Permit ' CITY O TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
't-6 - DEVELOPMENT SERVICES PERMIT #: ELR2006 -00093
`'`' 131 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/25/2006
PARCEL: 1S135BC-00700
SITE ADDRESS: 10799 SW CASCADE AVE ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Limited energy for data, (10) drops. Job No. 22.2872
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:
SPRINT TICE ELECTRIC
10799 SW CASCADE BLVD PO BOX 15009
TIGARD, OR 97223 PORTLAND, OR 97293 -5009 .
Phone: Contact #: FAX 503 872 - 8290
PRI 503- 233 -8801
FEES Reg #: ELE 26 -126C
LIC 166
Description Date Amount SUP 2586S
[ELPRMT] ELR Permit 4/25/2006 $75.00
[TAX] 8% State Surchari 4/25/2006 $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 foil -rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throug OAR 95 ao 1`--0 SO. You may obtain copies of these rules or dir questions to OUNC at 503- 246 -6699.
Issue By: ` ��4% +,4_ , Permittee Signdture:_ -z ?. 04..1... /1J.
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.
. 'h _,lobi1 2 . 2872 ...
jEiectricaa Permit.,A:, :.. icattOft ' .A- H'oR o Us : ONLY '
Ci of Ti ' ''A ' " Received 1 7 ash , X Perttait No.: E —‘703
13125 SW Rail Blvd., Tigard, OR 97223 (� �j Plan Review —
Phone: 503.639.4171 Fax: 503.598.1 600 r 4 � w �� ^"" +, 0 ? '• DUMMY: Other Permit:
Inspection Line: 503.639.4175 pr -, Ey. ,' - , Date Ready/By: 1� g1 See Page 2 for
Internet; www•ci.iigard.or.us l� f�i No tiSedNiothod ( �. SupplementalInfortn
V ° .. _ O ' ' , b ' PLAN REVIEW
Q New construction cliti 'ori%alteration/replacezo,ent Please check all that apply:
❑ Demolition ❑ether: ❑Service over 225 amps, comm'l ❑Hazardous location
.. []Service over 320 amps — rating 17}3uildng over 10,000 sd, ft.,
CATEGORY OF CONSTRUCTION of 1- and 2 - family dwellings 4 or more new residential
❑ 1- and 2- family dwelling a Commercial/industrial ❑ Accessory building ]System over 600 volts nominal units in one atmcture
['Building Multi - family ❑ Master builder Building over three stories ❑Feeders, 400 amps or more
❑ O ther; ❑Occupant load over 99 persons ❑Manufactured structures or
JOE SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Sob no.:
22 . 2 8 7 2 Job site address 1 0799 S W Ca s cads ❑Health -care facility ['Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt,.no.: Project name; Sprint nenaIpdon Qty. I pea _ Total l ••
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 so, ft, or less 145.15 4
Subdivision: Lot no.: h a. add'l 500 sq, ft. or portion 33.40 1
— Limited energy, reside 75,00 2 1
Tax m ap /parcel no.: Limited energy, non-residential 75.00 2
DESCRIPTION OF WORK • Each manufactured or modular ' 1
dwelling, service and/or feeder 90.90 2 i
( 10) data drops -
-... . p _.,... _.,_ Ser vices or feeders Installation, alteration, and /or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
• ® PROPERTY OWNER ❑ TENANT 401 amps to 600 amps 160,60 2
Name; Sprint 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: 1 0 7 9 9 SW Cascade
Reconnect only 66.$5 2
City /State/ZIP, Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone; ( ) Fax: ( ) 200 amps or less 66,85 1
Owner installation: This installation is being made on property that I awn which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am to 600 amps - 133.75 2
Owner signature: Date: Branch circuits — sew, alteration, or extension, per Faint
A. Fee for branch circuits with
El APPLICANT ❑ CONTACT PERSON _ _ service or feeder fee, each
Business name; branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: _ Each add'" blanch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
- Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 1 53.40 2
E-mail; Signal circuit(s) or limited- _
CONTRACTOR energy panel, alteration, or lbV
- extension, Describe: Page 2 7. 2
Business name: T Electric Co.
Address: PO Box 15009 Each additional inspection over allowable in any or above
Per inspection 62.50
City/State/ZIP. Portland OR 97293 -5009 Investigation per hour (I hr min) 62.50
Phone: ( 503) 233 -8801 Fax: (503 ) 872 -8290 Industrial plant per hour 73.75 .
--- - ELEC'T'RICAL PERMIT FEES'
CCB Lie.; 166 Electrical Lic.: 26 -126C Suprv, Lic.: 2586S Subtotal ,5.3-r4
Suprv. Electrician signature, required: 41,fq. Plan review (25% of pewit fee - Lill
Print name: John J. Maloney Date: 4/2 / 2 0 0 6 State surcharge (8% of permit fee) `$- a.2-7
- - TOTAL PERMIT FEE
Authorized signature: This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete l.d o
Print name: Date: R Fee methodology net by Tri-County Building Industry $cz Board
"" Number of inspections per pemat allowed, VUUU
i,\ 5ui Iting1Pormitt\ELC- permitApp.doo 12103 440- 46I5T(t0 /021COM/WES
CITY OF TIGARD
BUILDING DIVISION
411k PERMIT #: ELR2006. 00093
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 4/25/2006
Phone: (503) 639-4171 4 (4 k
Inspection Requests (24 Hrs.): (503) 639-4175 ...41■ 611
INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:04AM PAGE: 91
SITE ADDRESS: 10799 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SPRINT
DESCRIPTION: Limited energy for data, (10) drops. Job No. 22.2872
OWNER: SPRINT, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503-233.8801
Inspection Request Scheduled For: Date: 4/2712006 PoUr Time:
.d Inspection Description Confirm # Contact # Message
135 Low voltage 028816..01 503-872-8269
Icy:\
/Comments' Instructions:
•
•
PASS 7 PARTIAL APPROVAL 7 CANCEL 7 NO ACCESS
I FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
NB ii Inspector: Date: 41 1 1 /06 Phone #: (503) 718- 2.14-