Permit d CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00030
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/4/2008
PARCEL: 25101 DA -00100
SITE ADDRESS: 13010 SW 68TH PKWY 140 ZONING: C -P
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 007 JURISDICTION: TIG
PROJECT: PACIFIC SOURCE HEALTH
Project Description: installing Access Control, CCTV and Burglar Alarm systems
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: X
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
SCHNITZER INVESTMENT CORP SELECTRON INC
PO BOX 10047 7225 SW BONITA RD
PORTLAND, OR 97296 TIGARD, OR 97224
Phone: Contact #: PRI 503- 639 -9988
FAX 503- 684 -4357
- Reg #: ELE 26- 497CLE
FEES LIC 64341
Description Date Amount SUP 974LEA
[ELPRMT] ELR Permit 2/4/2008 $225.00
[TAX] 12% State Surch 2/4/2008 $27.00 REQUIRED ITEMS AND REPORTS
Total $252.00
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 503.246.6. 9 or 1.800.332.2344.
Issued By: �� j /0 = -•• , f
- mittee Signature: P� � W
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. ELEC'N: DATE:
LICENSE NO:
Cali 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.
, . h 1,.., FOR OFFICE 1.15E ONLY
Received -....
eceived r 1. PenT"14o,:
!A - 129 5 t : ' • ., igard, OR 97223� 1 $ 2008 Ptan Rc "ew Other permit: i U .
Dat e/B
Phone: 503,634.41 i 1 = -.: 03,595.19 Iwo; El Sec Page z or
� , , `., [ _ ' ;1 f ,� o � Bryn Date cd!Me o supplemental Information ;;ate lkr1 1 /4° 6Q V TiGARD Nnti 400 amps er more .
g , . - �. �1
- 11.1 : — 1 .A '. , r� T '' ," a�C�!:' '�yii i ` 1..i il i tsi! (:d i ` g q'r
.'' R •.p;= Please ms checked below.):
� — : : � . ' e. �i�• ...ITT, � ^ + ,;:. °• 1 ' , :;'..;'•':' .—.�� (submit sets
` C % i' i' 'i ; , ? •i:;• ? .`. •:.; di :. ... l i e . ,., , Please c ration /replacement ❑ Service or hock alt that apply is 3
� New constt construction 1 r f� � Addition/alteration/replacement theft 400 ❑ Building nver throe stories.. and hnatyardS.
El Demolition ❑ CtheT; ` t..; . ti : ;' 'IL: . ' . L amps M o t r ❑ Marina npng buildings. agricultural
where die av exceeds 1 0000 • o ❑ floating
777777: .,; m i c 7 ��� a ..F , <„� i. "' ` ` - less to ground, or exceeds 14,000 1:I Co
❑ addition
amps for nil other installations. Its'
O I - and 2-family dwelling .. ommorcial industrial ❑ Accessory t uildmg ❑ Biie pump, ❑ it buildings.
ion of 75 KV A of
Master builder Q Other: ❑Sic v Ya ,,,, larger separately derived system
ti-f
1vI artii 0 5 2�.:!��•` anew mo6or lord of ❑ "� ". '1:" "1.2- "t.� ",
,. . ..:-.'''."'1.•: ,..:; a�.,�'* +�'', -!' .:.' . .. �� mow or mare � us era 'oml vehicle
Job no.: ` -1`p Job site address: �iN ❑ Six or more rat ttat units. CI S ly voltage more than
.----- ❑ tfealth- c,'tre faculties. 600 voles nominal.
Ci /State/Z1P: • an - ❑ Hazardous tendons- more,
LY ❑ Serviec or fader 600 steps at
Suite;/bldg. /apt. Do.: 1 ' k 9 � � ; :: , ,. 3 ..;. �jrt Totnt: �;' ,. : ;! • Projec • name oZGt L .r�rP ,.,, ,.: ; , .:� � ?' � ' _a h'; �,i, : . ,�..
. Deec+4nnaa Qty Res
Cross street/directions to job site: - New residential single or multi - family dwelling unit.
---- includes attacllod garage d J
l 1,000 sq. ft ar less 145.15
Lot no,: 33.40 1
Subdivision.: Fsa. add'1500 sq. R o
map /parcel n o. Limited energy, residential 75 00 2
Tax .:':.•:::; (with ,hove sq. R) I
:: r • c •
;o 1 . !�/'.':
� h;. ;�,_ ::rr � ,:; :=:,. ... •,.,.... •. l ' ' limited energy, multi - family 75.00 2
C CT d residential w ith ab ove , R
. Iln l ter. Services or feeders installation alteration, and/or relocation
' 200 amps or less 111. 30 IMMO
c. '' ` "•` 20 raps 106.85 =Min ,:��.c; .f!�••'.>:�;p�'��,bl�!iElt� �}; •. ...zip; 4:' ,.l •s;+' ;l: lampsm400a
t ; :u< : `'� : :..... 160,60 2
401 amp to 600 amps Ill 2 40.60 2
Name: i/ f / 2 r _ ..Lit..-'ft,si ,_J iv 601 amp's to 1,000 amps 2
Addre �� /(�� Over 1,000 amps or volts 454.65 Temporary services or feeders installation, alteration, and/or •
City /State/ZIP: il�0{ (J ��7� — relocation
Phone: ( ) Fax: (
200 amps or leas 66.85 EN
6
zo1 amps to 400 amps 160.85
Owner installation; This installation is being made on property that 1 own which is not 401 a • s to 599 amps 10.30
'intended far tale lease, rcpt. or exchange, according to ORS 447, 449, 670, and 701 • Branch circuits - new, alteration, or extension, per panel
Datc. — A. Fee for branch circuits with
Owner signature: •:,, ,,i s service or feeder fee, 6,65 2
, ... •. , , P '.1 . n : ,. " above servi
7.:::E! , a;,:,,�.: , r „..,. •'.a . ��,,:,, 7 , :- ,.., , ,. ' 1,..... each branch circuit -- .
B . Fee for branch circuits
Business name: r . L 1;� without service or fader fee, 46.65 2
Contact name: ' tom t � +'k first branch circuit
_ d it Each add'l branch circuit x.65 I I 2
Address: Miscellaneous service or feeder n�cluded
Each rrtertufach or modular 90,90
City/State/ZIP: _ - dweilin :, service and /or feeder 2
( Reconnect only 66.35
Phone: ) 101st• 1' 5-2).4 — l Fax:: ) non circle 53.40 2
Pump or irrigation E mail: r Sign or outline lighting 53.40 2
.:��.,,,..:F,...::.. ,- . .. .. . . ........... �1�81 `i� t ai � limited-
,, .. �.. . '•: � ... ':;,;;''�
Business name ' SEL RON, INC y p el, alteration. or 1 75.00 Z
_ extension. 13caertbe: Page 2
Address; 7225 SW BOP(ITA RD •
---” F ax: ( 503) 6 844357 Each additional Investigation Ins ecdon over allowable in any of the above
Phone: (503) 639 -9988 ' e
City /StateJ'L1P; PORTLAND, OR 97224 – Per inspection 62,50
tigation per hour (1 In iron) 62,50 •
7
� � industrial ptmtt per hour 73. 5
Lie.: 2649 - � , ,.: r,
Elocvical Li 26497CLE Suprv, Lie.: ;.: • a , . , .�: r. , ;,..,t
CCB� • Lie.: 64341 ',: � ' ,•i;.; Vii! v tr �;' ., ... ." ;'„ . 1` •
Subtotal: '' -'�a '•
Suprv. Electrician signature, required: '. - . .
T Plan review (25% of pmt ):
Print name: JIM LEPPER Date: %)Cl I fate surcharge of permit fee): •
TOTAL PERMIT FEE: 00 �' ;ii,
Authorized signature:
This permit application aspires if a permit is not obtained within 7 1
Print name Date: days after It has been accepted as complete
• Number of inspections allowed per permit. '�a(� a
• 1 :TuiWingWermitmOLC•PdmhApprlec 0a / P/OR 440.461 r( I I/051COM/wF,R •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008-00030
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2!4%2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _. 1 1 41414 i ?'
''' I..
INSPECTION WORKSHEET FOR DATE: 2J 1212008 TIME: 7:O5AM PAGE: 38
SITE ADDRESS: 13010 SW 68TH PKWY 140 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 0p7 TYPE OF USE:
PROJECT NAME: PACIFIC SOURCE HEALTH
DESCRIPTION: installing Access Control, CCTV and Burglar Alarm systems
OWNER: SCHNITZER INVESTMENT CORP, PHONE #:
CONTRACTOR: SELECTRON INC PHONE #: 503 - 6339988
Inspection Request Scheduled For: Date: 2/1212008 Pour Time:
Code # Inspection Description / Confirm # Contact # Message
136 Low voltage 064872 -01 503-519-9253 N
l g a C-A,N p •
Corrections /Comments /Instructions:
FiWAL . to6S , 4 ®O \1 IicI6 e cc t P -1_-
V. a •
- , , - -
1
% - . ( /
PASS ❑ PARTIAL APPROVAL ❑ ' NCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADD TIONAL FEES ASSESSED
Inspector: C7 - • Nocs � Date: Z Phone #: (503) 718- 24 t,