Permit ,:- CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00114
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/1/2007
PARCEL: 2S 113AB -00600
SITE ADDRESS: 16125 SW 72ND AVE BLD.B ZONING: I - L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: PORTLAND VOIP
Project Description: Low voltage voice and 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:
PACIFIC REALTY ASSOCIATES OREGON ELECTRIC GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Contact #: FAX 503 -535 -2763
PRI 503- 234 -9900
Reg #: ELE 26 -95C
FEES LIC 203
Description Date Amount SUP 4460S
[ELPRMT] ELR Permit 5/1/2007 $75.00
[TAX] 8% State Surcha 5/1/2007 $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 or 1.800.332.2344.
Issued By: g /tA ADC Permittee Signature: App ran an
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.
APR -30 -2007 07:18AM FROM -OR ELECTRIC SVC 5035352763 T -450 P.001 /002 F -658
�i 11:a1 rermJ' ti U aL1L!M
Received permit No: � � - 00 114
City of Tigar _ D "�' B �
13125 SW Hall Blvd., Tigard, OR 972 EclVE ' e (i . _ Bate/By: Plan Revie:vv Other Permit:
Phone: 503.639.4171 Fax: 503.598.1 A PR 3 0 2 0 0 e RcadyBy im u! • ® Se 0 Page 2 for
inspection Line: 503.639.4175 Notified/Method: �Supptemeotal infermalion _
Internet: www.ci.tigartior.us —
:, rc,- = ii PLAN REVIEW
tTel?: ; �► Please check a That apply:
❑New construction A • • m . : terra o • atxment °Service over 225 amps, conttn'l ❑Haardous location
❑ Demolition ❑ Other: QServicc over 320 amps - rating ❑Buildng over 10,000 sq, ft, • of 1- and 2- family dwelling s 4 or more new residential
� - CATEGORY OF CONSTRUCTION. in one structure
❑System ova 600 volts nominal units
❑ 1 - and 2- family dwelling ®Commercial/industrial ❑Accessory building ❑Building over three atones ❑Feeders, 400 amps or more
❑Multi- Earnily ❑ Master builder ❑ Other: DOccupant load over 99 persons DManufactured structures or
• . RV park
I. JOB 9171E INFORMATION AND LOCATION ❑Egresslighung plan ❑Rabat: - "
Iob no.: 53560 Job site address: 16125 SW 72 1.1n AVE Submit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OR 97224 - The above are not applicable to temponay construction service. _
FEE* SCHEDULE
Suite/bldg. /apt no.; [ Project name_ PORTLAND VOID _ osaipaoa I QtY. 1 Fen 1 Total J.••
New residential single- or multi- family dwelling unit.
Cross strect/directions to job site: Includes attached garage.
1,000 a4 R Or less 145.15 4
Subdivision: J Lot no.: Ea. add'l 500 sq. It or portion 33.40 1 Limited energy, residential 75.00 2
Tax map/parcel no Li mited energy. non - residential 75.00 2 -
1 DESCRIPTION OF WORK Each manufacaued or modular
_ dwelling. service and/or feeder 90.90 - 2
LOW VOLTAGE VOICE & DATA CABLING Services or feeders installation, alteration, and/or relocation
200 amps orless _ 80.30 2
201 amps W 400 amps 106.85 2
!❑ PROPERTY OWNER ❑ TENANT' amps to 600 amps 160.60 2
• Name: p c' 601 amps to 1000 amps 240.60 - , 2
P 1 �`� ( Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 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 sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 401 amps to 600 amps 133.75 2
Owner signature: - Date: _ Branch circuit' - new, alteration, or extension, per panel
❑ APPLICANT _ I 0 CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fce for branch circuits
Contact name: without service or feeder fcc, 46.85 2
each branch circuit
Address: Each add'I branch circuit _ 6,65 2
City/ State/ZIP: Miscellaneous (service or feeder not )alluded)
_Pump or irrigation circle 53.40 ` 2
Phone: ( ) 1 Eax:: ( ) _ Sign or outline lighting 53.40 2
- E - mail: Signal eirwit(S) or limited -
i CONTRACTOR mew panel, alteration, or 1 Page 2 75. 2
extension. D
Business name: Oregon Electric Group V OI CC It
)Each additional inspection over allowable in any of the above
Address: 1010 SE 11th Ave p inspection 62.50
City / Statc/ZIP: Portland, OR 97214 I westigation per hoar (1 hr min) 62.50
•
Industrial plant per hour 73.75
Phone: (503) 234 -9900 LFax: (503) 535 -2763 ELECTRICAL PERMIT F>� '
CCB Lis.: 203 I Electrical Lic • 2 'SC S . . Lic.: 4460S Subtotal 1 5. DO
Plod review (25% of permit fee)
Suprv. Electrician signature, irgquined: `�` J -- �.k iy I �O )
State surcharge (8% of permit fee) v l
, y ��A� /� / Dote: '• i TOT PERMIT FEE Q , O O
Prink "Ina' 1 , r/ � V ��i• �1L v , �7 / O _
Authorized signature: % r ' r ate permit application expires If a penult Is not obtained wittdn 180
days after it has been accepted al complete
Print burner: a ter: 04/30/07 • Fee methodology set by Tri- County Building indastrY Service Board
Q V �� " Number of inspections per permit allowed.
1:1BulldiaglramnsleLC3'amit .Pp.doc 12103 440.4615TO0102/COwwaa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00114
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5//12007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 __—
INSPECTION WORKSHEET FOR DATE: 5/16/2007 TIME: 7:OOAM PAGE: 69
SITE ADDRESS: 16125 SW 72ND AVE BLD.B CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: PORTLAND VOIP
DESCRIPTION: Low voltage voice and data cabling.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503- 234 -9900
Inspection Request Scheduled For: Date: 5/16/2007 Pour Time:
Code # Inspection Description onfirm # Contact # Message
135 Low voltage 046354 -01 503. 793 -7292 N
!q of Fi NSA L
Corrections /Comments /Instructions:
TE 04L w i LL s O VE14t,V t �t ( Lw A►I..
(CiC Vt.) dcan t 461
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 61 ( ci Phone #: (503) 718 -1 'v
1
CITY OF TIGARD '%r- . `"1 °z22 1
BUILDING DIVISION °� PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: / 1 l
Phone: (503) 639 -4171 ..."44 a �
Inspection Requests (24 Hrs.): (503) 639 -4175 I i / ` /
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1i/2 1 i- c 7) ,A,/ . CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ,,�^
DESCRIPTION: _r- L C,i) l
OWNER CONT ACTORIA2 To A . . CA . PHONE #: `Cl i — Q 410
Inspection Request Scheduled For: Date: �, (� Pour Time:
Code # Inspection Description Confirm # Contact # Message OW NER
Corrections /Comments/ Instructions:
bIG (A41 e) zX b-ro l f-) C.AprzDC Nee - Lc...,
it PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NO® Date: Vi - J° 0 Phone #: (503) 718- 24LIJ