Permit ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
L�
DEVELOPMENT H P Tigard, (503) 639 - 4171 DATE SSUIED: E �R2 3 - 00339
SITE ADDRESS: 07007 SW CARDINAL LN 185 PARCEL: 2S112AD 01000
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Job #C23 - 312 Install Telephone Network cabling.
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:
PACIFIC REALTY ASSOCIATES CAPITOL DATA & COMMUNICATIONS
15350 SW SEQUOIA PKWY #300 -WMI 11401 NE MARX ST.
PORTLAND, OR 97224 PORTLAND, OR 97220
Phone: Phone: 503- 255 -9488
Reg #: LIC 142457
ELE 26- 1054CLE
SUP 3132S
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/3/03 $75.00 Elect'I Final
[TAX] 8% State 11/3/03 $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 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 may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699.
Issued by Permittee Signature GL,�.0 =71
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: ;24 -5
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
A
n OFFICE USE ONLY
El Permit A,p p i� ca t lon� C` ' Date received: /Iff i ' Permit no.: —40„ `7
II 111. '' `— Project/appl. n.� Expire date:
YO l; City of Tigard rc 1 Date issued: Bye 0 Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGAR 7��
R 97223' Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960
Land use approval: C►TY O F TIGARD
BUILD t,',...
TYPE OF PERMIT
❑ 1 & 2 family dewlling or accessory p Commercial /industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition /alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION ,
Job address: 7007 SW CARDINAL LANE City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot /account no.:
Lot: 'Block: N/A ISubdivision:
Project name: COMMON) 'Description and location of work on premises: TELEPHONE & NETWORK CABLING
Estimated date of completion /inspection: # # # # ## ' -
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: C23 -312 Fee Max.
Business Name: CAPITOL DATA /COMMUNICATIONS Description Qty. (ea.) Total no. insp
Address: 11401 NE MARX ST. New residential - single or multi - family per
City: Portland State: OR ZIP: 97220 -1041 dwelling unit. Includes attached garage.
Phone: 503 - 255 -9488 'Fax: 257 -7121 IE -mail: ray(n,cepdx.com Service included:
CCB no.: 142457 'Elec. bus • .no: 26- 1054CLE 1000 sq, ft, or less $ 145.15 4
City /metro lic.no.: 4542 Each additional 500 sq. ft. or portion thereof $ 33.40
_ e 10/30/03 Limited energy residential $ 75.00 2
Signature of supervising ectrician (required) Date Limited energy, non - residential $ 45.00 2
Sup. elect. name (print): Richard Martin License no.: 2865 - Each manufactured home or modular dwelling
PROPERTY OWNER Service and /or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: State: 'ZIP: 200 amps or less $ 80.30 2
Phone: Fax: IE -mail: 201 amps to 400 amps $ 106.85 2
Owner installation: The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 I
ENGINEER Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less $ 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E -mail: 401 amps to 600 amps $ 133.75 2
PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel:
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories El Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress /lighting plan ❑ Other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel, — -
alteration, or extension* I 11 $ 75.00 75.00 2
*Description:
Each additional inspectionover th allowable in any of the above:
Per inspection I I $ 62.50 I I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 75.00
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained State Surcharge( 8% ) $ 6.00
Name of cardholder as shown on credit card
$ withing 180 days after it has been TOTAL $ 81.00
Cardholder signature Amount accepted as complete.
CITY OF TIGARD 24 -Hour
BUILDING Insp, ctiof Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Z / 1 L • f 20 Date � Requested / 2 -// 5 /a-- AM PM BUP
Location 0 C ez-e c- Suite MEC
Contact Person Ph ( ) mil / 506-2943Lm
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ' 3 - c/ z7/)
Foundation Access :,
Ftg Drain EL:
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling p
Roof
Other: ///
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains - •
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
- MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final o -'' /z� ` 3--� ® $ T
e�
PASS PART FAIL
ELECTRICAL
Service
Rough -In GQ,f, t" -- I
owVo -.
F - •arm
RT FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• E. El Please call for reinspectio RE: 111 Unable to inspect — no access
Fire Supply Line
ADA t
Approach /Sidewalk Date � Inspecto
Other:
Final DO NOT REMOVE this inspection record from the Jo site.
PASS PART FAIL