Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
i DEVELOPMENT SERVICES PERMIT #: ELR2006 - 10005
., � — 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/3/2006
PARCEL: 1S136DD
SITE ADDRESS: 11560 SW 67TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 004 JURISDICTION: TIG
Project Description: Low voltage for fire alarm, 1 system for entire building.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
JOSEPH GREEN POINT MONITOR CORPORATION
PO BOX 1 4755 SW OLESON ROAD #102
DONALD, OR 97020 PORTLAND, OR 97225
Phone: Contact #: PRI 503- 292 -5533
FAX 503- 292 -5512
FEES Reg #: ELE 34- 508CLE
LIC 135901
Description Date Amount
[ELPRMT] ELR Permit 3/31/2006 $75.00
[TAX] 8% State Surcha 3/31/2006 $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.
Issued By: ✓ Permittee Signature: Q, s) f l
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.
CITY OF TIGAR®
BUILDING SERVICES DIVISION RESTRICTED ENERGY
ELECTRICAL PERMIT
13125 SW Hall Blvd., Tigard, OR 97223
503- 639 -4171 www.ci.tigard.or.us PERMIT #: 10005
A�,i DATE ISSUED: _0(,„ _0(,„ _
SITE ADDRESS: _. L 5 67714 -!g - - -- PARCEL #: — --
BLDG/STE #: ZONING:
SUBDIVISION: LOT: JURISDICTION: TIC
This is an interim permit issued during computer system maintenance.
Construction work and inspections may proceed under this permit number.
The actual permit will be issued and mailed to the applicant within one week of the date issued above.
___ PROJECT DESCRIPTION _L vC?l Tf lid M A'e. I'I'1
r, A. RESIDENTIAL r 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 LAND LIGHT: —
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: _
OWNER FEES 1
Name: CA Permit Fee $
Address: Plan Review Fee $ _
City /State /Zip: State Surcharge (8 %) $ �—
Phone: Other Fee: $
Other Fee: $
CONTRACTOR Total Fees: $ g coo
Name: __ VO_LJ- _ fl \_D_N I TO l-._ (4)
Address: 65" SIrJ o 0 2 -
City /State /Zip: (neXI- Jg Q�Q • 9' '7 .'
Phone: - 503 ' a .5b 3 3 .._.. Fax: - — a=
CCB Lic #: (35q0
Elect. Lic. #: S 4 -GOC E-
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 -0080. You may obtain copies
of these rules or dir que 'ons to OUNC y calling 503 - 246 -1987 or 1- 800 - 332 -2344.
Issued By: �-2r-� Permittee Signature:\ �'' a�
r - _ _.. .. .___ __._ ______. OWNER INSTALLATION ONLY _ I
The installation is being made on property 1 own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
( - -" CONTRACTOR INSTALLATION ONLY i
SIGNATURE OF SUPR. ELECTRICIAN: DATE:
LICENSE NO.:
Call 503-639-4175 by 7:00 AM for an inspection that business day.
Note: If you cannot schedule an inspection while the system is down, please call 503 -718 -2433 for assistance.
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.
1:\ Building\ Forms\ ManualPermi tForms\ManualELRpermit.doc 12/05/05
ITV OF TIGARD RESTRICTED ENERGY
ELECTRICAL PERMIT
BUILDING SERVICES DIVISION
13125 SW Hall Blvd., Tigard, OR 97223
503- 639 -4171 www.ci.tigard.or.us PERMIT #: gi - 10005
DATE ISSUED: -0(.
SITE ADDRESS: 11 s(J..--- ........_.. 1f _- ..__.._.._. PARCEL #:
BLDG /STE #:
ZONING:
SUBDIVISION:
LOT: JURISDICTION: 71 C.
This is an interim permit issued during computer system maintenance.
Construction work and inspections may proceed under this permit number.
The actual permit will be issued and mailed to the applicant within one week of the date issued above.
PROJECT DESCRIPTION: Lo 1(c9 LT _._._FIRE A,(Lm _.._..__...__..._.._._._...._---...___._..._..._..__---
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 LAND LIGHT:
OTHER: _....__ .__.. ...._.__ --
: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
OWNER FEES
Name: - Permit Fee
Address: Plan Review Fee _
City/State/Zip: _._...._.__._. State Surcharge (8 %) $ io
Phone: Other Fee:
Other Fee:
CONTRACTOR Total Fees: $ r pp
Name: 1- L' T _i_LO.__�- _ '
Address: 55.. S cv _.. _,t:_,g5G _ _JCb... _ .._._ /0 -
City /State /Zip:._._ -D1 T'LI1rNp 7°1a'
Phone: _.__.5.l?3.aa. 5633 ......
Fax: _ ' L 4 S 5
CCB Lic #: _.
Elect. Lic. #: S 4 •- 60C,4.5.- _
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 -0080. You may obtain copies
of these rules or dire que ions to OUNC y calling 503 - 246 -1987 or 1- 800 -332 -2344.
Issued By: f-t1.Cd..-- Permittee Signature: 4 1 ''
OWNER INSTALLATION ONLY
The installation is being made on property 1 own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELECTRICIAN: DATE:
LICENSE NO.:
Call 503- 639 -4175 by 7:00 AM for an inspection that business day.
Note: If you cannot schedule an inspection while the system is down, please call 503 - 718 -2433 for assistance.
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:\ Building\ Forms\. ManualPermitForms \ManualELRpermit.doc 12/05/05
4
- , Electrical Permit Applica ' V / FOR OFFICE USE ONLY
Tigard Rece
City of Ti ived ' 3 , Permit No.:15�? • 1!700
Y g Date
13125 SW Hall Blvd.. Tigard. OR 97223 ' l'f rr • I Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ,'.!1):1 r .
1. -� bs r . Plan Other Permit: • J �i f Date/ft
Inspection Line: 503.639.4175 r 1 Date Ready/By: Juris: E1 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF ' Notified /Method: Supplemental Information
TYPE CP VO
INC DlV t N
PLAN REVIEW
® 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 over 10.000 sq. ft..
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ® Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family 0 Master builder 0 Other:
❑Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: Job site address: .50 DHealth-care facility ['Other: _ �� Submit 2 sets of plans with any of the above.
City /State /ZIP: PORTLAND, OR 97332 The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: JOE GREEN BLDG - TI SPACES FEES SCHEDULE
Description I Qtc. Fee. Total **
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1.000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy. residential 75.00 2
Tax map /parcel no.: Limited energy. non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
INSTALLATION OF FIRE ALARM SYSTEM FOR THE TENANT SPACES dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
TYING INTO THE EXISTING SYSTEM 200 amps or less 80.30 2
❑ PROPERTY 0 . ER ❑ TENANT 201 amps to 400 amps 106 2
t 401 amps to 600 amps 1 60.60 2
Name: ! 601 amps to 1.000 amps 240.60 2
Address: it
D '*�� I G Over 1.000 amps or volts 454.65 2
City/State/ZIP: l v Reconnect only 66.85 2
/State /ZIP: - �6vyt,� �l/
Y 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 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
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee. each 6.65 2
Business name: SAME AS BELOW branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee.
46.85
first branch circuit
Address:
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel. alteration. or
extension. Describe: 1 Page 2 2
Business name: POINT MONITOR CORP
Address: 4755 SW OLESON RD #102 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: PORTLAND, OR 97225 Investigation per hour (1 hr min) 62.50
Phone: (503) 292 -5533 Fax: (503) 292 -5512 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 13590 Electrical Lic.: 34 -50CLE Suprv. Lic.: 34 -50CLE Subtotal ri5nD
Suprv. Electrician signature. required: " ` /' `' ,- Plan review (25% of permit fee)
Print name: N/ir.iC � '�
D . 3 -3 -06 State surcharge (8% of permit fee) 160(-) �a�� II,L C q TOTAL PERMIT FEE g
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Hark . ,11q1r Date: 3 -3 -06 # Fee methodology set by Tri- County Building Industry Service Board
'' Number of inspections per permit allowed.
i:\ Ituilding \tcrnliiOEI.C- I'crmi1App.doc 12/113 440 I11 /112 /CUM /WBII
• Electrical Permit Application - City of Tigard for all other installations
Page 2 - Supplemental Information
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:
t `COMMERCIAL WORK ONLY.
Fee for each commercial system $75.00
(SEE OAR 918 260 - 260)
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: 1
*No licenses are required. Licenses are required
is \Nuilding \Permits\ El C- Pcrmitnpp.doc 114 /O
, .
/ A CITY OF TIGARD RECEIPT
DEVELOPMENT SERVICES RECEIPT DATE:
zi,4 m,e0,11 .2s 13125 SW Hall Blvd., Tigard, OR 97223 JURISDICTION.: cv-
,:.„,
,...,_ „..„........,..,4, 503-639-4171 www.tigard-or.gov CASHIER DATE:
CASHIER RECEIPT #:
LINE ITEMS:
Case No. Fee Description 1 Revenue Acct. No. Amount Due
-- 1-12..a00&.• 1 b0o5 Low 1/ 01.474 L ,
Pfril ! 15
Co.oc,
i
1
_ _ ------- - — —
I
___ _ _ __
_____ __ __ _ _
_
_
I , i
1 1
1 - 1 -
i - —
----- — ------ ___J____
1 1
1
i I
i ±
- -
Total Due: $ 1 i. o d
• Li SEE ATTACHED FEE SCHEDULE.
PAYMENTS:
Payer: rp
0 01 r MIZ CORP.
Method Initials , Check No. ' Confirm No. Amount Paid
t+feck -is 1-4 39
91 .0 0
Total Paid: $ '2 1.00
L\Buildin \Forms NanualPermitForms\ManualReceiptdoc 03/01/063/1/2006
CITY OF TIGARD. .. , ...
BUILDING DIVISION - - .
A PERMIT #: ELR2006-10005
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 3/312006 . .
Phone: (503) 639-4171 .Vlir
Inspection Requests (24 Hrs.): (503) 639-4175 . — . __–
INSPECTION WORKSHEET FOR DATE: 6/912006 TIME: 7:02AM PAGE: 0
SITE ADDRESS: 11560 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: GREEN OFFICE BUILDING
DESCRIPTION: Low voltage for fire alarm, 1 system for entire building.
OWNER: GREEN, JOSEPH PHONE #:
CONTRACTOR: POINT MONITOR CORPORATION PHONE #: 503-2915533
, • • Inspection Request Scheduled For: Date: 8/912006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 031488-01 503-806-3004 Y
Corrections/Comments/Instructions: •
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PASS OVAL
ST)g . K NI L A El CANCEL 0 NO ACCESS
pi AIL -
fl CALL OR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G N(*.ic . Date: ( =I ' ct . t.lo Phone #: (503) 718-
. .
. ,
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: l: LR 2006 i00 ;if
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 3 /3,,M1f3
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 `�' '`•
INSPECTION WORKSHEET FOR DATE: 5/5/2006 TIME: 7:10AM PAGE: 67
SITE ADDRESS: 11560 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: VVEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: Gi.i:EEN OFFICE
• DESCRIPTION: I. or volt<rge tor fire ::alarm, _1 system I Or entire huildin9.
OWNER: GREEN, JOSEPH PHONE #:
CONTRACTOR: POINT MONITOR CORPORATION PHONE #: 503-:292-5533
Inspection Request Scheduled For: Date: 5/5/2005 Pour Time:
• = Inspection Description Confirm # Contact # Message
135 Low voltage 02918& -02 503-806.3004 y
Corrections /Comments /Instructions:
4\11 c ALL \ s e ca CA8 ' o G7a/ vk,R poL.
19 v6r • P .
•
•
❑ PASS 14 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED "
- (ye
Inspector: v V ` ` _ Date: • 06 Phone #: (503) 718- Ill& .
CITY OF TIGARD �
BUILDING DIVISION PERMIT #: dd0( -/ 0 D D 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 it
Inspection Requests (24 Hrs.): (503) 639 -4175 `_ `11
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / / 5sO 6 7 � CLASS OF WORK:
SUBDIVISION: / LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
3.P
OWNER: f PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: bate: 3 _g_ b Pour Time:
Code # Inspection Description Confirm # Contact # Message
i�� lam/ .:e�1 gz — - 53 3
Corrections /Comments /Instructions:
Ac j '7 C.O. 30
P ft.o v'► 1 c t"o Au. s J ct p
0�. • *Ca • 4 1 A. 30
0 cw`►pu att ( 6t fir' • Gi. Na t ok
(6 FART (43644A Clkt 'Etat(CI Cikea. fkkk‘
•
❑ PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0o‘16. Date: Ncl Phone #: (503) 718- 2 '00 •