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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT l DEVELOPMENT SERVICES PERMIT #: ELR2006 -00201 DATE ISSUED: 8/24/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S114AA - 00200 SITE ADDRESS: 16285 SW 85TH AVE 302 ZONING: I - SUBDIVISION: DURHAM HALL BUSINESS PARK LOT: JURISDICTION: TIG Project Description: Data/Telecommunications. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: BIRKEMEIER, BRENT T /JANET D TRS G G TELECOMMUNICATION CO BY THE BIRKEMEIER FAMILY TRUST 121 SW SALMON ST 10573 SW NAEVE ST STE F -1 TIGARD, OR 97224 PORTLAND, OR 97204 Phone: Contact #: PRI 503- 295 -2922 Reg #: ELE 34- 248CLE FEES LIC 59692 Description Date Amount [ELPRMT] ELR Permit 8/24/2006 $75.00 [TAX] 8% State Surcha 8/24/2006 $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: = 3 S' � Permittee Signature: ,/, • . l 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. Electrical Permit Auplicati Q — ( 0 ill l FOR OFFICE ESE ONLY Ci of Ti and Received G 6 - J • t Y g Date/B . /...... �� ° 13125 SW Hall Blvd., Tigard, OR 9722 t Pl R ev i ew Permit N II !` 2006 Other Permit: 503.639.4171 Fax: 503.598.1' e l U DateB . f I G n It I) Inspection Line: 503.639.4175 Date Ready/By: EMI El See Page 2 for I www.tigard- or.gov �� Notified/Method: Supplemental Information 0 T T \Tt j"1 PLAN REVIEW �T�� ❑ New construction [Addition /alteration /replacement • Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling FA Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 - ", Job no.: Job site address: 14285 si o z I Six or or more. occupancy. �� 3 ❑ Six or more residential units. ❑ Recreational vehicle parks. City / State/ZIP: I G fj1—ts ©R, ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg /apt. no.: Project name: 16 t tj L g T-' ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qtr. I Fee, I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 1 Limited energy, multi - family 75.00 2 1 J .6._e_ (A-T # r residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/ State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 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 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee Contact name: , 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: GG (/A pM /t. (u � r 0 , 44 . 76 , 1/4. 4 i . Signal circuit(s) or limited - energy panel, alteration, or Address: 12 j S 0 2 Att f0 ,,,, sGLt re.._ ? ` extension. Describe: 1 Page 2 2 City/ State/ZIP: ePd R....4't4 a O Q R 7 ZD [1 Each additional inspection over allowable in any of the above Per Z 9 5 - 2(422, ( G) 2 5 d 8 p 6 Investigation 62.50 Phone: (' ) , Fax: S 3 Investigation per hour (1 hr min) 62.50 CCB Lic.: 596q2 Electrical Lic.: � '(,(, Z4� Suprv. Lic.: LEA Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: � Subtotal: Plan review (25% of permit fee): Print name tE£� Q au G2 A Date: $ ; 24 —o6 State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp,doc 05/23/06 410- 4615T(I1 /05 /COM/WEB - Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 • Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. j COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system • (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* , • ❑ Protective Signaling 1 ` ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Pmnits\ELC- PmnitApp.doc 03/23/06 CITY OF TIGARD BUILDING - DIVISION PERMIT #: ELR2006- 00201 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/24/2006 Phone: (503) 639-4171 '' ICI • Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7 :00AM PAGE: 24 l i SITE ADDRESS: 16285 SW 85TH AVE 302. CLASS OF WORK: SUBDIVISION: DURHAM HALL BUSINESS PARK LOT #: TYPE OF USE: PROJECT NAME: DIGI WEST DESCRIPTION: Data/Telecommunications. OWNER: BIRKEMEIER, BRENT T /JANET C) TRS, PHONE #: CONTRACTOR: C r C TELECOMMUNICATION CO PHONE #: 503.295 -2922 Inspection Request Scheduled For: Date: 8/28/2006 Pour Time: Code # Inspection Description Confirm # . Contact # Message . 135 Low voltage 035648 -01 503 - 295~2922 N S Corree ons /Ci tions: g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: c ° t O6 1- c Date: %' O Phone #: (503) 718-