Permit •
q ' CITY OF TI GA ® ELECTRICAL RESTRICTED ENERGY PERMIT
0 . COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00002
TtGA.RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/2/2008
PARCEL: 2S 113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: OREGON STATE BAR
Project Description: Low voltage for access control.
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: ACCESS X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OPUS NORTHWEST LLC CONVERGINT TECHNOLOGIES
1500 SW FIRST AVE STE 1100 2040 SE POWELL BLVD
PORTLAND, OR 97201 PORTLAND, OR 97202
Phone: Contact #: PRI 503- 228 -8522
FAX 503- 228 -8521
Reg #: ELE 26 -1 173CLE
FEES LIC 148358
Description Date Amount
[ELPRMT] ELR Permit 1/2/2008 $75.00
[TAX] 8% State Surcha 1/2/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility No ' ' a io ; ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules o direct question- to O 4 N at 503.246.6699 or 1.800.332.2344.
..."
Issued ' • I ,�� _ � ,, l/ Permittee Signature: . `�
�{ ■
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
•
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i ii y:
F$ctrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
71 I. DateB .: / / Permit No.: Fa iii /$�
13125 SW W Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503 DateB : Other Permit:
T 1 G A R D Inspection Line: 503.639 Date Ready /By: RI See Page 2 for
Internet: www.tigard or.gov Notified/Method: — Supplemental Information
TYPE OF WORK PLAN REVIEW
ix New 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.
El 1 - and 2 - family dwelling Commercial /industrial ❑ Accessory building less to grail other er in seeds ons. ❑ Commercial -use agricultural
rY g 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 1 16 031 ;w O ('� 10OHP or more. occupancy.
. p 1�o0�Stk , w • ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: / , ., . O e 213 a El Health-care facilities. ❑ Supply voltage for more than
/� 0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1,U Project name: i , , a i' ^ , ',4, , . ❑ Service or feeder 600 amps or more.
FEE SCHEDULE . '
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1
( .' n l I New residential single- or multi - family dwelling unit.
?i o } ` `�E - ' • c -�' 1 z d /) oc b,,,Ity,M. 98 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
DESCRIPTION OF WORK • (with above sq. ft.) 75.00 2
Limited energy, multi- family 75.00 2
Lou— Uo title, (g ,Np.11 LA,2 70 mg- 1 /A 1/l�,o+V S residential (with above sq. ft)
�J a I Services or feeders installation and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER 1g1 TENANT 201 amps to 400 amps 106.85 2
Name: C� j'`7 oL �J l1p 401 amps to 600 amps 160.60 2
` ( 1 C
601 amps to 1,000 amps 240.60 2
Address: 1 P� 6r) <3 6 1....) ` „,� �, tl r c x ,� t � (7.11,11-1_ Over 1,000 amps or volts 454.65 2
J `Jj Temporary services or feeders installation, alteration, and /or
City/State /ZIP:
trl, eye r �722 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
T APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: (7mvea TPels to t B. Fee for branch circuits
Contact name: ®/J without service or feeder fee, 46.85 2
Z16YitM 7 ( tQ.l4 first branch circuit
Address: _801/0 , P�x�e!l i(Ll Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: ?an��ta Cr Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (ge3) zig - O G s 2z_ Fax: : (SO 0740'27.57,/ Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
Business name:
-niu ve m.41/7.( c#46444-9, To ot to �� energy panel, alteration, or � W i
'f v C°
Address: O O ��l/ '73 f/�� extension. Describe: Page 2 I � O 2
City/State/ZIP: ?� /a pv.eil fiff., 97 Z , Each additional inspection over allowable in any of the above
�+ Fax: ) Per inspection 62.50
Phone:
(�3) - . ,4%' a'S s (� J') zier- FS' ii / Investigation per hour (1 hr min) 62.50
CC ic.: Electrical Lic.: Industrial p lant per hour 73.75
4 R 3 5 g ectr z �- l/ �3CGE Suprv. p L ic.: 3�L � ELECTRICAL PERMIT FEES
a
SUp . Elect signature, "7(1 $ gnature, required: Subtotal: ,5�
Print name: A / vp / L Date: ! / Plan review (25% of permit fee): -O----
Cy / State surcharge ((mss or permit fee): 9 .6 0
Authorized signature: LC�'r/ ( TOTAL PERMIT F $ G� OCJ
2 v This permit application expires if a permit is not obtai within 180
Print name: /7v ,,,� p ,,� Date: }f / a( days after it has been accepted as complete.
' / u • Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: F_LR2008 00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/2/2008
Phone: (503) 639 -4171 I. 1 ,' ���i�t
Inspection Requests (24 Hrs.): (503) 639 -4175 ��
INSPECTION WORKSHEET FOR DATE: 1/11 /7008 TIME: 7 :01AM PAGE: 62
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 I 1 0 Q CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: OREGON STATE BAR
DESCRIPTION: Low voitago for access control.
OWNER: OPUS NORTHWEST E.. LLC, PHONE #: '
CONTRACTOR: CONVER4INT TE=:CHNOLOGIES PHONE #: 503 - 220 t3Ee22
Inspection Request Scheduled For: Date: 1/11/2008 Pour Time:
Code # Inspection Description C Contact # Message
136 E..ora voltage '/ - 053040 -01 N 503 - 793 -3414 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6g LE Date: 1 -it 'C D Phone #: (503) 718- 2-14IA
CITY ������U��������
��nm m ��m� mun�N�mu���
BUILDING DIVISION PERMIT #: ELR2008-00002
13125SVVHaU8|vd.. Tigard, DR07223 DATE ISSUED: 1/272008
Phone: (503) 639-4171
�` �--
Inspection Roquo�o(24Hmj:(6O3)83Q-4175 -«8�- *�� (_~
INSPECTION WORKSHEET FOR DATE: 7/3/2000 ' TIME: 7:OOAh8 PAGE: 21
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: C)REGON STATE BAR
DESCRIPTION: Low voltage for access control.
OWNER: OPUS NORTHWEST LLC. PHONE #:
CONTRACTOR: CONVERGINT TECHNOLOGIES PHONE #: 503
lnspection Request Scheduled For: Date: 7Y3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072181'01 503'220'8522 Y
Corrections/Comments/Instructions:
•
zr, ~^8S 0 PARTIAL APPROVAL 0 CANCEL [ 1 NO ACCESS
n FAIL ri CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Date: - -� 3 0
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELR20013 -00002
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: //212000
Phone: (503) 639 -4171 f � l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/10/2008 TIME: 7:02AM PAGE: 32
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 CLASS OF WORK:
SUBDIVISION: FAN■O CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: OPEGON STATE BAP
DESCRIPTION: Low voltage for ac :cess control.
OWNER: OPUS NORTHWEST LLC, PHONE #:
CONTRACTOR: CONVERGINT TECHNOLOGIES PHONE #: 603 -22B- 13522
Inspection Request Scheduled For: Date: 4/1012008 Pour Time:
Code # Inspection Description ,C—onfir \ Contact # Message
1591 Electrical final 0 +8141 -01 971- 212 -7363 N
Corrections /Comments/ Instructions:
�) P ,v∎ Ibc ocA. ‘UP". -irn i o Przer
c.Aa R. V N '11 u , Y N rns
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
►j FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V �� Date: 1 41 1 V)' Phone #: (503) 718- Vi 6b