Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
-
h i ° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00287
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/18/2007
PARCEL: 2S 113AD - 01900
SITE ADDRESS: 16640 SW 72ND AVE B10 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 009 JURISDICTION: TIG
PROJECT: VERIS
Project Description: Install low voltage 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: 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 CAPITOL DATA & COMMUNICATIONS
15350 SW SEQUOIA PKWY #300 -WMI 11401 NE MARX ST.
PORTLAND, OR 97224 PORTLAND, OR 97220
Phone: Contact #: PRI 503- 255 -9488
FAX 503- 257 -7121
FEES , Reg #: ELE 26- 1054CLE
LIC 142457
Description Date Amount SUP 2834LEA
[ELPRMT] ELR Permit 7/18/2007 $75.00
[TAX] 8% State Surcha 7/18/2007 $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. ' 6.6699 or 1.800.332.2344.
Issued B iii j //i Z / 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. 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.
FOR OFFICE USE ONLY
4— Elet , trical Permit Applie p-; � Received
��, � - r� y-, /� 5 , Permit no.:
!i ` C/ f}aa o i ,. Date /By: T i l/ 1 G L2z oo — 002
City of Tigard Plan Review
13125 SW HALL BLVD., TIGARD, OR 97223 JUL 1 8 200,4 ..1V Date /By: Other Permit: 13 t 1 /1 r�., J
C
Phone: (503) 639 -4171 Fax (503) 598 -1960 OF TIGARD Date Ready /By: Juris: / ❑ See Page 2 for
`'
Inspection Line: 503 - 639 -4175 � ?•° i i ci n Notified/Method: _ 11 _ Supplemental Information
Internet: www.ci.tigard.or.us BlltLDttis f l iiSaON
TYPE OF WORK PLAN REVIEW
❑ New construction U Addition/alteration/replacement 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.
❑ 1- and 2- fancily dwelling U Commercial /industrial ❑ 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.: C70284 Job site address: 16640 SW 72nd ❑ Occupant load over 99 persons ❑ Manufactured structures or
❑ Egress /lighting plan RV park
City/State/ZIP: Tigard Or 97244
El Health-care facility El Other:
Submit 2 sets of plans with any of the above.
Suite /bldg. /apt. no.: Project name: Veris Expansion The above are not applicable to temporary construction service.
FEE SCHEDULE
Cross Street/Directions to job site: Description I Qty. I Fee. I Total I "
New residential - single or multi - family dwelling unit.
Subdivision: Lot no.: Includes attached garage.
1000 sq. ft. or less $ 145.15 4
Tax map /parcel no.: Ea. Add'l 500 sq. ft or portion $ 33.40 I
DESCRIPTION OF WORK Limited energy residential $ 75.00 2
Network Cabling Limited energy, non - residential $ 75.00 2
Each manufactured home or modular
❑ PROPERTY OWNER 1 ❑ 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/State/ZIP: 601 amps to 1000 amps $ 240.60 2
Over 1000 amps or volts $ 454.65 2
Phone: Fax: Reconnect only $ 66.85 _ 2
503- 295 -5555 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
Owner signature: Date: 201 amps to 400 amps $ 100.30 2
401 amps to 600 amps _ $ 133.75 2
❑ APPLICANT I ❑ CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
Business Name: A. Fee for branch circuits with
service or feeder fee, each
branch circuit $ 6.65 2
Contact name:
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, Inc. extension. Describe: Network / Page 2 2
Contact name: Each additional inspection over allowable in any of the above
Per inspection $ 62.50
Address: 11401 NE Marx Street Investigation per hour (I hr min) $ 62.50
Industrial plant per hour $ 73.75
City /State /ZIP: Portland, Oregon 97220 ELECTRICAL PERMIT FEES*
Subtotal 7S. 612
Phone: 503 - 255 -9488. A bfil IC Fax: 503 - 257 -7121 Plan review (25% of permit fee)
r 4 6 X ' t i State surcharge ( 8% of permit fee) r Q 0
CCB Lic.: 1 (Electrical Lic.:26 1045CLE Suprv. Lic.: 2834 LEA 16II1iL? TOTAL PERMIT FEE 0 0"17
Suprv. Electrician signature, required: This permit application expires If a permit Is not obtained within 180
days after it has been accepted as complete
Print Name: Ray Younger Date: 07/18/07 • Fee methodology set by Tri- County Building Industry Service Board
Authorized signature: / L **Number of inspections per permit allowed.
Print Name: Ray YoungAr
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00287
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/18/2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/3/2007 TIME: 7:03AM PAGE: 49
SITE ADDRESS: 16640 SW 72ND AVE 810 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: Install low voltage network cabling.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CAPITOL DATA & COMMUNICATIONS PHONE #: 503 - 255.9488
Inspection Request Scheduled For: Date: 8/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 053357 -01 971 - 506-3396 Y
Corrections /Comments/ Instructions:
)
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • N 66 Date: p 3 Phone #: (503) 718- 2)44L
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00207
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/18/2007
Phone: (503) 639 -4171 /emu b •
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/27/2007 TIME: 7:03AM PAGE: 59
SITE ADDRESS: 16640 SW 72ND AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: Install low voltage network cabling.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CAPITOL DATA & COMMUNICATIONS PHONE #: 503- 255 -9488
Inspection Request Scheduled For: Date: 7/27/2007 Pour Time:
Code # Inspection Description C. iru # Contact # Message
135 Low voltage 052885 -01 971 - 506 -3396 Y
Corrections /Comments /Instructions:
P ( II •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: of . N t6-+ Date: 1'11'01 Phone #: (503) 718 - VW)