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Permit Roo 7 7 4; „j c ,¢ /S3 � 6 ? 634, v CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00002 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/4/2007 PARCEL: 1S136DD-03400 SITE ADDRESS: 11740 SW 68TH PKWY 250 ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG PROJECT: OREGON HEALTH CARE ASSOC Project Description: Low voltage for voice /data. Job No. 64259 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: 1 Owner: Contractor: PACIFIC NW PROPERTIES TECHNOCOM INC. PO BOX 2206 7929 SW BURNS WAY # F BEAVERTON, OR 97075 WILSONVILLE, OR 97070 Phone: 503- 626 -3500 Contact #: PRI 503- 682 -4195 FAX 503 - 682 -2781 FEES Reg #: ELE 34- 269CLE LIC 73872 Description Date Amount [ELPRMT] ELR Permit 1/4/2007 $75.00 [TAX] 8% State Surchart 1/4/2007 $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 reset forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or dired questions to OUNC at 503. . 699 or 1.: ie.33 .344. . Is ued By: , i Permittee Signature: -et - [ 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 j SIGNATURE OF SUPR. ELEC'N: ,i � ( i 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. Electrical Permit AppR CEIV ED FOR OFFICE USE ONLY 1 City of Tigard • Received / / n Ail „ 7 Date/13 : - i Permit No.:� i 4 ,r- 2 - 13125 SW Hall Blvd., Tigard, OR 97223 Jell 0 r' 200 ° Plan Review Phone: 503.639.4171 Fax: 503.598.1960 • ": ?' `� Other Permit: Inspection Line: 503.639.4175 CRY OF T`Q� 1 ' � I I I Date R ® See Page 2 for Internet: www.ci.tigard.or.us BUILDING DIV Notified/Method: MI Supplemental Information TYPE OF WORK - PLAN REVIEW ❑ New construction Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ❑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 7-Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ Multi- family ❑ Master builder ❑ Other: _ DOccupant load over 99 persons DManufactured structures or JOB SITE INFORMA // 74 o S4A) cfa 3/lighting plan RV park Ut- teatth -care facility ❑Other: Job no.: 1 Job site address: � I r�±I_ . , VQ/ Submit 2 sets of plans with any of the above. City/State /ZIP: / a�� l The above are not applicable to temporary construction service. Suite/bldg. /apt. no. Project name:9y0 D /-/ FEE* SCHEDULE .• V •`, 0. ! Description I Qty. I Fee. I Total Cross street/directions to job site: SD 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 n - f �`� .� N dwelling, service and/or feeder 90.90 2 X l Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 IO1' PROPERTY WNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: N. c t r e.._ W Aaopf/en E5 601 amps to 1,000 amps 240.60 2 Address: Over ` PoolC 29 b/_ Over 1,000 amps or volts 454.65 2 7 Reconnect only 66.85 2 City /State /ZIP:�j 01 OIL. 970 7 Temporary services or feeders installation, alteration, and /or • Phone: ( y2 ) // // Fax: ( ) relocation lD 2_6 ' via 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 1 ❑ 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 Contact name: without service or feeder fee, first branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or e / t � ens i on. Describe: Page 2 2 Business name: Technoconl / 0C v (o / YS• 0 Address: '- 9 1C7 S v i 80 rri5 U / S t Ito Each additional inspection over avowable in any of the above 1 nn � Per inspection 62.50 City /State /ZIP: wl 150 hi/ 1 1'P 0 r C1 7U �C, Investigation per hour (1 hr min) 62.50 Phone: ( ;) (4' Sa , cogs . Fax: (..): /eS- O. 9 .7 1 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 7 73 Electrical Lic.:' - Lic.: Subtotal 75 QO Suprv. Electrician signature, required: C „.. Plan review (25 °/a of permit fee) �' J Print name: D, Date /a J /0 / , State surcharge (8% of permit fee) e b 0 Y`� TOTAL PERMIT FEE 'y3 / n Authorized signature: / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: ` • S �(/ Date /e9 y/ �/1 • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i Building 'Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELR2007-00002 AI 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/4/2007 Phone: (503) 639 -4171 / Il i. Inspection Requests (24 Hrs.): (503) 639 -4175 P_ INSPECTION WORKSHEET FOR DATE: 3/14/2007 TIME: 7:OOAM PAGE: 65 SITE ADDRESS: 11740 SW 68TH PKWY 250 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: Low voltage for voice/data. Job No. 64259 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503- 62G3500 CONTRACTOR: TECHNOCOM INC. PHONE #: 503 Inspection Request Scheduled For: Date: 3/14 /2007 Pour Time: Code # Inspection Description Confirm Contact # Message 135 Low voltage 044757 -01 503. 209 -9276 Y Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - N be Date: S 1 0 7. 1 Phone #: (503) 718- 2tili'V CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELR2007 -00002 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/4/2007 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . ' IL. INSPECTION WORKSHEET FOR DATE: 2/20 /2007 TIME: 7:O9AM PAGE: 3 11"1wOSw b$ AV 1 2 -Ea SITE ADDRESS: AVE 2 50 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE: PROJECT NAME: OREGON HEALTH CARE ASSOC DESCRIPTION: Low voltage for voiceldata. Job No. 84259 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 6263500 CONTRACTOR: TECHNOCOM INC. PHONE #: 503-682-4195 Inspection Request Scheduled For: Date: 2/20/2007 Pour Time: Code # Inspection Description r fir # Contact # Message 135 Low voltage 04360E3-0\ 503-20 -9278 Y Co`1 - Corrections /Comments /Instruc • -: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` u Qv L-' Date: 12 / 7 4 - '61 Phone #: (503) 718- VA'