Permit ,• S.
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
` Ifil 0 DEVELOPMENT SERVICES PERMIT #: ELR2006 -10011
:��1- DATE ISSUED: 3/10/2006
---' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 BB -01400
SITE ADDRESS: 12100 SW GARDEN PL BLD4 ZONING: C -G
SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG
Project Description: Limited energy 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:
SPIEKER PROPERTIES LP A -REBS COMMUNICATIONS INC
4380 SW MACADAM AVE STE 100 5855 SW TARALYNN AVE
PORTLAND, OR 97201 BEAVERTON, OR 97005
Phone: Contact #: PRI 520 - 0625
FEES Reg #: ELE 34- 558CLE
LIC 86096
Description Date Amount SUP 2340RET
[ELPRMT] ELR Permit 4/1/2006 $75.00
[TAX] 8% State Surchar€ 4/1/2006 $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 fo . ru - ado. -d by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throug , OAR 952-0 0 t O'You may obtain copies of these rules or di r . uestions to OUNC :t150 - 246 -6699.
Issue By: , Pe rmittee Sig , ature: �
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 OF USE ONLY
City''ofTi Daze/Bed IU - "� Permit No.: gh.,� �p- /e29// 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639 4171 Fax: 503.598.1960 * 1,, A ��rll�y) ��� ' Date/B • Other Permit
Inspection Line: 503.639.4175 Date Ready/By �Ind 0 See Page 2 for
' /
Internet: www.ci.tigard.or.us Notified/Method 4 . Supplemental Information
TYPE OF WORK PLAN REVIEW '
❑ New construction ;S.- Addition/alteration /replacement Please check all that apply:
El Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION, of I- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ ❑Building over three stories El Feeders, 400 amps or more
❑ Multi- family
❑ Master builder Other:
0 Occupant load over 99 persons ❑Manufactured structures or
' JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: — Job site address: 1,.2. c3 ❑Health -care facility ❑Other:
''`�`' S {L �A� Dill ` Submit 2 sets of plans with any of the above.
City /State/ZIP: T.LAaJ p cc? L) •1..a. 3 The above are not applicable to temporary construction service
t
Suite/bldg. /apt. no.: Project name: RE 'A.fl FEE* SCHEDULE
Description I Qty. I Fee. I Total
Cross street/directions to job site: pA,2.1; a t --I New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
( ^ dwelling, service and/or feeder 90.90 2
t J /�' Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
•
fPROPERTY OWNER . ❑ TENANT 201 amps to 400 amps 106.85 2
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
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax : : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: A -�� ��1(V\ -TN) L "-'__' � it.._
Address: S8 ss S(.,J --i;ARA (...../ N kJ AV G.. Each additional inspection over allowable in any of the above
Per inspection ection 62.50
City /State /ZIP: ? I J RTba,1 L (DC 9 7 0) 5 Investigation per hour (1 hr min) 62.50
( Industrial Industrial plant per hour 73.75
Phone: 50 ) JZO 06'7_5 Fax: Si, ( 5Z1 E LECTRICAL PERMIT FEES*
CCB Lie.: 83( D a 9 / . Electrical Lic.:'� - SS:( tj uprv. Lic.:1 Z43 0 Subtotal
Suprv. Elect (n tore, required: j' 7/i j Plan review (25% of permit fee)
Print name: O3 5 - i - N t; Date:3 -10 _0 State surcharge (8% of permit fee)
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
Print name: Date: * Fee methodology set by Tn- County Building Industry Service Board
** Number of inspections per permit allowed.
c \Bmlding\Permits\ELC- PenniApp doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of,Tigard
Page 2 - Supplemental Information
•
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El- Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑
•
Protective Signaling
•
❑ Other
Total number of commercial systems: 1--
*No licenses are required. Licenses are required
for all other installations
I \Buildmg\Permits\ELC- PermrtApp doc 04/03
CITY OF TIGARD f-
BUILDING DIVISION PERMIT #: „w),(2 6- too i f
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �'N f�l
Inspection Requests (24 Hrs.): (503) 639 -4175 ....._..W
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / /7) (] fL `A CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: q `� i g� ,
DESCRIPTION: ►J�
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- ( (---/- 0 (0 Pour Time:
Code #,---/ / n . - ion se i• - Confirm # Contact # Message
1 a ot
e--6 n .-t-I-- t 9 \ 1 Ojel 5 0(a D --- g -
Corrections /Comments • - ' • _ •
L -6---_, I / / .� /
-----
..
PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
.tz I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 6* 1 LA. Date: 6 66 Phone #: (503) 718- -
1
CITY OF TIGARD‹
BUILDING DIVISION PERMIT #: o9 c, - f QO /
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 , ��
Inspection Requests (24 Hrs.): (503) 639 -4175 � _...
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS / 23 0 j pi, CLASS OF WORK:
SUBDIVISION: �� 6, � LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: 3 - /3 -0 (= , Pour Time:
,_ o e # Inspection Description Confirm # Contact # Message .
Corrections /Comments/ Instructions:
1■® o tee.. 0,- 1.0 s\s\pio tsw 1 ik '3
NJ o •
c_�LS.., FIcia ' ° i M ` Ir ! a
__,._ \
- .----____j
PARTIAL APPROVAL n CANCEL (l NO ACCESS
FAIL 4 CALL FOR G A
INSPECTION ❑ ADDITIONAL FEES ASSESSED
FtNP,L -, I
Inspector:
'• 1 v 6 Date: 31010 Phone #: (503) 718- 2-446
i