Permit C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
ilk DEVELOPMENT SERVICES PERMIT #: ELR2006 -00200
- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/24/2006
PARCEL: 2 S 110 D C -02400
SITE ADDRESS: 11565 SW DURHAM RD 110 ZONING: C -G
SUBDIVISION: SDR1999 -00022 WILLOWBROOK II LOT: JURISDICTION: TIG
Project Description: Installation of 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:
MOODY 2005 TRUST NATIONAL NETWORK SERVICES OF OREGON
9811 NE 114TH CIRCLE 302 SHELLEY ST
VANCOUVER, WA 98662 SPRINGFIELD, OR 97477
Phone: 503- 201 -3266 Contact #: FAX 541- 726 -8929
PRI 541- 726 -9209
FEES Reg #: ELE 20- 361CLE
LIC 154300
Description Date Amount
[ELPRMT] ELR Permit 8/24/2006 $75.00
[TAX] 8% State Surcharl 8/24/2006 $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 ithin 1.80 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you t follow rules .do.ted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throu h OAR 952 -I i 1 -f 00. You may obtain copies of these rules or dire stio to OUNC .t1503-24.-6699.
Issue By: l �4# j4 _ � . � " Permittee Signat a IF air j rJ� -= � -
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 Ai plicaltion i o>« of vicE usi °Ni.v . . .
City of Tigard 1 -� _
z{ �, a � Received
Y g osieia , X Mar Go A f- Perna Na El - iePee o ' 00,e0
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review
Phone: 503639.4171 Fax 503 598.(960 tea ;:. , oars /B otherPernut,
Inspection Lime: 503.639.4175 AUG 2 3 2006 . _ L-tte Re.,dym mu H See Page 2 for
Internet. www ci tigard.or.u5 Notified /Method, Suppirtneat,iI Information
l AllieYE . r' WORK U\1) PLAN REVIEW
❑New construction •31.3F > %rplaccm
�cn[ Please check all that apply
❑Scr over 225 airrps. comm'1 ❑Hazardous location
U Demolition ❑ Other:
['Service Duct 320 amps - rating ['Bulking over 10,000 sc.] ft
CATEGORY OF CONSTRUCTION of I - and 2•fatmly dwellin 4 or more new residential
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building ❑System over 600 volts notninal uniu in one structure
❑Building over three s tories ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑Other, ❑Occupant load over 99 persons ❑Manufactuied structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
fob no.: I Job site address:
1 1 S S(..3 Dur �{ , ❑Heahh -cure facility ID Other:
PY� Ctuhmu sets of plans with any of the above
City /State /ZIP. ;5,.rd� 0 r. The above ale rut applicable 10 temporary Constiuctiun service
Suite /bldg /apt. no.; 11 D 1 Project name fin C .�-� , ��� FEE* SCHEDULE rnum• 1 ' 1'l �^� DrranPiiun � c)u, L Fee, TOW ••
Cross street/directions to job site: _r5 z, s 1 , e. New residential single- or multi tamily dwelling unit.
1 �{Al'1 Includes attached garage.
ere \ rn td,_ 50 i prr,"( q m; '4-tAC f - c -1 -o sw 400 sq. ft. or less 145 15 4
Subdivision: 6,N i 'A \ 5 e cam ti LOC nn.: Ea, add sq. ft. or portion _ 33 40 1
Tax map /parcel no.: f `� Limited energy, residential 75 00 3
Limited energy, non - residential 75 00 2
DESCRIPTION OF WORK Each manufactured or modular
f ) dwelling, service and /or feeder 90 9(1 2
TYl l' -,A\ \., Q4J V D 1 li, CAI, lA. l , l e --o C �JG. Services or feeders installation, alteration, and /or relocation
r , A ()or K 20U amps or Ic« S0,30 2
❑ PROPERTY OWNER I ,TENANT 201 amps to 400 amps 1(16.65 2
401 amps to 600 amps 160.60 2
Name: Cre?M is - rn.∎v ,,.� p p
� C PC c7.� ' . 3 t U GO 1 amps to l ,UOU amps 240.60
Address: 1 I � , ) 5 b,“ k Q � Over 1,000 amps ur volts 454.65 2
+ Reconnect only 66 185 2
City /state /ZIP 200 s
7, ,, O . Tenaporur services or feeders installation, alteration. and/o
Phone' (5411 ) 6F/-07q J � I Fax ( )
2n p s
200 sn or less 66.ii5 I
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, ur extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for blanch circuits with
service or feeder fee, each G 65 ?
Business name' branch circuit
B Fee for branch eireuir,
COnlavi name:
without Srrvtcu ul Iseder 1'ec.
46.55
Address: first branch circui -
Each add' I branch circuit 6 65 2
Ci Cy /Stale /ZIP' Miscellaneous (service or feeder not lttcluded) _
) Pump or Irrigation circle 53 40 2
Phone:
( ) { Pax' :
Sign or outline lighting 53 40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel. alteration, or
II 'f extension Describe: Page 2 2
Business name: (�lt � l f)£f`(J,f k_ SetVes
Address: 3 t o ? ..5).\e,167/ Each additional inspectial over allowable in any of the above
l Per inspection 62 50
Ciry/State /ZIP- SVN\s 41 i - Q ` 9 L ' Investigation psi hour (I la min) 62 50
Phone: (� ) ) 7Zb -L, Z Fax ( sf q 1) "/ Z 1, — . 2. Industrial plant per hour 73 75
l ELECTRICAL PERMIT FEES'"
CCB ic. /s 2,0 Electrical Lic.: 0 —30 aeSuprv. Lic.: yZ1l /LE'A Subtotal
Sup Jet ician signature. required; &ft- / �� Plan review (25c7o of permit fee)
p Zq_ Sims surcharge (8% of permit tee)
Print name: Sco# DUl f4
TOTAL PERMIT FEE
Authorized signature: g / l D a This permit aU a rmit not nbn
day ppllca s after on It has expires been it aee is ,ts eotuptrte lined within ISO
Print name: 5' L &tip 7 Date i'19 " (•ee methodology SCI by Tn- County Building Industry Service Bo. I'd
" Number of inspections per pet mil allowed
i 1 8uiIdmg \Permlu,8i.(:•PermItAppd,s_ ILO) 440 -461 ST( t0/02 /IOM /WEB
1700 /C001A 33If :13S )I801h13N 1VNOIIVN 8Z8893L1179 X /J LI • 91. 9002/8Z/80
-.._.:
CITY OF TIGARD
BUILDING DIVISION - A PERMIT #: ELR200$-00200
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/24/7006
Phone: (503) 639-4171 tlyplitil\
Inspection Requests (24 Hrs.): (503) 639-4175 „AO.' ......
INSPECTION WORKSHEET FOR DATE: 9/26/2006 TIME: 7:06AM PAGE: 42
SITE ADDRESS: 11566 SW DURHAM RD 110 CLASS OF WORK:
SUBDIVISION: SDR1999 VVILLOWBROOK II LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UNION
DESCRIPTION: Installation of low voltage for data.
•
OWNER: MOODY 2005 TRUST, PHONE #: 503-201-3266 .
CONTRACTOR: NATIONAL NETWORK SERVICES OF OREGON PHONE #: 541-726-9209
Inspection Request Scheduled For: Date: 9/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 037133-01 641-913-1326 N
ict9 F-'104Q__. .
Corrections /Comments/ Instructions:
'4.
AL PASS PARTIAL APPROVAL E CANCEL I I NO ACCESS
fl FAIL 0 CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: G-. Wel i__-- Date: 9 2.4. 0 Phone #: (503) 718-2-4410
CITY OF TIGARD ., _•
BUILDING DIVISION PERMIT #: ELR2006-00200
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/24/2006
Phone: (503) 639-4171
. 4 :1 1 411(11 -
Inspection Requests (24 Hrs.): (503) 639-4175 ,_..—fal•- 1 -,-.
INSPECTION WORKSHEET FOR DATE: 8/29/2006 TIME: 7:01AM PAGE: 2/
SITE ADDRESS: 11665 SW DURHAM RD 110 CLASS OF WORK:
SUBDIVISION: SDR1999-00022 WILLOWBROOK II LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UNION
DESCRIPTION: Installation of low voltage for data.
OWNER: MOODY 2006 TRUST, PHONE #: 603
CONTRACTOR: NATIONAL NE1WORK SERVICES OF OREGON PHONE #: 541-726-9209
Inspection Request Scheduled For: Date: 8/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 036727-01 641-913-1326 N
Corrections/Comments/Instructions:
d .) N,p@RK■,4 Ak..,_ fpit,
toTka Sk.k4latt\i (G 6A9
0v 6 to
)7_ n PARTIAL APPROVAL D CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: N Date: % . CA' Phone #: (503) 718- 1J t- fo
1; ,