Permit C ITY O F TI CARD ELECTRICAL RESTRICTED ENERGY PERMIT
I,1 DEVELOPMENT SERVICES PERMIT #: ELR2005 -00130
VIII 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/24/2005
PARCEL: 2S115AA-OTOOA
SITE ADDRESS: 16055 SW 108TH AVE 100 CLUB HOUSE ZONING: R -25
SUBDIVISION: OAK TREE APARTMENTS LOT: OOA JURISDICTION: TIG
Project Description: 2 systems, voice and data, protective signaling.
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
OT2 LLC ESP TECHNOLOGIES
5437 ROSALIA WAY SUITE 100 7929 SW BURNS WAY STE. F
LAKE OSWEGO, OR 97035 WILSONVILLE, OR 97070
Phone: 503- 620 -4373 Phone: 503- 628 -4195
Reg #: LIC 73872
ELE 34- 269CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/24/2005 $150.00
[TAX] 8% State Surchar€ 5/24/2005 $12.00
Total $162.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 95 - 001 -0100. You may obtain copies of these rules or dire que tiaRs to NC at 503 - 246 -6699.
Issued By: j� � i ./ Permittee Signature:)
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
"\\D`-A _.
Electrical PermitrApplioatio'n FOR OFFICE USE ONLY
City 0)F Tl and Ft L L. 11 ® R eceived
g
Date/By: ' c 2 d 5 6 ' Permit No.: » .2003-_. (
3125'SW Hall Blvd., Tigard, OR 97223 Plan Review
9 � s. \ Other Permit:
Phone: 503.639.4171 Fax: 503,598.19604 2005 M Date/B
Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.ci.tigard.or.uCITY OF TIGARD Notified/Method: IIM Supplemental Information
0 To .'3t a- - - ro ' 6 - - ssaM4We, ,�»ap� - a ':„;r a. ",: �r :a 'gia'fr: 441 ,. a '
6';1 ;.: ,,, . . , ; •
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,n,� �$t� .lcts � ��,:5�'4S. .� ..,.,� -ro - �in �i' a': ��i�4"- :'u „�se;.. '-�. .' " r<i a.- ss,,; �'t�."�"r#i,.a,.�an..��+.t" .,.a,r.e� , ...� . , .. -
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other:
Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
fa t P , .;. ..'. ;3,; r. :z< x, : aa _ , ;` "�.i, "^'Er ." rt 4 .( ° {�,;eY`,".;:
r . , 4 ; lejiM a edigiaC-€T -„,„"- i PP of 1 -and 2- family dwellings 4 or more new residential
T ,, 0 0V.4 00 - 00- i a�uwx rnnit ..m- *4444100,0000,0444. + , i ,,,.. -.' i «., ,ti' .
❑ 1- and 2- family dwelling i8 /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: DOccupant load over 99 persons DManufactured structures or
gag P.-kr." y :r" 1:: -cWa u� .p�€ �, :�' .� - 5 + y ew r :: .; ,!-m s '� ? - RV park
:I® SI C, ORMATIQ ,a4u , -� OG O Fi . X. ❑Egress /lighting plan P
5
/ 1//1 / /art � 5/; 1 to/ EHealth-care facility ❑Other:
Job no.: l _1 (,r Job site address: V V -+� - Juv / U ��� Submit 2 sets of plans with any of the above.
City /State /ZIP: / / y et r� ,( The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name �/ r Ct �ry t� �- / /� �� ? l ' S_GHt � D) }Ea <:
/` + a4 ✓•'�+ti ascription Qty. Fee. Total **
Cross street/directions to job site: `) l '�tl, New residential single- or multi - family dwelling unit.
Ut l Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'1 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: _ _ Limited energy, non - residential 75.00 2
:� fi B r „b ��az .��- ae. t �t� �� =°>r£ q„ x :y• ... -.
" , Dk S.C�t1'' 1 t TX .' 1 § C )F W,O a ;, S `. i . 4Th r >� (, ; ; ,�,� � r � ��'�� � , ,,,,• Q,,,a ���.; ���"� "�o-w � - „, Each manufactured or modular
Q .1 dwelling, service and /or feeder 90.90 2
ail ..<-2- a r /1/� I111 94 / (6C C»c 64 1P Services or feeders installation, alteration, and /or relocation
if 200 amps or less 80.30 2
y , .., n ,. x. x s rw,:.r „ 201 amps to 400 amps 106.85 2
; act% { sip r = v*i r .i�`wt*1 G'u� a ' z:, l ,2' ?.., "' ; P P
Er ( R ®„P E TI" OQVIYEIi '` =a 4 Ft 5 : a .'1 & ®1' EIW r1NT .. "
I .mss ��.xG ay...• ��'^ ..� -. _,,, ,�� °' %ak 401 amps to 600 amps 160.60 2
Name: ` c° Q k + �'
r '� fi tr , f �.- (tik A / 4 601 amps to 1,000 amps 240.60 2
Gf
Address: l G Of / /0/ /fih f!-e_ • - - Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: 7\ /.`; �i Temporary services or feeders installation, alteration, and /or
r r 5 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 t0'ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 - 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
.z ": , � ° � . ;; + :..v 4; ra.� ; _ �; r i e ":r:''«`"` A. Fee for branch circuits with
4 s �#° ,, ,,.� " r�s ki �® C()1� C' "P�RSOIt,`; �' �°
�, x,..�:. service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: • without service or feeder fee,
each branch circuit 46.85 2
Address: E ac h a branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
' ° ° ""s i a � . �l s 7 � ' `4 ., � otl t. `�' .: " O.9 t ener anel, alteration, or
` ._.. , 4 w: bG® RA` T0$ m , *:..'x ... , t gy P
.H'>�a',�5'a! "a r ,` , ��. � .�.,c.:�,x � a sMib� . �� ",<'?�+�',.'� � �.�.'Y+�„s�
extension. Describe: Page 2 � 2
Q Business name: 5 � / Aak l o -' ! eS iE"
I // C Each additional inspection over allowable in any of the above
t - . Address: 7 2 - 5(2) /. eu -ik S : /f Per inspection 62.50
1 .
1 City/State /ZIP: /� 9 � L c e 7 / �2 76 ? 0 Investigation per hour (t hr min) 62.50
n I r � Industrial plant per hour 73.75
Phone: ) ax: _ , , T < -m,., . - r -, .��R4,±; ;'-
,\ �03 Co Z ' � � Y�g) ��� �O LZ+', =`:3I PEI. MITT E+�L+' *x is . "' . , , . .. _
L. CCB Lic.: 73 IZ Electrical Lic.: . z (,f 4 Suprv. Lie.: 3;ys 7_ Subtotal /5 (90
I - -o (. Plan revi 25% of elmit fee
Suprv. Electrician signature, required: LT.,-� �� '!-f ( p )
[ I State surcharge (8% of permit fee) I ' 7t 60
Print name: �"A,� \--cc( �"� Date: 5/2.iltS-
TOTAL PERMIT FEE / &Z CO
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i \Building \Permits \ELC- PermitApp -doc 12/03 440- 4615T(10 /02 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
=., ro��w: � as�u ',""'r'" x�+�vx:.tt�:"i Ntingl t Uaglike , *,E,;:
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:
Fee for each commercial system $75.00
(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
I Outdoor Landscape Lighting*
Protective Signaling
-. n ` Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
r\Buildmg\Pern its\ELC- PemutApp doc 04/03
OF TIGARD •
111111 DING DIVISION PERMIT #:
ELR2005-00'130
13125 SW Hall Blvd., Tigard, oR 97223 DATE ISSUED: U24 /2005
Phone: (503) 639 -4171 .4404 A
Inspection Requests (24 Hrs.): (5►3) 639 -4175 _
INSPECTION WORKSHEET FOR DATE: 9/9/2005 TIME: 7.07AM PAGE: 7€
SITE ADDRESS: 16055 SW 108TH A .. 100 CLUB HOUSE CLASS OF WORK:
SUBDIVISION: OAK TREE NO .2 AP "TMENTS LOT #: OOA TYPE OF USE:
PROJECT NAME: OAK-TREE II APARTM• TS
DESCRIPTION: 2-systems, voice and data, protective signaling.
OWNER: ''0T2 LLC, PHONE #: 503
CONTRACTOR: E P.TECHNOLOGIES PHONE #: 503 - 4195
Inspection Request Scheduled For: I -te: 9/9/2005 Pour Time:
Code # Inspection Description Con' irm # Contact # Message
199 Electrical final 0152 ' -01 503-88€ -2082 1
Corrections /Comments /Instructions:
n PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
.,i / p
Inspector: Al Date: ? - ? ' / Phone #: (503) 718 -