Permit 4.,., 'r' µ' a CITY OF T ELECTRICAL RESTRICTED ENERGY PERMIT
:... COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00033
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/8/2008
PARCEL: 25101 DB -00100
SITE ADDRESS: 07340 SW HUNZIKER RD 200 ZONING: C -P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: NATIONAL SEMI CONDUCTOR
Project Description: installing data telecommunication line
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:
ROBINSON DEVELOPMENT WIRED BY DESIGN
21360 NE AMBERWOOD DR 3057 NW OVERLOOK DR.
HILLSBORO, OR 97124 #1438
HILLSBORO, OR 97124
Phone: 503- 645 -8531 Contact #: PRI 971 -570 -3163
FAX 503 -614 -9485
Reg #: ELE 84- 694CLE
FEES LIC 163317
Description Date Amount SUP 3966LEA
[ELPRMT] ELR Permit 2/8/2008 $75.00
[TAX] 12% State Surch 2/8/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 . copies of these
rules or direct questions to OUNC at 503 • ...99 or 1.800.332.2344. �
Issued By:, / /�- / ��� Permittee Signature:
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 OFFICE USE ONLY
Received
City of Tigard Date /B �� ' III Permit No .R •
` ' q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review , a Other Permi ' / /` I i y/%
1 4 Phone: 503.639.4171 Fax: 503.598.1960 Date /B
Tl GAR D Inspection Line: 503.639.4175 Date Ready /By: Juris• 0 See ' age 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE WORK ' - , PLAN REVIEW
❑ New construction :Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
. ' , ' C OF CONSTRUCTION exceeds 10,000 amps at 150 volts or . ❑ Floating buildings.
' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND. LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new,motor load of ❑ "A ", "E ", "1 - ", "1 - ",
7340 sw 100HP or more. occupancy.
Job no.: Job site address:
L1� �1 1�f7 ❑ Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP: i rn 0 D g 7 Z Z6, ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: 2,00 Project name: N1Prr10N6 m/CJNDUci Cze coal ❑ S ervice or fe 600 am or more
FEE- SCHEDULE ,
Cross street/directions to job site: 7 Z ND Aar Description I Qty. I Fee. I Total I
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
' DESCRIPTION OF WORK • ' , (with above sq. ft.) 75.00 2
� 75.00 2
-
Limited energy, multi- family
J/I /� 1'T T - L-E GDil residential (with above sq. ft.)
/ Services or feeders installation, alteration, and/or relocation _
200 amps or less 80.30 2
' ❑' PROPERTY OWNER, ' ❑ TENANT .. • " 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT ❑CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: is -ilD �t rD,S C ._� B. Fee for branch circuits
without service or feeder fee,
Contact name: (VA,LC�qRa___ (,-k-��L'/ first branch circuit 46.85 2
Address: 305`7 NJ O3 C vii;2C � ,p,�, r t_- 14.,3 8' Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: 0 I (mss .0 / o t e 9 7/ 24- Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (q 7( ) c. �U .- 31 (, 3 - Fax: : ( 5)3 ) ( / 4 - - 54-8s Reconnect only 66.85 2
Wr
E -mail: `v,eA s b _ d l e s to° Ue rca, om' . N / L Pump or irrigation circle 53.40 2
'_'CONTRA'C'TOR :, Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: W 1 t0 (34 De S /6,-ti1 energy panel, alteration, or
extension. Describe: / Page 2 2
Address: 30S 7 NI u1/43 OVEcP — t_c - 0i� , ' 143�
City/State /ZIP: I I wS gc).r_o J n ,� Cal 71 +, Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (G 7/ ) 3 7e 3) 31 L 3 Fax: (5 O (0 11- -414-3S- Investigation per hour (1 hr min) 62.50
CCB Lic.: � 6 3 'l l 7 I Electrical Lic.: 3 9 (, �} S uprv. Lic.: 3 y /, Lam Industrial plant per hour 73.75
� t / `1 ELECTRICAL,.PERMIT FEES •
Suprv. El c leta24 j r[tre, required: /f / ,, P /.' �� Subtotal: � c - j �-
Print ( D.'e: Plan review (25 %ofpermit fee):
rint name:
I � �'`� Z f ��08 State surcharge (12% of permit fee): -(1
Authorized signature: *.e E TOTAL PERMIT FEE: L( pC/
/ This permit application expires if a permit is not obtained within 180
Print name: M/ yii_cL. 4-4-e9-e.- 4-4-e9-e.- / Date: 2 siU & days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /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*
n Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
I Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Building\Permits\ELC- PermitApp.doc 03/23/06
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CITY OF TIGARD
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BUILDING DIVISION PERMIT #: FLR2008-00033
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/8/2006
Phone: (503) 639-4171 .11 lit
Inspection Requests (24 Hrs.): (503) 639-4175 --„, - I -.....
INSPECTION WORKSHEET FOR DATE: 3/16/200B TIME: 7:0044 PAGE: 411
SITE ADDRESS: 07340 SW WICKER RD 200 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: NATIONAI. SEIvil CONDUCTOR
DESCRIPTION: inswing data telet:ornm Ullication line
OWNER: ROBINSON DEVELOPMENT, PHONE #: 503_645.8631
CONTRACTOR: WIRED BY DESIGN PHONE #: 971
Inspection Request Scheduled For: Date: 2/15/2008 Pour Time:
Code # Inspection Description OP -- • Contact # Message
135 1_ovv voltage - 065061 . -01 503-209-8567 N
•
Corrections/ComKtent ,Instructions:
. R.4) 0 ND A LI, Pro 6r- kt\c1C i (4.vbiN3
1-4%\b6 RA 0 `fT • iseT. ‘i,(0 .1 o(Q
N
0 PASS I I PARTIAL APPROVAL El CANCEL II] NO ACCESS
FOR INSPECTION EI ADDITIONAL FEES ASSESSED
I, 06 i a
Inspector: ---- --, —64 Date: 1---I I= ON't Phone #: (503) 718- PO).
CITY OF ��mn m ��m om����n��� . _
BUILDING DIVISION PERMIT PERK4|T#: ELR2008-00023
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: N81200B
Phone: (503) 639-4171 i 00,001,4 .
Inspection Requests (24 Hrs.): (503) 639-4175 =40 ^
INSPECTION WORKSHEET FOR DATE: 21121200 TIME: 7:05Ah8 PAGE: 45
SITE ADDRESS: 07340 SW HUNZIKER RD 200 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL SEMI CONDUTOR
DESCRIPTION: installing data tekcomrnurw::aton line
OWNER: ROBINSON DEVELOPMENT, PHONE #: 5034;154353 1
CONTRACTOR: WIRED BY DESIGN PHONE #: 971-570-3163
Inspection Request Scheduled For: Date: 3y12U2008 Pour Time:
Code # Inspection Description C Contact # Message
135 Low voltage 601 971'570'3163 Y
" `� .
{�orreotiono/C�omm�nta/|natruc�imna:
~�_ ���� ' ��� ,
=~- "~�' -~" —=~~
/ I PARTIAL APPROVAL 1 CANCEL I | NO ACCESS
| |'� #L ~ 17 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
� ' �\ so LE). �J���� Phone #: (603) 718-.
Inspector: G �� Date: °-^ ^~ \J 0
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