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Permit
• t/ .. a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00355 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/30/2008 PARCEL: 2S112DA -01400 SITE ADDRESS: 15350 SW SEQUOIA PKWY 190 ZONING: I -P SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG PROJECT: DIANA HARRISON CPA Project Description: TI. 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: Owner: Contractor: PACIFIC REALTY ASSOCIATES HASTINGS COMMUNICATIONS INC 15350 SW SEQUOIA PKWY #300 -WMI 10015 SW STEEPLECHASE CIRCLE PORTLAND, OR 97224 BEAVERTON, OR 97008 Phone: Contact #: FAX 503 -524 -5678 PRI 503- 789 -5852 Reg #: ELE 34- 602CLE FEES LIC 131979 Description Date Amount [ELPRMT] ELR Permit 12/30/200€ $75.00 [TAX] 12% State Surch 12/30/200€ $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. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: d a n Q , Q A Permittee Signature: as< 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. L. Electrical Permit Application RECE FOR OFFICE USE ONLY City of Tigard ' eceved Permit No.: i 12 ^ _ ' „ .2∎3- C W V EI ez 008.6G 3% `J f Ti g Date Q `Jl� 4 ° 13125 SW Hall Blvd., Tigard, OR 97223 p Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 E C 3 2 008 Date/By: Other Permit: lAp.7clop . G 038 TI G RD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for A Internet: www.tigard- or.gov CITY OFTIGARD Notified/Method: t 1 q I Supplemental Information TYPE OF WoiltUi DING DIVISION PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction E addition/alteration/replacement ❑ 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 . G mmercial /industrial El 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 ", "1 -2 ", "1 -3 ", (+ 100HP or more. occupancy. Job no.: Job site address: l 5 3S0 $(/1� S o- io la. r rill 19 ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: /0,1 A I ❑ Health-care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: l v4 le.174.1ele /St „v ❑ Service 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 I Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 1.-4 Z'7' V vo7q,GO (�l'! C,e_ i DA 74 residential (with above sq. ft.) 75.00 2 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: PA,u /L'/ C /2404$2.. 4-5 S 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 Owner signature: • Date: Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: • without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) ' City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax::( ) 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: /�� /Al S (51/NIM . C energy panel, alteration, or Address: / o-o / < s I,,/ S42 C. extension. Describe: Page 2 2 City/State /ZIP: g.4.. ✓� (A y 7 co g Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (5'V3 ) 789 S-SSZ_ Fax: (03 ) 5'21 S - 7 , 7 8 Investigation per hour (1 hr min) 62.50 CCB Lic.: l'319 ? 9 Electrical Lic.:a4 31 402. Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: �.'~da Subtotal: 7 .06 Plan review (25% of permit fee): Print name: PAr •1"/A/4 y Date: /Z _ 30 -. © g ) State surcharge (12% of permit fee): c t . OO Authorized signature: / �`. f.-- TOTAL PERMIT FEE: I..) .00 d 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. t:\ Building \Petmits\ELC- PennitApp.doc 05/23/06 44046t5T(II/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 \- Supplemental Information = iC . LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* • ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ . Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems • ❑ Landscape Irrigation Control* ❑ Medical • • ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required - for all other installations • I:\ Building \Pennits\ELC- PennitApp.doc 03/23/06 • CITY OF TIGARD BUILDING DIVISION 41 PERMIT #: hL.I? 2001 0O366 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/30/2000 Phone: (503) 639- 4171 a''��,,r 6iii Inspection Requests (24 Hrs.): (503) 639 -4175 . W INSPECTION WORKSHEET FOR DATE: 1t1412009 TIME: 7:01AM PAGE: 12 SITE ADDRESS: 15350 SW SEQUOIA PKWY 190 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE: PROJECT NAME: DIANA HARRISON CPA DESCRIPTION: TI OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: HASTINGS COMMUNICATIONS INC PHONE #: 603 -769 -5852 Inspection Request Scheduled For: Date: 1114/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 07969 ?; -01 503- 789 -5852 N Corrections /Comments /Instructions: 1N \\) ) \ I \ R ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G- 1 V iG Date: I -i Phone #: (503) 718- Ie '- `v