Permit C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PE RMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00025
' II i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1117/2006
PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY OZ O ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: Fire alarm low voltage.
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:
TIGARD TRIANGLE I LLC PERFORMANCE SYSTEMS INTEGRATION
4650 SW MACADAM AVE STE 220 7759 SW CIRRUS DR.
PORTLAND, OR 97201 BEAVERTON, OR 97008
Phone: Contact #: PRI 503 641 - 2222
FAX 503- 641 -1464
FEES Reg #: LIC 150747
ELE 34- 522CLE
Description Date Amount
[ELPRMT] ELR Permit 1/12/2006 $75.00
[TAX] 8% State Surcharl 1/12/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municip Code \State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved pI :ns. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 181 days ./ TTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those r les -a, et f. th in 1 AR 95 - 001 -0010
through OAR 952- 01 -0100. You ma btain copies of these rules or direct q e Lion . to e , NCf • -. - : 6699.
Issued By: Permittee Signature:
P PIk
•
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 cans 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.
ical Permit A III) IVED FOR OFFICE USE ONLY
of Tigard Received , Permit No.
r g DateB : - / / — at. _ .LS _ 0 O(, , coo d
13125 SW Hall Blvd., Tigard, OR 97223 SAN 1 7 2006 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / /, 4 Other Permit:
i� D ateB :
Inspection Line: 503.639.4175 r _ a)I� Date Ready/By: �L ®See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIQAR • Notified/Method: �'` %�� Supplemental Information
BUILDING RIVISION �ii���
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ® Other: Tenant Improvement ['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 ® 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
['Occupant load over 99 persons DManufactured structures or
JOB SITE INFORMATION AND .LOCATION ['Egress/lighting plan RV park
Job no.: 101302 Job site address: 13221 SW 68 Pkwy ❑Health -care facility [Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard / OR / 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: eV() Project name: Health Net of Oregon FEE* SCHEDULE
Description 1 Qty. 1 Fee. 1 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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
.DESCRIPTION OF WORK Each manufactured or modular
Fire Alarm Installation dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
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
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 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
® APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Performance Systems branch circuit
B. Fee for branch circuits
Contact name: Patrick Stine without service or feeder fee,
Address: 7759 SW Cirrus Drive
first branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/State /ZIP: Beaverton / OR / 97008 Miscellaneous (service or feeder not included)
Phone: (503) 641 -2222 Fax: : (503) 641 -1464 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
extension. Describe: Page 2 2
Business name: Performance Systems
Address: 7759 SW Cirrus Drive Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Beaverton / OR / 97008 Investigation per hour (1 hr min) 62.50
Phone: (503) 641 -2222 Fax: (503) ¢41 i 464 p I t k Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES *
CCB Lic.: 150747'/ S Electrical Lic 34 -5221E I ti Suprv. Lic.: 3456 LEA Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: 5e Date: 01/16/06 State surcharge (8% of permit fee) I
V TOTAL PERMIT FEE S(
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: 01/16/06 • Fee methodology set by Tri-County Building Industry Service Board
• • Number of inspections per permit allowed.
is\ Building \Permits\ELC- PermitApp.doc 12/03 440.4615T(10/02/COM/WEB
i 73.s..O
CITY OF TIGARD
BUILDING DIVISION PERMIT # : FLR2OfS� 0Stl {1t7t,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/ .
Phone: (503) 639 -4171 u e lp i di;
Inspection Requests (24 Hrs.): (503) 639 -4175 411.- —
INSPECTION WORKSHEET FOR DATE: 71 15/2006 TIME: 7:O4AM PAGE: 0
SITE ADDRESS: -i1 sw 60TH PKWY 020 CLASS OF WORK:
SUBDIVISION: TR `•• NILE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEA ,, H NET OF OREGON
DESCRIPTION: Fire al ', i low voltage.
OWNER: TIGARD T ', ANGLE( LLC, PHONE #:
CONTRACTOR: PERFORMA '. ,E SYSTEMS INTEGRATION PHONE #: 603-641-2222
Inspection Request Scheduled For: Date 2/15 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 026B90.07 503 N
Corrections /Comment /Instructions:
tv't ksalnS il ' = 3 hn
tsPi P2■••■■ 00 ; 0 71 -6 11 1 'seEqtit-.
1402414AL_,
Pees4
t amo -
. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &% 0 /it-A
Date: 06 Phone #: (503) 718- vi-t*
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1117/20G;
Phone: (503) 639 -4171 . it
Inspection Requests (24 Hrs.): (503) 639 -4175 "'J
INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7:O3AM PAGE: t3
SITE ADDRESS: 13221 SW 68TH PKWVIO2tJ CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEALTH NET OF OREGON .
DESCRIPTION: Fire alarm low voltage.
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: PERFORMANCE SYSTEMS INTEGRATION PHONE #: F.:03-641-2222
Inspection Request Scheduled For: Date: 1/19/2006 Pour Time:
Code # Inspection Description rm # \ Contact # Message
13( Low voltage 02521!'-;-01 03 -641 -2222 N
Corrections /Comments/ Instructions:
1.,14)
WALE. G OVVZ, o N -
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: / 1 Y o6 Phone #: (503) 718- 2- 2-4