Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
L` Y�I� J DEVELOPMENT H BMEN� Tigard, SERVICES 1639 -4171 DATE ISSUED: 04/09 200 00100
SITE ADDRESS: 13535 SW 72ND AVE PARCEL: 2S101DC -00300
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of data cabling. Job #T1074
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:
PACIFIC NW PROPERTIES LP SELECTRON INC
9950 SW ARCTIC DR 7225 SW BONITA RD
BEAVERTON, OR 97005 TIGARD, OR 97224
Phone: Phone: 639 -9988
Reg #: LAC 00064341
ELE 26- 497CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 04/09/2001 $75.00 2720010000 Elect'I Final
5PCT CTR 04/09/2001 $6.00 2720010000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by �,� � � � Permittee Signature 0'x i Opp Qr ,Gz( � !►'\ f►'�wY
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:
Cali 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES . PERMIT #: ELR2001 -00100
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 (GATE ISSUER: 4/9/01)
SITE ADDRESS: 13535 SW 72ND AVE 'ARG>tL: 251 ADC -00300
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Intercom /Paging. Job #T1074
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
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:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC NW PROPERTIES LP SELECTRON INC
9950 SW ARCTIC DR 7225 SW BONITA RD
BEAVERTON, OR 97005 TIGARD, OR 97224
Phone: Phone: 639 -9988
Reg #: LIC 00064341
ELE 26- 497CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 4/9/01 $75.00 2720010000 Elect'I Final
5PCT CTR 4/9/01 $6.00 2720010000
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. • •
Is ' � Permittee Signature
/ • 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. ELECN: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. forr an inspecti needed the next business day /.//, pAole:ct- ( "
Electrical Permit Application
Date received _ • —p Permit no.: 20o/ - 00 /0 0
�.n rt' +
,1l :� 1! City of Tigard Project/appl. no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
APR 0 9 2001 Land use approval:
•
COMM : OF PER111T - -
El 1 & 2 family dwelling or accessory L " ommercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction 0 Addition/alteration /replacement ❑ Other: 0 Partial
JOB SITE INFORNIATION
Job address: ir�� / , Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: it I Description and location of work on premises: p G a "" /1�1
64
Estimated date of completion/inspection: .;r' I /V
' CONTRACTOR APPLICATION FEE SCIIEDULI.
Job no: go Fee Max
Business name: Qom, Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address:
i '' ' // dwelling unit. Includes attached garage.
132311� /. %� ZA ZIP. " / ,`- Service included:
/LT i 1000 sq. ft. or less 4
Phone: Vg : `� r� `//� Each additional 500 sq. ft. or portion thereof
CCB no.: 1 h Elec. bus. Lc. no: 4;760 y q . T /G Limited energy, residential 2
City /metr lic. no.: nc, li a. Limited energy, non- residential 2
Each manufactured home or modular dwelling ME
Sig ature o rvising electrician (required) , D e Service and/or feeder • 2
Sup. elect. name (print): ° . ��� License no: ; orfcedets installation,
` �— ! a teration or relocation:
...I'ROI'HUI' O\1'iN1iR r _:...
200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - .
which is not intended for sale, lease, rent, or exchange according to htstallatlon ,alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
• 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am . s 2
ENGINEER - Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: I Fax: 1 E -mail: Each additional branch circuit:
Mlsc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
0 Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories ❑ Feeders, 400 amps or more ;Description:
•
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan ❑ Other. Per inspection 1 1 1 1
Submit sets of plans with any of the above. Investigation fee
_ The above are not applicable to temporary construction service. Other
—., Permit fee $ '75
Not all jurisdictions accept credit cards, please call jurisdiction for more i nformation. Notice: This permit application
0 Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ �- .
Credit card number: / 1 within 180 days after it has been State surcharge (8 %) $ L ' , UU
Expires accepted as complete. TOTAL $ SS/ • ad
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6/00/COM) 0071f4--J
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Work Involved:
Residential - per unit
1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 Burglar Alarm
Limited Energy $75.00
• Each Manuf'd Home or Modular ❑ r
• Dwelling Service or Feeder $90.90 2 Garage D oor Opener
or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2 ❑ Vacuum Systems
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps . $240.60 2 ❑ Other
Over 1000 amps or volts ` `'•=' $454.65 2 . . .
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
2u0 amps or less — $06.85 2 - _(SEE OAR 918 - 260 -2 _ _ _
201 amps to 400 amps $100.30 2
401 amps to 600 amps • $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits • ❑ Boiler Controls •
New. alteration or extension per panel .
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional Inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 El Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ n Other •
8% State Surcharge $ / Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ • * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ 5
Enter total of above fees • $ 7
0 Trust Account # o
8 /o State Surcharge $
Total Balance Due $ $
i:\dsts \forms \elc- fees.doc 10/09/00
Z 3)P
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24- I1opr Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested I ' L � AM PM
q BLD
Location 35 3 7 2-'- Suite MEC
Contact Person gkc Ph C9>9- 9 f PLM
Contractor P007 Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR &0 /—GU /v U
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling �I!
Roof 4/1 d, ° (e! /Y1 - 5" .5
nnisc: 5
Final
PASS PART FAIL
PLUMBING �j `? / — / SS
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL /1
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
e e / 1 el -
Rough In � A/4,, j
Low Voltage
Fire Alarm
i n . ASS PART FAIL
Backfill /Grading '
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Other oach /Sidewalk Date 0 / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.