fix) !
` State surcharge (8% of permit fee s
Print name: pe ii ce „� D ato: i ! �, �i1 1
j. ' ` TOTAL PERMIT FEE `
signature: '
� /�
Authorized si � �� ,.�/f��� . Th is permit application expires if a permit is not obtained within 180
J [[[[ l e � days after it has been accepted as complete
Print name: 41 ,. L , (i1 /?�� i i (.,,l ` � Date: �116-1" .) • Fee methodology set by fri Cocmty Building Industry Service Board
r - • • Number of inspections ocr rennit allowed.
CJIY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005-00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 .'
Inspection Requests (24 Hrs.): (503) 639 -4175 '•'I (.:
INSPECTION WORKSHEET FOR DATE: 9/30/2005 TIME: 7:45AM PAGE: 100
SITE ADDRESS: 16600 SW 72ND AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 409 TYPE OF USE:
PROJECT NAME: FLIGHT DYNAMICS
DESCRIPTION: Central Vacuum.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: GARY'S VACUFLO INC PHONE #: 503- 775.2042
Inspection Request Scheduled For: Date: 9/34/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 . Low voltage 017070 -01 503- 772 -5430 N
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (3 Ms Co Lt a • Date: 1 °1 Phone #: (503) 718 -1A