Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00033
DATE ISSUED: 1/24/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 6394171
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 020 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: Limited energy for voice and data cabling. Job No. 106076 -10372
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:
TIGARD TRIANGLE I LLC DYNALECTRIC
4650 SW MACADAM AVE STE 220 2904 SW FIRST AVE.
PORTLAND, OR 97201 PORTLAND, OR 97201
Phone: Contact #: PRI 503- 226 -6771
FAX 503- 226 -7720
FEES Reg #: LIC 66793
SUP 4653S
Description Date Amount ELE 26 - 59C
[ELPRMT] ELR Permit 1/24/2006 $75.00
[TAX] 8% State Surchar€ 1/24/2006 $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 foil. • - ado.ted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 - 0010
throug ' OAR 952 - 1-11•A You may obtain copies of these rules or directlestions to OUNC 503 - 246 -6699.
Issu =d By: ' I / FP '� Permittee Signatur
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.
- 24 -00; 1:24PM; Dyne Iectrlc service ;503 226 7720 # 2/ 4
.',x ctrical P,ermi A lie "0 FOR OFFICE USE ONLY
El\I
City of Tigard Received /
Date/B : �N 0 Pemtit No.: e L / �` f,
1 3125 SW Hill Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / -• t• t.,
il ,•�„ � D Other Permit:
Inspection Line: 503.639.4175 ►JAN 24 /_' I�' tt�l -• DateRead /B : 7urtr
Internet: wwr.ci.tigard.or.us Notified/Method: S See Page 2
�.... ;_ .... -•; :��� :•_ : :, :,. -- ,., :.!,.,..,- : : : : : : :: • mental Information
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❑ New construction Please check all that apply:
❑ Demolition ❑ ['Service over 225 amps, comm'l ❑Hazardous location
_. _ r „ " ..:...... .... ..........,,,,_.,.;,., "• ,,,. a , _ _ _ S. ervice over 320 amps Buildngover 1
.t - > `ii� " �'y';`i :c ':iiYl� !,_�� :; , "! � rating 0,000 sq. ft., `, „ C*F-.0 ll '4�,DF' COaS(S TRtI�G -ION . ^ +i , . t Y r, • ; �e r r of 1 -and 2- family dwellings 4 or more new residential
❑ I - and 2 dwelling gi Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure -- ❑ Multi family ❑ Master builder ❑ Other: ❑Building over three stories -- ❑Feeders, 400 amps or more
:,.;., :,+, : :: , l ;- „'.a:- , :, :- :._..,.,- .. : -. -. : :,, : :,• : :;,: - <- _,., _.:........_....:,.,,-„ ...- Occupant load over 99 persons ❑Manufactured structures or
- 0; :�;4r:� st . r.. L:!dr..:gl:i ::Ti ii=,;,i2 ^;1li .
$fill iil1! ` `M' .. U1 i a?� r
.� „JQB :. ..._,..- •..,.-,�: :, : : : : <:.,_. <. d��Crd( - eR�� " ;�n �S k. '�... . ,: "� ❑Egress /lig htingplan RV park
Job no.: l( J(( -I Job site address: 1 3221 SI.tJ (Dr Ye_WD ❑Health - care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: 1 - c 0 e_ (11223 The above are not applicable to temporary construction service.
8� _.iieS: ia,: 1 i;iri -:ii ” ; - :* • � - - -
Suite/bldg./apt. . /apt. no.: laeal. N Project name: + :: : , ���t :. :....... �_
Description I Qty. i Fee. I 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
. J ,
a G :..,;. _• : : : -_ r . :!;i ., i!i ,:: ;,,,, ,, Limited energy, non - residential 75.00 2
i . n:. m: :: -:::•: SRI : .. O : i . ' O Y . ,',t::: , :4N ,..- fa ; .,r z
v. ., : :. �.. � : : : : :' .'•.:6, - :;: o :n. ,� .,, . �.,..: • Ap1 ,.: y: r . :.,,pp..,..I;t' :- a,.........,= h;x,i4'fZi' :ih�i�i?iya ?'sie�
- • �• -• •• - - �• '••••'- "� _'��� � - � Each manufactured or modular
\ O . ,, (MCI ,.J /1 n in dwelling, service and /or feeder 90.90 2
V u 11-+ VI L �• I l).. j Services or feeders installation, alteration, and /or relocation _
200 amps or less ' 80.30 ` 2
':r. ' s ri `� :nf =ti r' w',p:: i :I•rt•� :r. tin 't:^.::w.uq. 'ye i :�.. ,: � :r:.. 201 a
, = - P = ..t i er` �..., t =` t. :,•;, r ;� k, � +�11 :�i , :•�at.t = t..r..�,: :�. :; amps to 400 amps 106.85 2
.: .,.!' : ? ,s, ,_,,,,oi;',..m11j, F,i:,. ;:,, : alt- i :•�..' „ "' °° 3i TE :ti :J•.I.r4st.' 1 -
... . as" s. .i,.:. ........: ..trcd. is:,a4,. !!nF:• :?'�j�%..... y�>>1y
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
Phone: ( ) l Fax: ( ) relocation
200 amps or Tess 66.85 F 1 1
Owner installation: This installation is being made on property that I 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
t ,.is AI!I= • ,,,.,.: tii;;1 :; Vic: tq : ; '� iY ,,..:; :, , :�:::et, il ,, gi.sil siC :rip; ..%kiu t A. Fee for branch circuits with
r } ,:; ”' "' • t ! t•� °` - - service or feeder fee, each
Business name: branch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'1 branch circuit 6.65 2
City /State/Z1P: 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) s or limited-
f`� ()
.+,t gm�rE, ,i :rJ�;F -u .c .;..:,: L;F!.3Ari ?:c: >•pp.0� � II..: I!•rr �'��ii<� lcCrij = �oeir :;t� �vr �k;lfi'.ie
,...... q.: ::::;r .r,:n .... t...,._ t.. t:,: f,:. �. ....r..- ..a.ej....,, :a?tG:..... :ate....._ �L �i 'r.... -Uc :nit : :,!f ._i..,.:,.:.. •._ , u ,}. t 5 energy panel, alteration, or `�
.. a
Business name: n G t extension. Describe: Page 2 2
Address: -242\0 Sw )< Each additional inspection over allowable in any of the above
Per inspection ' 62.50
City /State /ZIP: P .--1- I t-, O724 1 investigation per hour (I hr min) 62.50
Phone: (5)3 ),26,- (071 I Fax: (5)3 )9.2/,,- 1531 ' Industrial plant per hour 73.75
vl ; ::;tc -i i<iii =' ` 'li'E'= G.415 . li .R°i S il,
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y ::. :�. t'4'.+.. �...:�,Y'.. i - �. .._..........�I� :t!A ...f`t...: �..... :. :!'5 : :ffi,:_.
CCB Lic.: ( ,01 / 0 773 Electrical Lic.oV�7 Suprv. Lic.: 5g � Subtotal 7,5 P-9 Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: �� yr d xidpi l Date; //6 / State surcharge (8% of permit fee) � . G�
(v TOTAL PERMIT FEE e O D
Authorized Signature' ' This permit application expires if a permit is not obtained within 180
, � jy1 �/ , days after ft has been accepted as complete
F ri nt name: " Date : y /e2 � • Fce methodology set by Tri- County Building Industry Service Board
•* Number of inspections per permit allowed.
, Doi iding \ Permits \ELC•PermitApp.doc 12/03 440 -461 ST(I0 /02/COM/WEB
CITY OF TIGARD EZ�2
BUILDING DIVISION PERMIT #: 2& J Ov 0 33
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 3 1 42 8' 2-v CLASS OF WORK:
SUBDIVISION: L OT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 —9-0 (e Pour Time:
Co" - Inspection Descrr'ption onfirm # Contact # Message
9,
Co - tions/ , ments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: [1\16. Date: 3 C i CV Phone #: (503) 718 - Y 1"
CITY OF TIGARD ,. -- _
BUILDING DIVISION PERMIT #: f=:l- R2006- O0033
13125 SW Hall Blvd., Ti and OR 97223 DATE ISSUED:
9 � 1/24/2006 Phone: (503) 639 -4171 .� ,e
Inspection Requests (24 Hrs.): (503) 639 -4175 ,J11— jl –
INSPECTION WORKSHEET FOR DATE: 2/16/2006 TIME: 7:07AM PAGE: 78
SITE ADDRESS: 13221 SW 60TH PKWY 030 CLASS OF WORK:
SUBDIVISION: - I • RIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEALTH I4ET OF OREGON
DESCRIPTION: Limited energy for voice and data cabling. Job No. 106076 -10372
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: DYNALECTRIC PHONE #: 503-226-6771
Inspection Request Scheduled For: Date: 2/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 026956 - 01 503--849A511 4511 N
Corrections /Comments /Instructions:
L PASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL [CALL FOR INSPECTION _ 111 ADDITIONAL FEES ASSESSED
�`
Inspector: G"'Agt 0 vV Date: 1 6 0 t7 Phone #: (503) 718 -.6