Permit CITYOFTIGARD ELECTRICAL 4 RESTRICTED E
1 , DEVELOPMENT SERVICES PERMIT #: ELR2004 -00340
Ail 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/2/2004
SITE ADDRESS: 13221 SW 68TH PKWY 500 PARCEL: 2S101DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Data cabling.
Job # 107 - 114 - 07701.
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 NETVERSANT CASCADES INC
4650 SW MACADAM AVE STE 220 9740 SW NIMBUS
PORTLAND, OR 97201 BEAVERTON, OR 97008
Phone: Phone: 503 646 - 0533
Reg #: ELE 34- 589CLE
LIC 150328
SUP 2903LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/2/2004 $75.00 Elect'I Final
[TAX] 8% State Surchari 11/2/2004 $6.00
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.
Issued by 7Z_r 1 �2 Permittee Signature _Ice, c) A1),
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
11/02/2004 13:01 FAX 503 641 6613 NetVersant Cascades, Inc IZ001
. . . . •....:• •:_. „.. . , .. ..
El qdeall Permit .. .....; • - '':'''' ; " '. ' ''. '...''. ' *; FOft OFFICE. USE. ()NIA - :. s.., ...: .'...'..••.7...': .' ...,..:*... : •
. . . .
•
Received i AA P 'ttslo . 120 poj
City of Tigard - -,
Date/B . „ r
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revinw - Other Panic
Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
Inspection line: 503.6394175 ,44• ' ;"7 :1 ' ' Dale Ready/Br .----- Jun= i r El See Page 2 for
internee www.ci.tigard.or.us Magi/Method! - / tr Supolemencd Information
:'gA .. :5:it.
0 New construction a Addition/alteration/replacement Please check all that apply:
EiServicc over 225 amps, corrun't ['Hazardous location
0 Demolition 0 Other: OService over 320 aims - rating [lBuildng oveir 10,000 sq. ft.,
:ftqAtNtiltTai,ti,A,F0,„"!i+ilininti;SW,tittwiligifet 6 AVU p
igggR-$5 of 1 - and 2-family dwellings 4 ar more new residential
-:,7,:ikalit:•:ra....;•..;.:0,),..eq•::,;„,4::4:;411w.,..,,,,,,,.. ...:,.,.....,.........,,,,,,, ,..
01 and 2 dwelling NiCommacial/inclustrial LI Accessory building ' ['System over 600 volts nominal units in one structum
OBuilding over three stories ['Feeders, 400 amps or more
ID Multi 0 Master builder _ El Oth er °Occupant load over 99 persons ElManufactured structures or
• ;• -- - , :7,t, .... • n ii i /r -- emi . -.:11 1-1,
RV park
ii '‘' .. :. • ..L ••• •• .. • • ,., iv4e- '''' L-l&g reSSIli g htin g P lan .
..,..• ....., M1 .. I .o...,........... • . • • • • ••• , •••• ....... . ..... . .......• , ......• ....
Job no.: • Wit Job site address: % 1 W rs,?. .,,,He.n.h_ca,...ility 0 Other -
- . I , . Submit 2 sets of plans with any of the above.
City/State/ZIP: vi • c-, l emb 1 • • j 1 ri The above arc not applicable to temporary construction service.
'',.'•'.'.1i2k.e:P.
Suite/bldg./apt_ no.: 5 0 0 Project name: -yein4 eit it ed-an
DeStripti011 1 Qty. I Fee. I TOtal I "
. •
Cross =et/directions to job site: un I M j i s r b . . 04 4.. ov y New residential single- or multi-family dwelling unit.
Includes attached garage.
?WO tt 0 leiri4V /WIC . • 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited maw, residential 75.00 2
Tax map/parcel no. ..„.., ... ... Limited energy, non-residential 75.00 2
iikiagr?,4firamitotietfolvo,;:wovIii';fiipii.:624:iy:6;4:A: Each manufactured or modular _
Da-1-4 e_a in tivi5 dwelling, service mid/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
77.•••1::;:..5:..::.:::.•.,...i.tip,w,;,4„...tifima.,,iii,:&•:,::tf:79,1;,;iaripiE.:7,-:07.4v.::r::,:::;:ttriiiiiii..;.;;;:....;•;,:::;4;7;;;;;A:;;;:. 201 amps to 400 amps 106.85 2
,..:::••... :...,4%y:: ,..-.n..1.54 .:....,.....,i,....•:-..,!::..•••••-:.1,:e;tV-7-:fc...'!•!.s.
401 amps to 600 anips 160.60 • 2
NalTle: A patto C5120ki 14 . 601 amps to 1,000 amps • • 240.60 2
.
Address: ' l 5 E. • • . &x,ilit;k- Over 1,000 amps or volts 454.65 2
i 1Zeconnect only 66.85 [ 2
Cfty/State/ZIP: a to s X, 41 2_ 4'5 3 3. Temporary services or feeders installation, alteration, and/or
Phone: (V)) 5 .1 50 ,4 ) Fax: ( ) relocation .
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 salc, 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 - ncw, alteration, or extension, per panel
•i A-Fee for branch circuits with
5;'.0Z;*00t4*0*§Ori.444. iui
----" • service or feeder fee, each 6.65 2
Business name: branch circuit
B. pee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit . Address: A )( P lir& Each add' I branch circuit
6.65 2
, A. illiNik
City/State/ZIP: Nm enutllli Miscellaneous (service or feeder not included)
Iliillallimmim
Phone: ( ) ax: Immo.- Pump or irrigation circle 53.40 2
• :
sign Or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited- -
55;.Mil'aaiali" ..,....cncrU Panel' alterati°n' °r •
- S
' ' - extens . ._ iaibe: Page 2 - is.o . 2
Business nasne: if si I lk_1 •
Address: 4 1 9 Q SW A i i of b us fttieit Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: be 0 egarm 6 ieN Investigation per hour (I br Min) 62.50
1
Phone: (6115) frit t ...0 s-5s 1 Fax: (4 AIM 1 4.1 UP I 4
Industrial plant per hour 73.75
Mi
;iiiELWITIOCO
CC13 L 2
ic.: 15b ,7 C6 Electrical Lic.5 Suprv. Lic.:31 •• giiiii
2
v. Subtotal 75. CI 0
Suprv. Electrician signature, required: k „ „il , N.4 0 ..i /!, „. j Nan review (25% of permit fee)
-........
print name. .
• , ': - t 0 •
, , f 'V • • 0 1 • • _M •
ateD . i I a d
. I ' ..q State surcharge (8% of permit fee) to - 6 0
A
TOTAL. PICAUVIIT lEVAR l ig I . 0 0 t
'This t applicatiaa expire. it' a Der•Mt. sa not abr.:nett vAthio ISO
day,. (Met is Sksis
Mitiata SgIMIt'. • V.. nwszo4otora sato/ Tri-c-ttuFTY ElundinZI...ausvrY Scvng' "
Date: •• rturober of impeeuom per acroat allawca.
arle.4615
VItt Viat:-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: . (503J 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / • /1 ? AM PM BUP
Location ! :3 �- ( �� ^ 'r"
E -� Suite -COO MEC
Contact Person Ph ( ) 330 - /' (5 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access:
ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: �q'� SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear c j J 4i S G (� ` 3 ; , J \` 1 ` a 1, :
Framing ,`
Insulation q3 W N A \
Drywall Nailing
Firewall nk k mannE' — VI n'
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _ ((�` �1� tS
Roof I , I f A , -+ ' 1 �1
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
ft1-4
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PASS PAR
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 11 14
SITE ❑ Please ca 1 for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line ) ;(�
ADA
Approach/Sidewalk Date / ( V Inspector Ext
Other:
y
Final DO NOT REMOVE this Inspection recor from t = job site.
PASS PART FAIL