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11/ 1''`r CITY �Y ®� TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00097
TIGARD„ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/17/2007
PARCEL: 1 S136DD -04100
SITE ADDRESS: 11850 SW 67TH AVE ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT: 007 JURISDICTION: TIG
PROJECT: TIGARD TRIANGLE COMMONS
Project Description: Building 1 - Low voltage for access control system.
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 CON X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC NW PROPERTIES SELECTRON INC
ATTN: PAUL GRAM 7225 SW BON ITA RD
P.O. BOX 2206 TIGARD, OR 97224
BEAVERTON, OR 97075
Phone: 503- 626 -3500 Contact #: PRI 503- 639 -9988
FAX 503- 684 -4357
FEES Reg #: ELE 26- 497CLE
LIC 64341
Description Date Amount SUP 974LEA
[ELPRMT] ELR Permit 4/17/2007 $75.00
[TAX] 8% State Surchar€ 4/17/2007 $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
503.246.669' : .; t 0.33 34 .
Issued =y: - I / i I Al ' Permittee Signatu . s_ % «_.)
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.
� r'ical Permit Ap.e lic, ' t . F OR OFFICE USE ONLY
i
Receved / /t€ 14, ily of Tigard I �� Date /By: 0 ' �i Permit No.: / 7 �� Q p !
I 11 Q 175 CW Poll Rlvd • Tigard. f)R 9722 plan Review (•
P f one 503.639.4171 Fax: 503. APR 1 6 2007 /�'" j t I'' Date/By: Other Permit:
Insion Line: 503.639.4175 f+ _t- I L Date Ready /By: 1 ® See Page 2for
Internet: www.ci.tigard.or.us CITY OF " - -- Notified/Method: " ..1. 1 8/..../
1 Supplemental Information
T TWING DKUiSIQt�
PLAN REVIEW
❑ New construction 76 Addition /alteration/replaceme1 t Please check all that apply:
❑ Demolition 0 Other: ❑Service over 225 amps, comm'l ['Hazardous location
El 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
❑ I- and 2- family dwelling t6 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi- family ❑ Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/Iighting plan RV park
Job no.: L.2 Job site address: f SS() S4 lei Aoe ❑He t2 -care facility
fp ay DOther:
Submit 2 sets of plans with any of the above.
City /State /ZIP: "r 5A4 , - 0 1 6e °1-722. 3, The above are not applicable to temporary construction service.
!�
Suit: • • • : apt no.: l Project name:'r�� � '� k l w 1 ., FEE* SCHEDULE
o Description Qty. 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'l 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
1 dwelling, service and/or feeder 90.90 2
1 r\s - J aAl aL bs c St/St-4 -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
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 1 2
intended for sale, lease, rent, or exchange. according to ORS 447. 449, 670, and 701.
401 steps to 600 amps I 133.75 I j 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: branch circuit
B. Fee for branch circuits I
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address:
Each add'l 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: I Page 2 — 2
Business name: IerL- _ \ lhc_
Address: — 2,2,5 5)x.1 j2� I .�- a q� Each additional inspection over allowable in any of the above
1f Per inspection 62.50
City /State/ZIP: t�r+lat -gel U ie ci 7 4 Investigation per hour (1 hr min) 62.50
Phone: boa )(3C1 - C C6 V Fax: (sU3) ( ._0..,1 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 10 - 13 L i l Electrical Lic.: - 8-„..4.-.;-.j E ,21 Suprv. Lic.: Subtotal -15 i3°
Suprv. Electrician signature, required: :i Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) b .00
GI thin Crt,�, y I 1 - zJ c �
TOTAL PERMIT FEE ! Ly
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
is \Building'JPennits\ELC -Penn itApp.doc 12/03 440- 4615T(10 /02/COM/WEB
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r i/ CIT Y OFTIGARD .
BUILDING DIVISION PERMIT #:
FL R2007- 20f17- 0 C)iif 97
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/17/2007
Phone: (503) 639 - 4171�1"'l (1
Inspection Requests (24 Hrs.): (503) 639 -4175 ±i- I I
INSPECTION WORKSHEET FOR DATE: 0/29/2007 TIME: 7:00AM PAGE: qg
SITE ADDRESS: 11060 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE E COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 - Low voltage for access control system.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 603 -626 -3600
CONTRACTOR: SELECTRON INC PHONE #: 503..639.9900
Inspection Request Scheduled For: Date: 8/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 054804 -01 603 - 6710.5216 N
Corrections /Comments/ Instructions:
k.' L__,e G. it//9- 4 . /WM° I) ')
O _PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: 6,/'/6 . Date: 77 i D --1 Phone #: (503) 718 -