Permit 1
• _
ELECTRICAL PERMIT -
;:
CITY T'GARD RESTRICTED ENERGY
1y DEVELOPMENT SERVICES PERMIT #: ELR2003 -00323
'`" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/16/03
SITE ADDRESS: 11308 SW 68TH PKWY PARCEL: 1S136DA -00100
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: Job #19615 Limited energy panel for alteration of existing fire alarm.
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:
BENSON CAPITAL OREGON ELECTRIC CONST /GROUP
1708 3RD AVENUE 1010 SE 11TH AVE
NEW YORK, NY 10017 PORTLAND, OR 97214
Phone: Phone: 503 234 - 1001
Reg #: L5G3- 2342000
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 10/16/03 $75.00 Elea! Final
[TAX] 8% State Tax 10/16/03 $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 Permittee Signature trYL C°c�,o la(
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: `I `('U 5
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
/is
-
Electrical Per •• i i _ion OFFICE USE ONLY
City of Tigard Date received: IO/1b j Permit no.: �u�jrp3 �jroti3
13125 SW Hall Blvd
T Project/appl. no.: !� ` Expire date:
._n4' -'I'I I Phone: (503) 639 -4171, FAX: (5038 -196 2 00 3 Date issued: By: � (Receipt no.:
Internet address: www.cl.tigard.or.us Case file no.: Payment type:
24 - Hour Inspection Re • uegl
U 1&2 family dwelling or accessory latali i8lft5 1�' U Multi- family ID Tenant improvement
❑ New construction ' addiition/ aj{eratio cement ❑ Other. . ❑ Partial
JOB SITE INFORMATION
Job Address: 11308 SW 68th Parkway Bldg. No.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision ,
Project Name: Tigard Data Center Old Mail Room Description and location of work on premises: Limited energy panel for alteration of existing
Estimated Date of completion/inspection: fire alarm
Will ou call for ins•ection within 24 hours? Yes ❑ No ❑ Pro'ect Contact Ga Hatch 503) 546 -6083
CONTRACTOR APPLICATION FEE SCHEDULE
'axno.
Job No.: 19615 Description Qty Fee (ea.) Total Ins)
New residential - single or
multi- family per dwelling unit
Business name: Oregon Electric Group Includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. 'moo se. tt or less $ 145.15 $ - 4
City: PortlandjState: OR Zip: 97214 Ea Add! 500 SF or Portion $ 33.40 $ - 1
Phone: (503) 234 -9900 Fax: (503) 234 -1001 1E-mail: Limited Energy, 1 8 2 Family $ 75.00 , $ - 2
CCB no.: 203 _Elec. bus. tic. no.: 26-95C Limited Energy, Multi- Family $ 75.00 $ - 2
Ci /metro lic. No.: 1 • -5
Each manufactured home or
modular dwelling. Service
Sig „ ,. /,� ,,,� J rmi 4. , a ate• 10/16/2003 and/or feeder. $ 90.90 $ - 2
� , llTu 1
- • n Service or Feeders •
Su nt ark Installation, Alteration or
Relocation:
PROPFP. Y OWNER 200am.sorless $ 80.30 $ - 2
Name (print): 201amps - 400amps $ 106.85 $ - 2
Mailing Address: 40lamps - 600amps $ 160.60 $ - 2
City State: !Zip: 601amps- l000amps $ 240.60 $ - 2
Phone: Fax: 1E-mail Over 1000A or Volts $ 454.65 $ - 2
Owner Installation: The installation is being made on property I own which is Reco only $ 66.85 $ - 1
g according Feeder
not intended for sale, lease, rent, or exchange accordin to ORS 447, 455, Fe mpo s •I rary Servkes nstallation
,
479, 670, 701. Alteration or Relocation:
Owner's si nature: Date: 200 am s or less $ 66.85 $ - 2
201amps - 400amps $ 100.30 $ - 2
Name: Over4olamps- 600amps $ 133.75 $ - 2
Branch Circuits - New,
Address: Alteration or Extension Per
Panel: A. Fee for branch
City: State: Zip: circuits with purchase of service
or feeder fee, each branch
Phone: Fax: E -mail: circuit $ 6.65 $ - 2
B. Fee for branch circuits W /Out
Purchase of Service or Feeder.
PLAN REVIEW 1st Branch Ckt $ 46.85 $ - 2
❑ Service over 225 amps -comrr ❑ Health -care facility Each additional branch circuit $ 6.65 $ -
❑ Service over 320 amps - rating of ❑ Hazardous location Miscellaneous - (service or
feeder not Included)
1 &2 family dwellings ❑ Building over 10,000 square feet four or Each pump or irrigation circle $ 53.40 $ - 2
❑ System over 600 volts nominal more residential units in one structure Each Sign or outline Lighting $ 53.40 $ - 2
❑ Building over three stories ❑ Feeders, 400 amps or more Signal Circuit(s) or Limited Energy
Panel Alteration or Extension*
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park 1 $ 75.00 _ $ 75.00 _ 2
❑ Egress/lighting plan ❑ Other: *Description: .
Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. Each AdditlonalInspecUon over
the Allowable In any of the
Notice: This penult application Above Per ins
$ 62.50 $ -
expires Ha permit Is not
obtained within 180 days after it Investigation fee:
has been accepted as complete. (Other
Permit Fee $75.00
Plan review 25% $0.00
State Surcharge 8% $6.00 N . 9
Total $81.00
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Busines Line: • '(503) 639 -4171 MST
/ J' - o BUP
Received 1 1 S ( '1 Date Requested O M • PM BUP
Location 0 O 6 ^ Suite MEC
1 Contact Person �A� �'��� � Ph ( / -4/0 FSLM
Contractor ( Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: Z 2
Fo
Foundation 3 -60 33 ✓
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing i-
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART . FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final 1 •
PASS PART FAIL
MECHANICAL ' 1 Q .f;, 5
Post & Beam
Rough -In
Gas Line��d3 _ Q
Smoke Dampers J S
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
10110 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'ART FAIL
0 Please call for r- ins . ection RE: Unable to inspect — no access
Fire Supply Line ''
ADA
Approach/Sidewalk Dat ,� r ' Inspect . Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL