Permit r•-. -' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00073
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/14/2007
PARCEL: 1 S136DD -00900
SITE ADDRESS: 06830 SW ATLANTA ST 200 ZONING: MUE
SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG
PROJECT: COLUMBIA MORTGAGE
Project Description: Low voltage for 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: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MALCOLM ESLINGER ASHLAN COMMUNICATIONS INC.
11575 SW PACIFIC HWY. 7534 N ELMORE AVE
PMB0160 PORTLAND, OR 97217
TIGARD, OR 97223
Phone: 503- 620 -9515 Contact #: PRI 503- 849 -9523
FAX 503- 286 -2158
Reg #: ELE CLE -33
FEES LIC 169323
Description Date Amount SUP LEB3333
[ELPRMT] ELR Permit 3/14/2007 $75.00
[TAX] 8% State Surcha 3/14/2007 $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
Utilit • . '.- enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
r -s or direct quests. s • 0 at 503.246.6699 or 1.800.332.2344.
I / •
-
,
- sued By: . e� Permittee Signature: 1C
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 Application FOR ,OFFICE USE O NLY„
z, , pity of Tigard Date/B /� O� , i40 Pe No.: / ���7, 7j
° 13125 Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
.
Ins Line: 503 Date Ready /By: � pP HI See Page 2 for
T I G AR .. Notified/Method: Su lemental Information
Internet: www.tigard- or.gov �
TYPE OF WORK PLAN. REVIEW
r5New 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 ❑ 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 12 Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 1. 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 ", "l - ", "l - ",
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Job no.: Job site address: 6839 Sw it /G-.l 4a S 4 1 Six or or more residential R occupancy.
7 ❑ Six or more residential units. ❑Recreational vehicle parks.
City /State /ZIP: Q ❑ Health -care facilities. ❑ Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Zap Project name: 6 /46,1/4, e ❑ Service or feeder 600 amps or more.
FEE SCHEDULE.
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Cross street/directions to job site: Description L Qty. 1 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 I
Limited energy, residential 75.00 2
'DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2 • 7 r ° /r 041,ow.v ee o.t I g, 74 residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2 ,
❑, PROPERTY OWNER ❑ -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
Owner signature: Date: Branch circuits — new, alteration, or extension, i er panel
A. Fee for branch circuits with
' ❑ APPLICANT ❑ `CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 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: : ( ) Reconnectonly 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
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Business name: Signal circuit(s) or limited -
ASL\ a./. C()tv.iv. QA x Co. it (' s =,, C • energy panel, alteration, or
Address: 7r3 y A). € /j?o� rive
extension. Describe: / Page 2 75-' 2
City/State /ZIP: A /At, d 0 g 97Z I7 Each additional inspection over allowable in any of the above
' Per inspection 62.50 .
Phone: ( 5-03 ) �. l / - CJ S 3 Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lic.: /6, 83.2 3 Electrical Lic.: aB_ 33 Suprv. Lic.: Lci3333 Industrial plantper hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: is
Print name: ��,/- _,Civi< /q /,/ Date: -.7 y47 Plan, review (25% of permit fee).
State surcharge (8% of permit fee):
Authorized signature: X�_ - TOTAL PERMIT FEE:
Print name:
� �� / / This permit application expires.if a permit is not obtained within 180
i / n / 1 Date: 7 / Y�7 days after it has been,accepted as complete.
x Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440 -46 15T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK;ONLYa
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
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
0 Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
O Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other -
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: \Building\Permits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00073
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2007
Phone: (503) 639 -4171 A ftp l ow� ll�i l h� � .
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7 :01AM PAGE: . 14
SITE ADDRESS: 06830 SW ATLANTA ST 200 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: COLUMBIA MORTGAGE
DESCRIPTION: Low voltage for data.
OWNER: ESLINGER, MALCOLM PHONE #: 503.620 -8515
CONTRACTOR: ASHLAN COMMUNICATIONS INC. PHONE #: 503.849 -8523
Inspection Request Scheduled For: Date: 4/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046634 -01 503 - 897 -8478 Y
Corrections /Comments /Instructions:
PAS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
, Inspector: tgt-E
Date: 1 . 4 1r1 NI Phone #: (503) 718- 7-111110
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2007 -00073
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14 /2007
Phone: (503) 639 -4171 1 /aNarV�Ql &j�"�
Inspection Requests (24 Hrs.): (503) 639 -4175 ��! I 'I I..
INSPECTION WORKSHEET FOR DATE: 4/16/2007 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 06830 SW ATLANTA ST 200 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II ! LOT #: TYPE OF USE:
PROJECT NAME: COLUMBIA MORTGAGE
DESCRIPTION: Low voltage for data.
OWNER: ESLINGER, MALCOLM PHONE #: 503 - 620.9515
CONTRACTOR: ASHLAN COMMUNICATIONS INC. PHONE #: 503-849-9523
Inspection Request Scheduled For: Date: 4/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046551 -01 503 - 997 -8478 \ Y
Corrections /Comments /Instructions: 0 Q ' YCLIJ N 1 ERIE -W t OM �� 6i cA L
5 ) 1 \ 1 c cetAb v' a.. rr ('Ic W g-1
OE Lta- cA L e ANItit),
•
IN PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
rsFAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector,: G MA LE Date: Phone #: (503) 718- 1'141
'1-14c)---
CITY OF TIGARD
,ff
BUILDING DIVISION / PERMIT #: ELR2007-00073
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2007
Phone: (503) 639-4171 I/iPi 1 1
. 1
Inspection Requests (24 Hrs.): (503) 639-4175 a
INSPECTION WORKSHEET FOR DATE: 3/20/2007 TIME: 7:00AM PAGE: 49
SITE ADDRESS: 06830 SW ATLANTA ST 200 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: COLUMBIA MORTGAGE
DESCRIPTION: Low voltage for data
OWNER: ESLINGER, MALCOLM PHONE #: 503-620-9515
CONTRACTOR: ASHLAN COMMUNICATIONS INC. PHONE #: 503
Inspection Request Scheduled For: Date: 3/20/2007 Pour Time:
Code # Inspection Description _Confrm # Contact # Message
135 Low voltage 045088-$' 503-849-9523 Y
c.._ \ L‘ t■
Corrections/Comments/InstrLtions:
PASS I PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
•
Inspector: C.. ) M L__ Date: 311- T1 Phone #: (503) 718- VC'