Permit a Fes.
v
CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
°' ` COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00273
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/14/2006
PARCEL: 1 S134AD -06201
SITE ADDRESS: 10450 SW NIMBUS AVE RC ZONING: I - P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Low voltage for data cabling. Job No. 43250
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:
KG INVESTMENTS CACHE VALLEY ELECTRIC COMPANY
KYLE LATTA 9315 SW NIMBUS AVE BLDG 10
10240 SW NIMBUS SUITE L3 BEAVERTON, OR 97008
PORTLAND, OR 97223
Phone: 503 -598 -9980 Contact #: PRI 503- 431 -6600
FAX 503- 624 -1436
FEES Reg #: ELE 26- 1135CLE
LIC 148222
Description Date Amount
[ELPRMT] ELR Permit 111141200E $75.00
[TAX] 8% State Surcharl 111141200E ,$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 follow rules adopted by the Oregon Utility Notification Center.
Those rules rth in OAR 9 2- 001 -0010 through OAR 952 - 001 -0100. You may obtain copie • : se rules or dire uestions to OUNC at
503.24. 99 or 1.800.332.2 • • .
Iss d By: C 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 �/�
`J Tigard Date/By: // / DC� 4� r!-,1%GC/ 5
City of Ti and Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 : Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: orris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: � Supplemental Information
--
TYPE OF 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.
CATEGORY 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 C&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" "l -2" "1 -3"
Job no.: U 39 Job site address: c, n 100HP or more. occupancy.
1 1b 1 SO & fi rwrribu aim im ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: QOt and (? C7aa3 ❑ Health-care facilities. ❑ Supply voltage for more than
J ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: G Project name: sAtocut -WUI-pSy N o ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description
I Qty. I Fee. I Total
�� ��� New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
\ 00 -r `t Limited energy, multi - family 75.00 2
V 1 ,((� LA ��! residential (with above sq. ft)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I )33 TENANT 201 amps to 400 amps 106.85 2
Name: (ife , pr551(}HQls 401 amps to 600 amps 160.60 2
o
601 amps to 1,000 amps 240.60 2
Address: 1U.i i 1,.,3 n. bu ( tC._ (, Over 1,000 amps or volts 454.65 2
City/State /ZIP: pty i an d / 6Y. q.7 ? 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I 1,4 CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: ro ,s ( 1,� n v c o B. Fee for branch circuits
\f Contact name: l lY without service or feeder fee, 46.85 2
first branch circuit
Address: C1 2 4, SW r - bus o� i6t[J�+� to Each add'I branch circuit 6.65 2
City/State/ZIP: � (3 v Miscellaneous (service or feeder not included)
Ci
tY Bul +( G Each manufactured or modular 90.90 2
Phone: (503 1 4-N t took ) r Reconnect
dwelling, only and/or feeder
Fax: : � �pa1� — � ' �t 3� Recot only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: 011.0-10 V /! e
Signal circuit(s) or limited -
l � energy panel, alteration, or
Address: '13' 5 51,6 r1,1 �s �11 1�P� fs1 ' O
extension. 1 Page 2 `l rj -0� 2
City /State /ZIP: (Sp Each additional inspection over allowable in any of the above
, ^ i / �" Per inspection 62.50
(�. 1 OO Fax: F
Phone: ( 555) t/� � r 4 3(
Dc� � -t :.J�o Investigation per hour (t hr min) 62.50
CCB Lic.: (4 a). Electrical Lic.:ai a Suprv. Lic.: Industrial plant per hour 73.75
`'774& - 7 ///0 . 6 --- lV 1� ELECTRICAL PERMIT FEES
Suprv. Electr signature, required: Subtotal: 15
Print name: 'mil `k ( Date: 11 -1LI - b to Plan review (25% of permit fee):
' `r State surcharge (8% of permit fee): ID . 00
Authorized signature: �! y //, TOTAL PERMIT FEE: t4g � ,
Print name: This permit application expires if a permit is not obtained within 180
Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Buitding \Permits \ELC- PennitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #11.1V-0043• 002.13
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ' l ill
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 3 44 TIME: PAGE:
SITE ADDRESS: 10i6 0 SV■ «S twe. CLASS OF WORKEINt1313b "Q47-13
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: 1 _ W V � q � E •
OWNER: J- � PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -09 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �', N L Date: a'Ili ✓ �� Phone #: (503) 718 - 2 '
CITY OF TIGARD -- . *-°
BUILDING DIVISION PERMIT #: ELR2006 00273
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639 -4171 j r
Inspection Requests (24 Hrs.): (503) 639 -4175 F '! �..
INSPECTION WORKSHEET FOR DATE: 12/13/2006 TIME: 7:04AM PAGE: 42
SITE ADDRESS: 10450 SW NIMBUS AVE RC CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SOFTWARE PROFESSIONALS
DESCRIPTION: Low voltage for data cabling. Job No. 43250
OWNER: KG INVESTMENTS, PHONE #: 503 - 598..9980
CONTRACTOR: CACHE VALLEY ELECTRIC COMPANY PHONE #: 503-431-6600
Inspection Request Scheduled For: Date: 12/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 041024 -01 971 - 2359461 N
Corrections /Comments /Instructions:
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C'1kGZ- 0 0e e Date: 12 '1 i of Phone #: (503) 718- 29'0 •