Permit / r CITY O T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
4y,r DEVELOPMENT SERVICES PERMIT #: ELR2004 -00147
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/3/2004
SITE ADDRESS: 13190 SW 68TH PKWY 200 PARCEL: 2S101 DA -00101
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: C -P
BLOCK: LOT: 003 JURISDICTION: TIG
Proiect Description: signal circuit
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SCHNITZER INVESTMENT CORP HILLSBORO ELECTRIC
PO BOX 10047 21185 NW EVERGREEN PARKWAY
PORTLAND, OR 97296 HILLSBORO, OR 97124
Phone: Phone: 503 439 - 9666
Reg #: ELE 34 -4399C
LIC 134481
SUP 4941S
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/3/2004 $75.00 Elea! Final
[TAX] 8% State Surcharl 6/3/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
through OAR 95 : 1 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by /.. / ,/__ / iI Permittee Signature 7Vi G L -2 i (fit
OWNER INSTALLATION ONLY
The installation is being made on property 1 own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
From:HILLSBORO ELECTRIC LLC. D 5036013680 06/02/2004 09:39 #002�P_.000/ 1
�v
E DPI •
Electrical Permit A I OR t)rri(_r_'. 1.1: c),ul.y
2 2004 Received - 1
City of Tigard
13125 SW Hall Blvd.. Tigard, OR 97223 P snn Review �� i - / ��
Phone: 503.639,4171 Fax: 503.598.1966 IN of TIGAR ;�t >�1� Dat Other Permit: EL L 2po - a0 /y/
inspection Line: 503,639,417$ �j IV ! Date Ready /By, Juris: el Sae Page 2 for
w.c
Internet: wwi.tijrd.or,us • * "- NNotified/Method: � / ,;, �. � D ir�1M Supplemental In Formation
' ': TYPE OF WORK " • .: :•:.:.. . ., ... • , -• ; :•:' " ' : PLAN REVIEW
❑ New construction 0 Addition/alteratiONreplaeement Please check all that apply:
❑ Demolition 0 Other. OService over 225 amps. comet ❑Hazardous location .
DService over 320 amps - rating ❑ Buildng over 10.000 sq. R,
...:•....,::..• :• .... .. • • CATEGORY OF CONSTRUCTION• . ...5 ;::: . • 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 Q Master builder ❑Other: ❑Buildin over three stories ❑Feeders, 400 amps or more
-- ... AT IO • .. ,. d over 99 persons ❑Manufactured structures or
. ',•; .: .. DOccupaM lea
:.,,NFORMN';ND „'LOCTIO
API:. ' `'
� • ::::',?:*........!•;':::.;;....;::: .; JOB SITE 1 A . .; . ° • .. 0E1p plan RV park • Job no.: Job site address: SO • {� d ❑1-iealth-care facility ❑Other:
1 19 0 �O p r K Submit 2 sets of plans with any of the above. •
• City/Statc/ZIP: 3 0 R .Q cQ . The above are not applicable to temporary construction service.
I
3� 30.3 ,,,,,,�, FEE'` SCHED.W.E. i ”: , , ; ...; . ,
Suite/bldglapt. n o.: Projcd nffitle: .: ' . . = „ :. :;
De scription I QtY. I Fee. I Total . I
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: . I Lot no.: • Ea. addi 500 sq. ft, or portion 33.40 I
Tax map/parcel no.: .
. Limited energy, residential 75.00 2
„ .. :- .-.. •; , ... ESCti PTION OF ' WORK ;; ; ,i, ..: ...: • . ., .. . Limited energy, non-residential
•' ' .,. • Fach manufactured or modular
(•�
1 _ Q 019 t dwelling. service and/or feeder _ 90.90 - 2
� Services or feeders installation, alteration, and /or relocation
' 200 amps or less 80.30 2
.. ::., ; , . .. _ 1 amps to 400 amps 106
:.,. •❑ .PItOPERTIr• OWNER..... ...:' .:; ,::.,.:.;:..... .::........... ..... t .. .. -. ,.,:..•.. .. ". • ...:
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 _ 24
City/State/ZI P: Temporary services or feeders Installation, alteration. and/or
• • Phone: ( ) I Fax; ( ) relocation
_ 200 amps or less 66.85 . 1
Owner installation: This installation is being made on property that l 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: 0 Date: Brooch circuits -new, alteration, or extension, per panel
. •0 :APPLICANT.: :1:.. ;:`.: .0 •CONTACT - A, Fee for branch cirruita with
se rvice or feeder fee. each • Business name: branch circuit 6.65 2
8. Fee for branch circuits
Contact name: • within& service or feeder fee,
46.85 • 2
Address: each branch circuit
Each add'i branch circuit 6.65 _ 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
: ':. <: ^ :z:.;, :: :�...: • :.•.: :...;. ':":::::*•• ::: CONTRACTOR•:•' :::" ` ;? ... .... ,_.. energy panel. alteration. or
extension. Describe: l Page 2 7,c 2
Business name: Hillsboro Electric L.L.0 . _
Address: 21.185 NW Evergreen PKWY Ste #110 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Hillsboro, OR. 97124 Investigation per hour (t hr min) 62.50
O Phone: (5 0 3) 439-9666 1 Fax: (`5 0 3)601-3680 Industrial plant per hour 73,75
•• .:ELECTRICAL :PERMIT FEES* . ' .. • •
CCB Lic.:1 3 4 4 81 Electrical Lic.:3 4 — 4
99C _ Suprv, Lie.: 4941s Subtotal 7 , op
Suprv. Electrician signature, required: /V44 Plan review (25% of permit fire)
State surcharge (8% of permit fee) t D O
Print name: Joey Vitacco I Date: 6�z/o•� _
. TOTAL PERMIT FEE Fell 60
Authorized signature: • This permit application expires ifs pertnit is nor obtained within 180
days after It has been accepted as complete
Print name: . Date: • • Peas methodoloby set by Tri -County Building Industry Service Board
'• Number of inspections per permit allowed.
hlBuildingWannils \ELC- ParmaApp.dOC 12/03 44II /W
l3T(iotavcOMBB '
Case Activity Listing 2/22/2006 9:30:03AM
TIDEMARK Case #: ELR2004 -00147
COMPUTER SYSTEMS. INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
ELRC001 Application Received 6/2/2004 None RECD FAX 6/3/2004
RCP
ELRC003 Permit Created 6/3/2004 None DONE GWL 6/3/2004
RCP
ELRC725 Low Voltage None 6/3/2004
Inspection RCP
ELRC500 (F) Issue permit 6/3/2004 None DONE BB 6/3/2004
BB
ELRC725 Low Voltage 6/3/2004 None PASS KA 6/3/2004
Inspection KA
ELRC799 Elect'1 Final 6/3/2004 None PASS KA 6/3/2004
KA
ELRC800 Case Finaled 10/18/2004 None DONE RB 10/18/2004
RB
Page 1 of 1 CaseActivity..rpt