Permit a CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00305
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/15/2006
PARCEL: 1 S 136DD -03400
SITE ADDRESS: 11740 SW 68TH PKWY 100 ZONING: MUE
SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG
Project Description: OMA. Low Voltage for audio - visual system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC NW PROPERTIES HANSEN TECHNOLOGY GROUP
PO BOX 2206 PO BOX 83783
BEAVERTON, OR 97075 PORTLAND, OR 97283
Phone: 503- 626 -3500 Contact #: PRI 503 -351 -1290
FEES Reg #: ELE 3090LEA
LIC 154012
Description Date Amount
[ELPRMT] ELR Permit 12/15/200E $75.00
[TAX] 8% State Surcha 12/15/200E $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 or 1.800.332.2344.
Issued By: %� ,� Permittee Signature:
■ j p \?,Q
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.
,
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Electrical Permit Application UR OFFICE: LISE ONI,Y
Ci of Tigard RECEIVE - I , RYC ,iwed � � � � C J < ' �6 'Uo,3p.c
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13125 SW Hall Blvd., Tigard, OR 97223 DEC 1 4 / f ' , Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DatclBy: other Permit'
T I G A P D Inspection Line; 503.639.411D CITY OF TIGAR Date Ready /by: ' Ju ' : 121 Soo Paso s for
Internet: www.tigard- or.gov N orif,rd/Mmhod: "� Supplemental information
134 IAIS�. ®IUiC�( ;
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:„„: :,.a� s . ..ft,:u .r., � . •r,. ; -i��: i.j � ;, ' A na :.�.. � F :r! i' t • .:p.
.•...:.. ....e.,rt t ,....,,.., _, x, •• IQalt v :, .., .�. �t .. : . .... ......,
Ej New construction ❑ Addition/alteration/replacement Please check all that apply (submit II sets of plans wine= checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
r .. ••. r;;, . •....,•. , .• ; + •• • •' ,.,,, r: V, . .:r: amps at volts or ❑ F1oaiIn bwld,e
+��: ',,•1 ';( �as� I.�p' •O�� "'= : :i;� , - ,.. exceeds l�
... „ . . ,.,,. ...,.:•:�- ':,..,... ab altars]
�:, � :, i, . ; z; > ; � :':�5�3 " :.. = ? ";';: ` y, {egs,o groetnd. or exceeds 14,000 ❑ Co
, , :........::.:., � _, ., ........ • .... ewnere use
ia►. uric
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all outer installations, buildings,
1 Mas builder ❑ Other: CPO pump. P. ❑ Installaton of 75 KV A or
1,21 mad-family iJ Master ,,. m,.,,. ,, „NC "" =C; ;:':% ❑ Emergency system. larger separately derived system.
.,,,.....:., /��� y'1 > w ntotor load "A "E",
; ; ;, ; ;�: � '•ir r. ' ' gin►, ; " c ��i:X`r Q�':. F, : " ;. � t;o.,.;.... � ... ..... Addition of ❑ - 1-2", "1-3"
Job no.: I Job site address: 11/40 SW 68 Parkway 100HP or more- occupancy.
❑ Six or more nssidaansl units. ❑ Reurea it mai .clink parks.
City /State/ZIP: Portland, OR 97223 ❑ them •ears faoilitiea. ❑ Supply voltago for more than
0 Hazardous locations. 600 volts neural.
Suite/bldg. /apt. no.: I Project name: Oregon Medical AssocJatto ❑ service or roodor 600 amps or .non.
• 1. ",�� h'9a'p;S ryyiN.!i ,�• P. .1,�5 :Nq�FJi: ",'sy' "iC�.
1i.;5>' 1PilY. dh�u14(' ri• �{;: ��°al3f::Prr'....�ti"..'.' <:!R. arAi. la ;+��
Cross Street/directions to job site: Description 1 oty- [ Fee. 1 Tani 1 •
New residential tingle!• or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Eat. udd'I S00 sq. ft. or ponion 33.40 1
Tax map /parcel no.: Limited energy, residential 7500 2
. " ,., ' ' • ;? i (with above . fi )
;�,n.
_ .•• :" „ " ,. , ..... - - Limited energy, multi-family 00 y
prewire and termination for low voltage audio- visual system residential (with above au. ft,) e 75.
Services or feeders installation, alteration, and/or relocatio
200 amps or less 80.30 2
::A ; •:t... 4 :.,,> ,(, : . t : e:',rr:. ::. `' 201 amps to 106,85 2
5 .;�s�I'�• . r ............... ' , .
401 amps to 600 amps 160.60 2
Name: Oregon Medical Association 2
601 amps to 1.00 onepa 7An 60
Address: Over 1,000 amps Or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: c
Phone: ( )
F ax: ( ) 200 amps or less 66.85 1
201 amps to 400 amps 100.30
Owner installation: This 2
installation is being made on property that I own which is not 401 amps to 400 amps 133.75 2
intended for sale, lease, rent, or exchange, according t4 ORS 447.449, 670, and 701. Branch circuits – new, alteration. or ex tension, per panel
Owner signature: Date: - A. Fee for branch circuits with
�7ti,r •+ "`P'' i;�: 41;}f!•CiW'�'Is;.`i+i:° '4,V ? . ::`f ..,fit NT Ip� '' :; ;1 above serviuc Ca feeder fw, 6.65 2
A "' „ {�I::?�3 ltsrrr� ;n:R1,,, :N: !;Y i ,!I.! : : %::• „ :: ,., ...,' w *'�i��'iif�$ iii% ' ; i. S , ;;;
_ each brturch circuit
Business name: Hansen Technology Group B. Fee for branch circuits
�-- widener service or feeder fee,
46.83
Contact name: Flora Novarra first branch circuit
Each add'I branch circuit 6.65 2 ,
Address: PO Box 83783 — - — Miscellaneous (servire or feeder opt included) ._
City /State/ZIP: Portland, OR 97283 Each manufactured or modular 90,90 2
dwelling. service and/or feeder _
Phone: (503) 313 -2010 Fax:: (503) 692 - 1739 Reconnect only 66.85 2
2
alter circle
S3
.40
E-mail: fnovarraBgm &tLcom Pump � ems .. ... .....,... ,� :. �,� .., . ... • • , .n...a "• - ., ., , ,.•n ' !1';: l• ., 1ri °i ':.i? 0Y ; Sign Or outline lighting 2
' : :! g ::.:.+I ; l i ii>i.V.h1ei :.; . ai _ .... ..A PI. -
' $ib+aal cin>uit( ^.) or limited -
53 40
Business name: Hansen Technology Group en perm, alteration, or
extension. Describe: / Page 2 2
A 1dreks: PO Box 83783 _
City / State/ZIP; Portland, OR 97283 Each additional inspection over allowable in any of the above
Per inspection 62.50
1'huuc: (503) 351 -1290 Fax: ( ) _ lnvestipatina per hour (1 hr min) 62,50
I 5
Lic.: 3090 In dustrial plant per hour 73.75
CCB Lic.• 154012 Electrical LEA 1 Suprv. Lic.. yi l r plant pe w pzr�. r.a,L li — .T r w : ' ;; rs
psi•.!!:', ' "•Ya ";' ;'1 a 1'� . ili . e.S
IFU n. w ...
Suprv. Electrician signature. required: q. Subtotal: _
Plan review (25% of permit fee);
Print name: Pete Hansen _ J Date: 11 - - State surcharge (8% of permit fee):
Authorized signature: /�. TOTAL PERMIT FEE: 7) . I
• 11 This permit appli<atioa expires if a permit is out obtaineu within 180
Print taunt: Pete l Jansen I Date: 11-27-06 days after it hus been accepted as complete.
• Number of inspections allowed per perm,t•
muiidiagwwwiIM.C•PermitAss. ust-km 440-4615T(11 /05,COMWEa
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CITY OF TIGARD Lz /�-
BUILDING DIVISION --1 PERMIT #: Qlp p�3ps�
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /m #
Inspection Requests (24 Hrs.): (503) 639 -4175 1 L!
INSPECTION WORKSHEET FOR DATE: 1 TIME: PAGE:
SITE ADDRESS: / L v /i / CLASS OF WORK:
SUBDIVISION: s• ° . TYPE OF USE:
PROJECT NAME: � � / .12t—/ 019 DESCRIPTION: '� / $ Z'L/L�1
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 .12 • Pour Time:
Code # Inspection Description Confirm # Contact # Message
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•
Corrections /Comments / Instructions:
I. 6 ; £ ')E6 .
MAW,. (ZA 1
41 et) 6 � - 6 e7•1 , Acs A 1k.
Ni( Nr a C_SWEIWZ 711
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PASS 'kft- Cr. QIt•e . 3\I lA01)
- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
31 ill 6C 6
Inspector: W b b Date: 3j 01 Phone #: (503) 718- 24-1k
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200G- 00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/16/2006
Phone: (503) 639 -4171 loptpu
Inspection Requests (24 Hrs.): (503) 639 -4175 s r
INSPECTION WORKSHEET FOR DATE: 12/22/2006 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 11740 SW 68TH PKWY 100 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE:
PROJECT NAME: OMA
DESCRIPTION: OMA. Low Voltage for audio-visual system.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626 -3600
CONTRACTOR: HANSEN TECHNOLOGY GROUP PHONE #: 503 - 351 -1290
Inspection Request Scheduled For: Date: 12/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 041473 -01 503- 504 -3098 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �1'`t Da 12,4:2,-- O� Phone #: (503) 718- 24445