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Permit
'. CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT i h DEVELOPMENT SERVICES PERMIT #: ELR2006 - 10031 :.� � I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/30/2006 PARCEL: 2S101 DC - 00200 SITE ADDRESS: 13535 SW 72ND AVE ZONING: C - SUBDIVISION: 72ND AVE OFFICE BUILDING LOT: JURISDICTION: TIG Project Description: Network cabling. 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: INSTRUMENTATION: OTHER: NETWORK X TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC NW PROPERTIES LTD PTNSHP CAPITOL DATA & COMMUNICATIONS 9665 SW ALLEN BLVD STE 115 11401 NE MARX ST. BEAVERTON, OR 97005 PORTLAND, OR 97220 Phone: 503- 626 -3500 Contact #: PRI 503- 255 -9488 FEES Reg #: ELE 26- I054CLE LIC 142457 Description Date Amount [ELPRMT] ELR Permit 4/6/2006 $75.00 [TAX] 8% State Surcha 4/6/2006 $6.00 REQUIRED ITEMS AND REPORTS 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: ) c / J, Permittee Signature: c 2Ntc 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 card 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. ' lect Permit Application en Received FOR OFFICE USE ONLY a` .' -- � r Permit no.: e �. /d13 / Date/By: / (/V City of Tigard Ira Plan Review Other Permit: 13125 SW HALL BLVD., TIGARD, OR 972 X10! „LL ,i�I Date/By: Phone: (503) 639 -4171 Fax (503) 598 -1960 VtAR O CITY OF TIGARD Date Ready/By: Juris: II SeePage2 for Inspection Line: 503- 639 -4175 cap Notified/Method: Supplemental Information Internet: www.ci.tigard.or.us OF-��a ©N' TYPE OF WORK ` ``4 ( 'a D`v` PLAN REVIEW U New construction U Addition/altei> }r iTacem Please check all that apply: ❑ Demolition • ❑ Other: ❑ Service over 225 amps, comm'i ❑ Hazardous location CATEGORY OF CONSTRUCTION ❑ Service over 320 amps - rating ❑ Building over 10,000 sq.ft. • Li 1- and 2- family dwellin U ,Commercial /industrial U Accessory building of 1- and 2- family dwellings 4 or more new residential ❑ Multi- family ❑ Master Builder ❑ Other ❑ System over 600 volts nominal units in one structure JOB SITE INFORMATION AND LOCATION ❑ Building over three stories ❑ Feeders, 400 amps or more Job no.: C60152 Job site address: 13535 SW 72nd ❑ Occupant load over 99 persons El Manufactured structures or ❑ Egress /lighting plan RV park City / State/ZIP: Tigard Or 97233 ❑ Health -care facility ❑ Other: Submit 2 sets of plans with any of the above. Suite/bldg. /apt. no.: 3rd floor Project name: Optilink The above are not applicable to temporary construction service. . FEE SCHEDULE Cross Street/Directions to job site: Description I Qty. J Fee. I Total I ” New residential - single or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: - 1000 sq. ft. or less $ 145.15 4 Tax map /parcel no.: Ea. Add'I 500 sq. ft or portion • S 33.40 1 . DESCRIPTION OF WORK Limited energy residential $ 75.00 2 Network cabling Limited energy, non - residential $ 75.00 2 Each manufactured home or modular LI PROPERTY OWNER - 1 U TENANT • ' . dwelling, Service and /or feeder $ 90.90 2 Name: - Service or feeders installation, alteration, and /or relocation 200 amps or less $ 80.30 2 Address: 201 amps to 400 amps $ 106.85 2 401 amps to 600 amps $ 160.60 2 City / StatelZIP: 601 amps to 1000 amps $ 240.60 2 Over 1000 amps or volts $ 454.65 2 Phone: Reconnect only _ $ 66.85 2 Temporary services or feeders installation, alteration, and/or Owner installation: This installation is being made on property that I own which is not relocation intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less • $ 66.85 1 201 amps to 400 amps $ 100.30 2 Owner signature: 401 amps to 600 amps $ 133.75 2 U APPLICANT - I • U CONTACTPERSON Branch circuits - new, alteration, or extension, per panel Business Name: A. Fee for branch circuits with service or feeder fee, each Contact name: branch circuit $ 6.65 2 B. Fee for branch circuits Address: without service or feeder fee, each branch circuit - $ 46.85 2 City / State/ZIP: Each additional branch circuit: $ 6.65 2 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 circuits(s) or limited- . . CONTRACTOR energy panel, alteration, or Business Name: CAPITOL DATA & COMMUNICATIONS extension. Describe: • l Page 2 2 Contact name: RAY YOUNGER Each additional inspection over allowable in any of the above Per inspection . $ 62.50 Address: 11401 NE MARX ST. Investigation per hour (1 hr min) $ 62.50 Industrial plant per hour $ 73.75 City /State/ZIP: PORTLAND, OR 97220 -1041 ELECTRICAL PERMIT FEES' . Subtotal Phone: 503- 255 -9488 Fax: 503- 257 -7121 Plan review (25% of permit fee) ' State surcharge ( 8% • of permit fee) CCB Lic.: 48748 jElectrical Lic.: 26 -496C JSuprv. Lic 2834 LEA TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Suprv. Electrician signature, required: days after it has been accepted as complete Print Name: RAY Y•1 ER Date: 03/29/06 • Fee methodology set by Tri- County Building Industry Service Board Authorized signature: **Number of inspections per permit allowed. Print Name: RAY YO b / / CITY OF TIGARD BUILDING DIVISION PERMIT #: - n6— /0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171i°� Inspection Requests (24 Hrs.): (503) 639 -4175 `'II INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 1 3S3S 7 2 � CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: (� e '1 PHONE #: CONTRACTOR: 1 r L jox. . PHONE #: Inspection Request Scheduled For: Date: q - 3 _ 0 c Pour Time: ode # Inspection Description Confirm # Contact # Message 1 1 g 9 at- h n� - Corrections /Comments / Instructions: • C/ A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Y V e, L Date: 3( .(5 Phone #: (503) 718- 24