Permit r '',
III �� TY OF F TIGARD I G A R® ELECTRICAL RESTRICTED ENERGY PERMIT CI
. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00375
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/25/2007
PARCEL: 2S101AB -02703
SITE ADDRESS: 07450 SW BEVELAND RD 120 ZONING: MUE
SUBDIVISION: MCA OFFICE BUILDING LOT: 027 JURISDICTION: TIG
PROJECT: WESTSIDE SLEEP CENTER
Project Description: LV Phone /Data cabling and Audio.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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: 2
Owner: Contractor:
MCCAFFERY & ASSOCIATES FIRE PROTECTION SERVICES
7450 SW BEVELAND RD. #100 5573 SW ARTIC DR
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: NA Contact #: PRI 503 -590 -3732
FAX 503- 628 -6214
FEES Reg #: ELE 34- 488CLE
LIC 154333
Description Date Amount SUP 4120LEA
[ELPRMT] ELR Permit 9/25/2007 $150.00
[TAX] 8% State Surcha 9/25/2007 $12.00 REQUIRED ITEMS AND REPORTS
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 or 1.800.332.2344.
Issued By: . " j f �I _, _ : Permittee Signature: e yl 4,12/914. e IJYL
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.
Sep 25 2007 11:23RM Fire Protection Services 503 628 -6214 p.1
{ F
Elec i . cal vn
P er°rnit Anp et of f
City of Tigard fl
Rec �{ \'
13125 SW HaII Blvd., Tigard, OR 97223 ❑ate By: a /O r Perm N D `1 —ot t7
Phone: 503.639.4171 Fax: 503.598.1960 2 5 2 r ''':, � � , Datdy: P1sn s; w
5 Other Permit:
Inspection Line: 503.639.4175 _ i
' I i Dale Ready/Br. mrs: ® See Page 2 for
Internet wow et tlgard or us Ci � 1 oed /Methad; I Supplemental Information
ff Ut � ��� /-� I � Nnfi
;f7���i.. } i }t } }�sl°'�>="u,x � to ' �' 1 £ �4 s i3 e�: t ax' -5€ �' �y, " . . "+s R a k
' ,..5 ?!^�'t a:3gi . w.. .- h 'tk , t t �. ..�� .. ❑ £ zv 3.�. ' "
: „ : .z 3 -... r7 p i. k 'z'� . 3' #'�St 7 }H '_> tF`> � - ..� A t8
..- . .. ' t Y .,. � di � ��? ��� r^� .. �1i•at � F } �`�.z ° . j 17 e ,., , - ) 4i3� -3,Fln ....
❑ New construction ■ Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, carnm'I QHazardous location
1:11 Demolition ❑ Other
-' �-� ' � € s" � � s . t "u G;_ ` . y k s Service over 320 amps - ratio
to -..i': i 3 ; ;Q a, t,� =._ r , .,. 0.- : �c* r_. `' ' ;a 4k27 i 'j `"' - ` ? ' 1 , � of L- and 2 - family dwellings g ❑Buildng over 10 000 S . ft.,
4 or more new residential
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑Systeal over 600 volts nominal units in one structure
❑ Multi - family El Master builder 0 Other: ❑Bolding over three stories OFeeders, 400 amps or more
. `, �tg gg� , l,.{ } . a� - r:. : , s r ' ,: - .: m , , i: ❑Occupant load over 99 persons ❑Manufaetlired structures or
a.'r �" ; ,;$ �P.g541 #? i:. ..t '. . viii,c`'....>.t,9 !'.r1.c.y; i a.. 1 • ,14. i s r 71 , a ,a,& ❑ gress/lighting pion RV park
Job no.: 2478 Job site address; 7450 SW Beveland ❑Health -care facility ❑Other:
Submit .2. sets of plans with any of the above.
City/State/ZIP: Tigard, OR The above are not applicable to temporary construction service.
fi s . z wt r 'r T ate x , } a in: ;� Tffi F"( ZZ
Suite/bldg./apt. no.: 120 Project name: Westside Sleep Clinic 3 q x .���i�t'� *�i, ��•.�, 3 s _,;�_ �� ,. .. �.� ,��.;��.�,�:
_ Description Qty. Fa. Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: P Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
ti a1,,,iitji , dax"Eau : , , Limited energy, non - residential 75.00 2
U: _ ' ..., .'.i ; ' 1,y rsy e.,. s?3zgs :. i vu iz4r .k�s Fr t e.,. e , ;- #kg:o-a
a . ° a4 �u � s e ?Y9 ��Y'�5 v ��. ;� s'
1 . � .� : .„ 41 , Each manufgcttlned or modular
LV - Add Phone/Data Cable Runs & Audio dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
..ti i,� z rlf � �s�� '� (¢ gl ( 201 amps to 400 amps 106.85 2
i: i w 'ffii :Ea« s. . .. �£°l i a i ra . _. � 3 .. €:- :�..._ x X 1 1 , ; as ... ? :rNxa ii.i §y13
401 amps to 600 amps 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
Phone: ( ) i Fax: ( ) relocation
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 am ps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
�,_ �..L -w a � F1b! �.,� a 'e' � �,. e^cw, �, 3 - � 17 � " . � � { z U? a .. .,,tx.. s� r ..
"- v . s ; a 3 " k �' wc ' t } i e t �„ �"'' e � . Fe for nui wfth
mw .. (.. a. , . ; r ., ,... fiz a. F :., t.:x ii t A serv e ice or bra feeder ch circ fee, ts e ach
Business name: FIRE PROTECTION SERVICES, INC. branch circuit 6.65 -
Contact name: DAVID M. PHIPPS B. Fee for brunch circuits
without service or feeder fee, 46.85 2
Address: 5573 SW ARCTIC DRIVE each branch circuit
Each addl branch circuit 6.65 2
City/State/ZIP: BEAVERTON, OR 97005 Miscellaneous (service or feeder not included)
Phone: 503 590 -3732 Pump or irrigation circle 53.40 2
( ) Fax: (503) 628 -6214
Sign or outline lighting 53.40 2
E-mail: phipps@fpsnw.com Signal circuit(s) or limited -
�, "" atr+t� c ,�#�� t�5 �� �sa1 s F ' � Si' � r•
:3' `r^ r: kii F- _...... '?r; 1•¢� rii i .._. a�� a ... 1a . :1 5 , �' k4a ii:¢ 3 . r- .xr`s1 ? .€ sf: l i'. 1 3;- r?i: energy panel. alteration, or
Business name: FIRE PROTECTION SERVICES, INC. exte»sion• describe: page 2 2
-
Address: 5573 SW ARCTIC DRIVE Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: BEAVERTON, OR 97008 Investigation per hour (1 h• min) 62.50
Phone: (503) 590-3732 Fax: (503) 628 -6214 industrial pl per hour 73.75
x" ?5 ..;: r� 2(k3< 5 �3 , 1 , x-, ., 5 q.:5 t i.i i �, rY r.»s.; ='A :I p
t) "°"
_ -#;.
CCB Lie.: 15433 Electrical Lic.: 34- 488CLE Suprv. Lie.: 4120LEA Subtot t � al I 5 0 .
� F
Suprv. Electrician signature, required %' � , / Plan review (25% of permit fee) Co g -
Print name: / �'i Date: 925/07 State surcharge (8% of permit fee) ' .a
Authorized signature: % — TOTAL PERMIT FEE t (0 a,
„/ This penult appliction expires if a permit is not obtained within 180
days after it has been accepted as complete
1 M I I I rAi � D aze: 09/25/07 • Fee methodology set by Tri-County Building Industry Service Board
• • Number of inspections per permit avowed.
i "PercnitApp 12/03 440.46157(10/O2/COMPNEe
' - _
CITY OF
��m n n n��n TIGARD
BUILDING DIVISION
'
~°~°"~~~�"""~° ~�.°"~°"~~.~ ' PERMIT #: ELR2007-00375
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: M/25,12007
Phone: (503) 639-4171
Inspection Requests (24Hmj:(5U3)83Q'4175 . � � � «���
INSPECTION WORKSHEET FOR DATE: 11121/2007 TIME: 7:00AM PAGE: 38
SITE ADDRESS: O7460 GWBEVE}'AN[)flC`120 CLASS OF WORK:
SUBDIVISION: MCA OFFICE BUILDING LOT #: 037 TYPE OF USE:
PROJECT NAME: WESTSIDE SLEEP CENTER
DESCRIPTION: LV Phone IData cabling and Audio.
OWNER: KdCCAFFERY& PHONE #: NA
CONTRACTOR: FIRE PROTECTION SERViCES PHONE #: 503-590-3732
Inspection Request Scheduled For: Date: 11/21/2007 Pour Time:
Code # Inspection Description - ' — Contact # Message
199 Electrical final 0d0101'01 503-090-3733 N
Corrections/Comments/Instructions:
•
p RARTALAPPRO\AL CANCEL NO ACCESS
n || FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
��- m]�� �� ��LH
Inspector: ^~� - �`«v��� u-�� Date: 1.1 C0 Phone #: (503) 718''L�-�L
• -.'..-''''', ,.- i .
CITY OF TIGARD ,.
A
BUILDING DIVISION PERMIT #: ELR2007- 00375
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91250007
Phone: (503) 639-4171 lawpitgliq
,Inspection Requests (24 Hrs.): (503) 639-4175 ..,,-41 11.
INSPECTION WORKSHEET FOR DATE: 9/77/2007 TIME: 7 PAGE: 62
SITE ADDRESS: 07450 SW t3EVELAND RD 120 CLASS OF WORK:
SUBDIVISION: MCA OFFICE BUILDING LOT #: 027 TYPE OF USE:
,PROJECT NAME: vvr SLEEP CENTER
DESCRIPTION: LV Phone /Data cabling and Audio.
OWNER: MCCAFFERY & ASSOCIATES, PHONE #: NA
CONTRACTOR: FIRE PROTECTION SERVICES PHONE #: 503,590.3732
Inspection Request Scheduled For: Date: W17/700'7 Pour Time:
Code # Inspection Description --- o - hfirryt Contact # Message
135 Low voltage 056445-01 503-590.3732 V
Corrections/Comments/Instructions:
-CD iN • 7100. ‘.0 OraCZIC - SA ' -- E --} 1 p Okl SI ci L--•
- 0 t.ct.„. T., CID tO o c19.6 \\ 01, ti6' ki e czAriftvz.
paND-I. ciwki-Lx-cl(A).
VI PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS
i.--
--- - -ALL FOR INSPECTION
l'‘ ri ADDITIONAL FEES ASSESSED
G
Inspector: • IOC!;! (--t Date: 91 211d1 Phone #: (503) 718- 1)1L1-t,