Permit A CITY OF TIGARD RESTRICTED EN RGY
���/ DEVELOPMENT SERVICES PERMIT #: ELR2004 -00320
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 10/18/2004
SITE ADDRESS: 13221 SW 68TH PKWY 400 PARCEL: 2S101 DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Voice & Data cabling.
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 10/18/2004 $75.00 Elect'l Final
[TAX] 8% State Surchar€ 10/18/2004 $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 �Q S')e Permittee Signature SP .f,
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
10/18/2004 10:34 FAX 503 641 6613 NetVersant Cascades, Inc 0001
•
Electrical Permit Ap_plicaticee , .
- :,,,:: •-:::-.,,‘::_:: FOR OVFIKE USE ONLy.: :,. : . ,•.: y ..::•::::: : 1 :'
Ctiy of Tigard . All Received —
IVES Datedlivid / Z V IS PeralitNo.:
13125 SW Hall elvd., Tigard, OR 97223 RE Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 , . ' 20 I 'tf7'144ffil'i'' Date/ly: OtberPermic
inspection Line: 503.639.4175 • ' ' ' -- , - 7 .! Date Rcady/By: Au P
k
- 1 (r S Inf
Internet www.ci.tigard.otus . ef TiGA ) Notificd/Mediocb
6nAINi&g 3 ' ...1« : ' . t7IWiggl : g ) i4 Vfii
CI New construction VA Addition/alteration/replacement Please check all that apply:
liti
El her:
DScrvicc over 225 amps, comm [(Hazardous location
Demoon NI Ot
OScrvicc over 320 amps - rating C(Builchig over 10,000 sq. ft.,
'. A .'. .;M :. .N ., '.::,gfilIFIRD?..ii . 004 : 9 . ***it . ?,":' ":. - .. - .'zitt:1: . p.r. , ...ff , i,:mtpug.xgw:,i , of 1- and 2-family dwellings 4 or more new residential
0 1- and 2-family dwelling 12 Commercial/industrial 0 Accessory building [(System over 600 volts nominal tants in one structure
[(Building over duce stories OFeedcrs, 400 amps or more
D Multi-family E] Master builder 0 Other:
. ... . . . 00ecepant load over 99 persons OManufactured structures or
ATOR * **14.010.00tEtgamiggr °E plan • RV park •
Job no.: tov- Job site address: 1 2 S (I) te 6 . A
___ . °Health-care facility 1:10ther
i • el
Submit 2 sets of plans with any of the above..
City/State/ZIP: i r et.E il , E 7 _, a v - 1 q 2 Th. above Bre not applicable to temporary construction service.
Suite/bIdg-/apt. no.: 9 n„. Project name: 146. ..
ttnteitniOn Qty. Fee. Total ..
A .
Cross strect/directions to job site: fir . '4+ Chill. a 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
iiMAT;:girAlliEttiiierititgop*.pitr E manufa o mod
dwelling, service and/or feeder 90.90 2
MraEillMlt
Services or feeders Installadon, alteration, and/or relocation
200 amps or ieSS 80.30 2
201 =Ps to 400 amps 106.85 2
At*AWOt ,.. ".,:iftwaii
401 amps to 600 arnps 160.60 • 2
Namc:146. " ,
. A - C /10' ... . 601 amps to 1,000 arnps • 240.60 2
Address: I; lz 4
...,,,--= Is r•/
r-to Over 1,000 amps or volts _ 454.65 2
— --- Reconnect only 66.85 r 2
Temporary services or feeders installation, alteration, and/or
Phone ( ) 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 10030
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. f 2
401 amps 10 600 amps 133.75
Owner signature: Date: - Branch circuits - new, alteration, or extension, per panel
k4.iga.4.1 nT...-i'..f.04:k4#.4`.4:4401,10Nr4-V.4..i4 A. Pea for branch circuits wiril
service or feeder fee, each
Business name:
branch circuit • 6.65 2
B. Fee for branch circuits
Contact name:
without service OT fccder fee,
46
Address: .85 2
each branch circuit
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 cireuit(s) or limited-
!O energY Panel, alletatiari, 0 - 7 — 1
usin ,,..0j.)
•"""""gta 1 Page 2 1 1 2
BeSS name A - Y'rsarri - # SC eies In( _ .
Addrcss 91 0 SK/ Nidtb s H . ,4 ' Eacb addid tional inspecon over allowable in any of the above
•
Per inspection 62.50
City/State/ZIP! ; •, ,, -- , co r Investigation per hour (1 hr loin) 62.50
Phone: (sas ) mr. OS 3, 3 Fax ( SR (11-0 0 IS Industrial plant per hour 73.75
imtaimterske‘...7xmolottormFororesmow=',..*
CB Lic.: ($3. !' Electrical Lie.: 341...5,170E Suprv. Lie.:3IZ - pt
Subtotal IS', 0 0
Stipp/. Electrician signature, required: f ium!,,,,,,Hippr Plan review (25% of permit fee) iv ni.
p State surcharw (8% of permit foci 6 0 tp
) .
Print UM. 6. • e %, 4 . • 4 Dntee OM / oq_ TcrrAx. asreosrr tire 141..0 0
,
Tins peri.t app1Pmano =Wee If a permit Is not obtained within use
doze anew tt ass bee. aceepted ca cote se .e. Ewer,
NilhafiZa S
. Fee meth000kw gettry 7 ri-Couticy Building Ind
Date: .. Nosioor 01 titePectiona WI P
VIVA t2:°. mo-uststoolarcotama
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
l BUP
Received Date Requested / J l C f AM PM BUP
Location / 3 Z Z S uite 4/0 D MEC
Contact Person Ph ( ) 33 = l 4 9 2 PLM
Contractor Ph ( ) - 3 d /5 SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR _ 0� , 3 Zy
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
/ 41
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
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab L
olta �L (� y " G c / ` o " M reA- P"‹ X 12 /0' 1
Fire Alarm
Fina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Zrbi PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line /
ADA Date /6 //1 � Inspector s (o Ext
Approach/Sidewalk ///
Other:
Final DO NOT REMOVE this Inspection record from th ob site.
PASS PART FAIL