Permit •
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00125
.ICI
'--L 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/20/2005
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: Fire alarm & data.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
OT2 LLC FIRE & SECURITY GROUP LLC
5437 ROSALIA WAY SUITE 100 2538 NE EVERETT ST.
LAKE OSWEGO, OR 97035 CAMAS, WA 98607
Phone: 503- 620 -4373 Phone: 360 - 833 -9938
Reg #: LIC 153226
ELE 37- 338CLE
FEES SUP 3862LEA
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/20/2005 $150.00
[TAX] 8% State Surcha 5/20/2005 $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 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: v p Permittee Signature: %? `Z. his
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.
May 20 05 11:51a Rick Stevenson 360-833-1727 p . 5
-• tr
Electrical Permit A - FOR OFFRA t:SF. ON1..\
City of Tigard Pal
0 7005
Datc/BY: ' ) ...,e, &5 V--1 nit N°. : 6(-7i ii...
13125 SW Hal1131vd., Tigard, OR 972231Nig 2 - - Plan Review
Phone: 503.639.4171 Fax 503.598.1960 Datc/By: ''''' '''INitre:/; '1.• °therPelnut - ad /4 (
UY OF T1GA RD „,,,
Inspection Line: 503.639.4175 -- .11" "i 1: Date Reedyn3y:
3...5q - RI See Page 2 for
Internet: www.ciligard.or.us Notified/Method: - T - 1(r Supplemental Information
null nli\li; DIVISION .. _
New construction 0 Addition/alteration/replacement Please chedc all that apply:
Dscrvice over 225 snips, comm'l 011azardous location
0 Demolition 0 Other. 0 Service over 320 maps - rating CIBuildng over 10,000 sq. ft.,
CATRC9R OP CONSTRUCflON of! and 2flunity dwellings 4 or more new residential
0 1- and 2-family dwelling Commercial/industrial 0 Accessory building °System over 600 volts nominal units in one structure
DBuilding over three stories OFeeders, 400 amps or more
C] Multi 0 Master builder D Other: 0 occupant load over 99 persons CI Manufactured structures or
, '.: 1 ••-• :, ::: ':. : ''.; ::'•::: -.. ::::;:, 4011 . ***F40**004: 1 *,.* - ,10.0*Ty*. : ; ;.... ' -..:: . :- ....: ::: ElEgress/lighting plan RV park
Job no.:4fitI1Er I Job site address: /40$ s / je ,r(etiii5 0Health-care facility 00ther
- , , \ Submit 2 sets of plans with any of the above.
City/State/ZIP: Thi 0 p_ . (124cgil floc 5 -i The above am not applicable to temporary construction service.
"-.,, ': ::‘::.'„; •,i, ,:::;:', -: , ::::. '.-:".` • :•': ' .....::••:' . ;... :' ..: :IF , '...
Suite/bldg./apt. no.: &It f Project name: ..0A K-rgeE fte rs :.
Description I WY- I Yoe 1 Toed 1 **
Cross street/directions to job site: PI / 0 , r--- 1 . ( C tai t i o ci si- . - - ) New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea.. addl 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
:',•,: : :.: ::' '; : • ', : '-'... : : '.• :-.• •.: '::'..• .•••:-DESOB*1701,1;,-Of *OW .;: : ::::;; ::,1 '.".. : .::- .::- : ;• .. , - ...;:i: . Each manufactured or modular
e
bipiA-pin Arab 13A--t "ridril U dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2 201 snips to 400 amps 106.85 2
. : - . . , . . • •
s t 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
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
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 - new, alteration, or extension, per Panel
0: kiPti6141 : ''• j. 4:' .::: ,t 2$4*,ii. .•,:"•:,:-? A- Fee Air branch acui with
sem= or feeder fee., each 6.65 2
Business name: ft. k SL-Caccr( &rebid. Li C..• branch circuit
B. Fee for brarich circuits
Contact name: ( C. STF N.1 without service or feeder fee, 46.85 2
each branch circuit
Address: a_63 N.e - EvEg_e -f. Each add'I branch circuit 6.65 2
City/State/ZIP: Co 13 S (A) A 9 g607 MisceRaneous (service or feeder not inclnded)
Pump or irrigation circle 53.40 2
Phone: (ad) ) -i9 3g 1 Fax: ( 3100 ) 8 33-1 7..)- 7 Sign or oudine lighting 5340 2
E-mail: Signal circuit(s) or D limited- /) /J / jP
:::.T.' ... • -. - ,1. . : - .. s ., co t■dfiatt011t. :-,::::'::',' : '.- ..•.':' . 7 ' - :':: ' :'•'; I e
,' :: : ,:.: i'. : , .: energy Panel- alteration, or tf /
- - , 1'
xtension. escribe: Page 2 ... )5 2
i)..."'"
Business name: 34 F _ AS ae
Each additional inspection over allowable in any of the above
Address: Per inspection 62.50
City/State/ZIP: Investigation per hour (I hr min) 62.50
Phone: ( ) [ Fax: ( ) Industrial plant per hour 73.75 i ._.1% -
, - : " '''.•:'': •• ;::':: BIZ PERMIT :: EEF /).- ti
CCB Lie.: 6.5 gac Electrical Lic.:5 S.. . Lie.: 3 Subtotal 3
Suprv. Electrician signature, reqttired: {6 : r --- --------: . Plan review (25% of permit fee)
, .
t • I
a
Print name: R;c4iti sT.004-so,--„, Date: -z)19_06
, State surcbarge (8% of permit fee) 0.'
TOTAL PERMTT FEE 1
-4......1:: .......)::: :....
Authorized signature./,. .;, . (
.t ) ,V ,--- E-- -. - - - . - . 2.----.-N This penult application eiqpires ir 5 permit is not oLtained within ILO
days atter ft has been sieeePted as comPiete
Print name: ' ( _ STC.:VG A/So /.1 Date: 5/9_5 1 0 5 * Fee methodology set by Tri-County Building Industry Service Board
** Number of' inspections per permit allowed
N
.C1 -Y OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00126
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/20/2005
Phone: (503) 639 -4171 :aN�ii�i�ll'i
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHE \FOR DATE: 91912005 TIME: 7:07AM PAGE: 81
SITE ADDRESS: 16055 SWV1 );TH AVE t0 - CLUB HOU -SE . CLASS OF WORK:
SUBDIVISION: L OT # TYPE OF USE:
OAK TREE NO. 2 APARTMENTS OOA
PROJECT NAME: OAK -TREE II AP RTMENTS
DESCRIPTION: Fite -alarm & data.
OWNER: OT2 L P HONE #: 503-620-4373
CONTRACTOR: FIRE & SECURITY GRC P LLC PHONE #: 3%833.9938
Inspection Request Scheduled For: Date: 919/2005 Pour Time:
Code # Inspection Description onfirm # Contact # Message
199 Electrical final 0 245-01 503 - 888-2082 (, Y
Corrections/Comments/Instructions:
,,\PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspecto : i Date:
5 Phone #: (503) 718-
;