Permit Al 1. CITY OF T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00179
1 II DATE ISSUED: 7/31 /2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S113AB-01201
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505 -16535 ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Voice & Telecommunications.
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 VERIZON STRUCTURED CABLING
15350 SW SEQUOIA PKWY #300 -WMI 20575 NW VAN NEUMANN DR
PORTLAND, OR 97224 ATTN: TONY GIOVINGO
HILLSBORO, OR 97006
Phone: Contact #: PRI 503- 626 -9155
FAX 503- 626 -7284
FEES Reg #: ELE 34- 495CLE
LIC 49350
•
Description Date Amount
[ELPRMT] ELR Permit 7/31/2006 $75.00
[TAX] 8% State Surcha 7/31/2006 $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: A l 2 2 J 1 . A Permittee Signature: _ i?, \ s'
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.
07/28/2006 10:13 NO. 258 P003
F ectriea1 Permit ' tit hl 1 r t.. IF FOR OFFICE USE ONLY
' City Ti alyd R eceived i / r _�^� } /fL�
t3 ' g Dare/B3- 7 � o z --p Permit No. c3L' id/0 (�C! / / /
13125 SW Nall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.598.196 x: ! ~'• Date/By: Other Permit:
Inspection Line: 503.639.4175 JUL 2 0 2006 •.- 1 'I L{ Date /B Tuni El See Page 2 for
Internet: www.ci.tigard.or.us - Notified/Method: f� Supplemental Information
1 j, w. . ,•,,.:r: ,-..., ..,;- - •� • s rte: : -- - - - :t:: .1 • „ . .u.. ,. - -
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� l.. 1 I I . ... �, ,.....,, e��.�ln . t 4 r v.. ,.�.. ..�ii.l , 1. I f.. __ •.,t • J..II 1,.1 - - -
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�' : ll1:111filLitdl. .� } t!1 i `, ^.... ..r..- ,;:;;i; .:li -: :Vr rid -�'L •T riE._._i:..-.- ...., � I � I I I �i ; I 1 , ��� �� Ann
:
❑ New construction ' •l i .. i it. 1 f��:. as , repl?t ,tent • Please check all that apply: sue..:
•
❑ Demolition ❑ Other: ❑Service over 225 amps, ootlam'l ['Hazardous location
;:; 7 ., _ i !:, G . _ ,, „ -a': a^ i!�cT ' ❑Service over 320 amps - rating
['Bulldog over 10,000 sq. ft.,
V, � li .. • -. y; . i t ic c y tr t ; 1 1 a r „ { `I' j j.i i of an-fam ly dwellings more new resident
. .f '� - �' � • .:a -i: i ' � - • , y,L' . { , . 1 • -' L ' : f 1d 2 dwlls 4 or 8
0 1- and 2 - family dwelling C Commercial/industrial El Accessory building ❑ marline' over 600 volts rrline' units in one structure
El Multi family ❑Master builder ❑Other ❑Building over three stories ❑Feeders, 400 amps or more
- . Multi ;' !t m i . . M ; il Ip ;,;i,a -- ❑Occupant load over 99 persons ❑A'lanufactured structures or
,
: :!i• :1:: 1 •;::r 1 t . '• : :, 1 : n i _ ;1 _ :; - =` P_ `a•s -4 ;42F!l,ii , ` -Fli•� RV park
�_...• • .. ..... ..- _ F-:_.1 @:• - u11hIN �i =:ia:i.� - - . � < � . r. .�, ,- f5 --� Egress/hP,htlIISPlan P
❑Health -care facility ['Other: lob no.: Job site address: k � /2_45 � Submit,, sets of plans with any of the above.
City /State/ZIP: "C`Gr i s oR SILZA The above are not applicable to temporary construction service.
t.
li;il : ill' : _: - -. 4. ; ;. . fir= !Till; = • -; 7 -4 . ,�
Suite/bldg. /apt. no.: Project name: 5p,( ‘1, { I_.;. -.. i'.� , , >: rs�....._•. =.. ,..�
Descrtpdon Qty. Fee. Total
Cross street/directions to job site: 5� AUm g� New residential single- or multi - family dwelling unit
Includes attached garage -
k
7t.'' 1 k4 1,000 sq. ft or less 145.15 - 4
Subdivision: I Lot no.: Ea. add'1500 sq. ft or portion 33.40 1
fax map/parcel no. Limited energy, residential 75.00 2
w or. :;: r!p c;� { uu;lt i�l:' :ij i'ij rtU,,; , a Intuited energy, non 75.00 2
~ flf0 ii i is�lll 1! i i. +7...:.= '•5y 1. ,.:{ ,il ppg igiiy { { p
:'endiiiiIii r nar *nodular ;�; tt fl t !!!!f�; - ; s „;; •..::in::t + f`' ������fitltif ';;'�' Ij�lllt't(I''" Each ufactiaed or d
i:�,a,unuri i„✓1' P•.,,;, , 11 ! {. 1 IIIIL,.,
\ la S \ AU v 1 0NtE Rr�� * ��{s '`PalE dwelling, r fe service feeders Installation, 90.90 2
� Y l Services or Ceeders Installation, alterattOA, and/or twJOCadon
200 amps or less 80.30 2
PLt f I � �a,xrm: �..:•;. 'd' �] ;.1•�*m;f;..;; .I tl .. 111;: ��' "fi 7"ori, -� 1 �� 201 Sups to 400 amps 106.85 2
�u.rti� a LIP. :. _ itul 1. • 11_i;:.t,.. ;Niiii
li: %` 6 G kin` , �,a- w: F n_, _: C x11 ._•2d:6 lf#NNl1 . "!!� 401 amps to 600 arts 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 annps or volts 454.65 2
Keconnect only 66.85 2
City /State/ZIP: Temporary services or feeders Installation, alteration, and/or
Phone: ( ) I F ax: ( ) relocation
J 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 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 circuits - sew, alteration, or extension, per panel
111 1 JV B 1 1. ; ��i .v it • `' ijii ii?:y ?r : • . , . R.. ,,_ : I;j ear ... '; A Fee for branch circuits with
ii t. P ru �;w F7� "•Wt;` ; -r -.� 1� c aid�llldt_ _ service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee far branch circuits
Contact name: without service or feeder fee,
46.85 2
Address: first branch circuit
Each add'l branch circuit 6.65 2
City /State/ZI: Nlliscellaneous (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 cut tiit(s) or limited-
_r2 ;i`.- r6 L,... = ._ •:go4iR " TIjil l uijuiiiii i li {jl Ti1 IFFEI!;!i p s i ;"J . " panel, alteration, or
.2" ` � � _ ..,i � d, -. t.. '. utrlt•- � II l Ir.a:G;: C
e_c..4_. � �.._ ....... .._.. E = - -i v m I t .,. - I�rt,l•- I n.�.,.. 1�� � -..:c;a 6ner�l t0
Business name: \\ ,. xaoi s --2VC�1;�D extension. Describe: Page 2 7 J - 2
Address: ll ,‘ss 5 ‘sJ esJy„it t \u 5 pjL� Each additional inspection over allowable In any of the above
Per inspection 62.50
City/State/aJP: g n ` `\- min) Investigation per hour (1 hr n) 62.50
Phone: (503) ten.,_ ns \ S Fax: (5a3) 42b....7Zg L-\ Industrial plant per hour 73.75
111/11 {t 1 1111y ''11tH{! "; ii `'-i . ,'.ST. Pau . } /so. j lL'.'. /ill' '
1111111 •"
CCB Lic.: y \35o I Electrical Lic.31k.wt c Suprv. Lic.: Subtotal a
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) Ca
Print name 1 I Onto:
•
Authorized signs f . ` ' _..k > , i TOTAL FERMIT )FEE `
N This permit application wires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: ■ G `A \* 'x�p Date: 7_47 -06 • Fee methodology set by Iri- County Building Industry Service Board
•• Number of inspections pa petmtt allowed.
is\Bui115cg\PerrAsV ].0 -Fete itApp.doc 1210i 440- 4615T(10X12/COM/wBB
CITY OF TIGARD
A
BUILDING DIVISION PERMIT #: ELR2006-00179
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/31/2006
Phone: (503) 639 -4171 "Olt
Inspection Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE: 10/31/2006 TIME: 7:01AM PAGE: 37
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505.16635 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SAFECO
DESCRIPTION: Voice & Telecommunications.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: VERIZON STRUCTURED CABLING PHONE #: 503
Inspection Request Scheduled For: Date: 10/31/2006 Pour Time:
Code # Inspection Description - • Contact # Message
135 Low - age 039050.01 503 -504 -7401 Y •C...:. • •• •• - • _ structions:
/\,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� : 1 \ 1 4 L & Date: 1 8• 1 6‘ Phone #: (503) 718- 2440
CITY OF TIGARD -
BUILDING DIVISION • - PERMIT #: ELR2006 -00179
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006
Phone: (503) 639 -4171 cI�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/20/2006 TIME: 7 :01AM PAGE: 61
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505 - 16535 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SAFECO
DESCRIPTION: Voice & Telecommunications.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: VERIZON STRUCTURED CABLING PHONE #: 503 - 626 -9155
Inspection Request Scheduled For: Date: 10/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 038572 -02 503-888-0214 N
Corrections /Comments/ Instructions:
N• sr •
? '9 Co 11 -1-0 ?
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
►A FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( Date: # 1. dO Phone #: (503) 718- 214,
CITY OF TIGARD
V
BUILDING DIVISION PERMIT #: ELR2006-00179
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s_' wo F 'I L ,
INSPECTION WORKSHEET FOR DATE: 8/17/2006 TIME: 7:01AM PAGE: 66
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505.16535 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SAFECO
DESCRIPTION: Voice & Telecommunications.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: VERIZON STRUCTURED CABLING PHONE #: 503.62E-9155
Inspection Request Scheduled For: Date: 8/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 035130 -01 425 -231 -3926 N
Corrections /Comments /Instructions:
cg % L % s in a,ppab vi € & �tv ,.
•
C�
4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr Wee) Date: 1.11 tit Phone #: (503) 718 - i+1ii4.-