Permit •
CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
i.1,, I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00216
c II 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 8/1!2005
PARCEL: 1 S135BB -00500
SITE ADDRESS: 10329 SW CASCADE AVE ZONING: C -G
SUBDIVISION: CASCADE COMMERCIAL CTR. LOT: JURISDICTION: TIG
Project Description: Limited energy for phone and data lines.
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:
CASCADE BLVD CENTER LLC + COBURN ELECTRIC, INC.
CORNELL LIMITED PARTNERSHIP PO BOX 118
BY GEORGE B HELLIG ATTY HOOD RIVER, OR 97031
CORVALLIS, OR 97339
Phone: 503- 639 -5549 Phone: 541- 386 -7866
Reg #: ELE 33 -2C
LIC 861
FEES SUP 436S
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/1/2005 $75.00
[TAX] 8% State Surcharl 8/1/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to folio -s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throug - OAR 952 -06 -! 10AYou may obtain copies of these rules or direct�estions to OUNC at 503 - 246 -6699.
Issue. :y: J/!4L4 Permittee Signatur .
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From:Coburn Electric 5413863778 07/29/2005 11:21 #857 P.001 /002
. • -, !*
Electrical Permit Application O(: Orrlt R l NI ONLY
City of Tigard Received
13125 SW FIsll Blvd., Tigard, OR 97223 e ECE E ' ! P1 n y: ,, 7 _ a s " - , ParmitNo :; v10As -0Om2/(o
Phone: 503.639.4171 Fax: 503.598.19 • • , H t: ;', Other•Pentsie
Inspection Lute: 303.639.4175 , ∎ .. p Readyl 1 : 5tl See Pa ge Z ter
Internet: www,ci.tigard.or.ua Jul 2 9 , ' NoUlled/l hod: £ I • SupplementalInformaton
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0 t c Please ch eek all that a 1
New constructionAdditirl si/ Please y: la Demolition Other: u ❑ Service over 225 amps, oomm'l ❑ Hazardous location
❑
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. .:'' 'r'•z'.$; , ::... ;, ..c .', ,., y,,: sa .. $( , i . j 115.:. , ;, , ( . :. j . y j; ; ,
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,.), ,,; C, I .g9-0 t`il d tO ;,W . r P.... , .s • •, of 1"
and 2- family d Aar m new O rasidentiaft
0 1'- and 2- family dwelling EC orumercial/indnstrial 0 Accessory building
❑ Syatcm over 600 volts nominal units in one structure
0 Multi falnil Master builder Other: ❑ Building over three stories ❑ Feeders, 400 amps or more
y f Occupant load over 99 persons ❑Manufactured struot .res or
:'.! . i kig': "Y(B:10ITE �1- y C.. I . ;• '
i ... ?:f" r;.J,. ,. �i?; M,..`, �' f�y ?i`�► ": ::....,.., �;�eas/lighting RV park
O
r Job no.: Job site address /0,3 o2 9 �? G C e ID Health-care facility ['Other:
_ � "\'JC { ■ Submit .2,_ amts of plans with any of the above.
City /State/ZIP: 1 ;‘ Cx. f .. A 0 Sk The above are not applicable to temporary construction service. • \ 1 ,', i jJ ' fy i iK ;.')f':'",is(}��tji,%i:;kt+,'P •,. !, 0giA.; g :g;'' /nf',�P
Suite/bldg. /apt no.: I Project name: `�-� n.�1e. Daacrlptton Q4• Fed L rota[ ••
Cross street/directions to Job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
-
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'! 500 aq, ft. or portion 33.40 1'
Tax map/parcel no.: ! Limited energy, residential 75.00 2
_ Limited energy, non'rcaidential i 75.00 1 j,OC) 2
; .., ; f {;: ': �, ACI�Ohl: ?;�.
'T F�.WORk 0 .... Ea rnanufhatwed or modular
' ��Q\ 0 (o k \1\ 'EY 1 3\ 1`Y\ 4 ► `m n' ._,. (), '1\C�I d ooti dwelling, service and/or feeder 90.90 2
, Services or feeders hrstallation, alteration, and/or relocation
200 amps or less 80.30 2
'L'.�. . n. y : t t )., ,. ;
:. 201 amata400ams 106.8 2
��l\ t''' f'a i''.!�. <:� , rn ^ /s , "° o..l,: :.1 ,.1 { r ..:5,;. :, -
P
'.1,. •!, .nQ �RpPT,I� �w .. # fi r:: ::):, :�::,,. f :.(% +5. ^' %,L7,�,$NAl�'!<',:; . .1:•:, �l.i' : p
:$,::
snips to 60 amps 2
..', .:..:....:..... :.. . «.. ,.., <, , . 401 0 am 160.60
Name: ,"'', "- ('A„va� 4, ,Nr\c 601 amps to 1,000 amps 240.60 2
Address: �r) � J f :\ ' .� ; Y` f t' Over 1,000 amps or volts 454.65 2
_ . Reconnect only 66,85 2
City /State/ZIP: •-- , f . C . xY � � A Cj \ -16 Temporary services or feeders Inetalladwy alteration, and/or
Phone: ( ) `• r Fax: ( ) relocation
200 amps or lees 66,85 1
Owner installation: This installation is being made on property that I own Which is net 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. ; 401 strips to 600 amps _ . 133.75 2
Owner signature: Date: ' Branch clrculte -- stew, alteration, or extension, per Panel
( •' >•45w 'yix;a i .';; '''' ;<, 4. A . aN': :';:a, ,! , A Fee for branch circuits with
. i ; 2 ,.'% ?'i »:t ` :!:!r' ?! f '�:. �" • .i`'• : :C O PI T . CT s 'PERS N 1 : :;! : � . ;
:•t,'i'"i.., '' :
:., .. �.:,',�' i' . ; 'a;•. , .1>i..l! S :,,,,....,.. .. y . . , . Y..;' .f1'1[ f each
Q, serv or feeder mm, m 6.65 .
Business name: Q„ VAf e .. • , f -• 1 ^ C. „ branch circuit
� !� B. Pee for branch circuits
Contact name: S'\- ' i - w ithout writes or feeder fee
y-- vi ' n Lk) Ct.`�\ {�7Y1��\ _ 46.85 2
p j� V each 'branch circuit _
Address: \-' , ., {� 0 1 l � ^ Each add'l branch circuit 6.65 2
Ci ty \ /State/ZIP: A.0-06 C ' ' Miscellaneous (service or feeder not included)
R 1_ ( 0 t U � Purnp or irrigation circle 53.40 2
Phone: ( t : ) t . \) '.".. ( C y - `l c t . k0 ( , 6 ( . . . , ; ( - k \ ) Fax: : t \) . , •' ' r"1 % SSign or outline luting • 53.40 2
E -mail: V.) T .) 'CY t. \ e--C -, AA Signal circuit(s) or limited-
'.d: ti, •,' - ¢ {;,',;g.: ;,?;L • •. ∎:c . a, ' %'. .,,� Q, ener Panel' alteration, or • extension. ...t,.,' <r ; .a. „•. ,'t.; ?:' #? ;,'a,;+o.ana`.,., .... TRPi T.qJ...,, :, !cfg..v\
�:';`. .' ` :t. ',,'-:�' " ', ' '`' Describe: Page 2 2
Business name: C (;11.3A t v l L \t'..t;,' .. Y.. 1 �C. .. ; \A C:. .
Address: r � � 1` Each additional inspection over allowable in any of the clove
> Per inspection 62.50
City /State/ZIP: - t�r ' `` e) h=r () Investigation per hour (I hr min) 62.50
t ` � r Industrial plant per hour 73.75
Phone; ( V Q , `y Cy I Fax ( t , `l : ' ° ,. .�,�r y,, � ,,; ,,•. ,::,,., .
t( V S� �:,,'�k"... .Fi� V �'1 Y !� tt : '" r A: ��i��i�r;-'. 5.': �•' �a< is��" !:SL�I:II�,�'.A'�t�.�:�rl.P�i -' 1�NI� .`�•'_;,A 4N�, R.';'t^: } : < >D:`i ;' =`'.
CCB Lic.. q \ Electrical Li 35... :1:1 Q' . I Supry, Lic.: (1 .S (.„,S subtotal i 5 00
Suprv. Electrician signature, required' / 2•Z".-4:4,'.;;, , .. / z.... , ';''',: : ?..
,';:' '.'c•':`.... Plan review (25% of permit fee) .
'-- I r State surcharge (8% of permit fee) �` l l
Print name: � (�Y11 p.., ( )( ..,o_.-....1. ' 1. E Date: � �1 �`? 7 t5 ,
1� ' 11 TOTAL- PERMIT FEE
Authorized signature: / ,(.�if!.s' ,,. .,,rt1i: , .', ) _ . : „ '° , - , Thta permit liation eep a res If a mit 1s obtained wilt in 180
e ' " ' 'C''' ` : ;?: : °y days appc attar It has bean accept ea not complete
w
A C . - Date: 1 * Feemet hodology set by Tri- County Building Industry Sol H Davi
Print name: •CkYI �.,A %� C .� (\� Dt "� ! 01 C Cy .Z:11 _ _._...
.CTY OF TIGARD
BUILDING DIVISION PERMIT #: ELR005 -0016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1/2005 /�im
Phone: (503) 639 -4171 ' i i Ngivit i I +h
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/5/2006 TIME: 7:0 2AM PAGE: 41
SITE ADDRESS: 10329 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: CASCADE COMMERCIAL GTR. LOT #: TYPE OF USE:
PROJECT NAME: STAPLES
DESCRIPTION: Limited energy for phone and data lines.
OWNER: CASCADE BLVD CENTER LLC +, • PHONE #: 503 - 639 -5549
CONTRACTOR: COBURN ELECTRIC, INC. PHONE #: A1-316 -7866
Inspection Request Scheduled For: Date: 8/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage _ 012928 -01 . -386.7866 V
Corrections /Comments /Instructions: A
`I\ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• ❑ FAIL ❑ C LL FOR INSPEC ION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: / 0/ Date: 8-5 Phone #: (503) 718- Zti LY) •