Permit CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
, .
. e COMMUNITY DEVELOPMENT PERMIT #: ELR2006 -00280
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/17/2006
PARCEL: 2 S 102AC - 01701
SITE ADDRESS: 12700 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Voice and Data low voltage.
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:
CHC ENTERPRISES LLC PROCOM COMMUNICATIONS INC
18100 SW KRAMIEN RD 8326 SE 17TH AVE
NEWBERG, OR 97132 PORTLAND, OR 97202
Phone: 503 -516 -9509 Contact #: PRI 503- 233 -8037
FAX 503- 233 -8052
FEES Reg #: ELE 3- 397CLE
LIC 109929
Description Date Amount
[ELPRMT] ELR Permit 11/17/200€ $75.00
[TAX] 8% State Surcha 11/17/200€ $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 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 or 1.800.332.2344.
Issued By: ,(e , �f j 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.
Nov 17 06 12: 00p Procom Communications 5032338052 p.1
Electrical Permit Applic 6'. EIVE FOR OFFICE USE ONLY
City f Tigard i ft I I ri bk , �� ycrnut /� ey' „� 012 ,
25 g Date ti, �� � o-vv 1111 13125 SW Ball Blvd., figartl, UR� 13
C Phone: 503.639.4171 Fax: 503.598.196 1 7 2006 Plan Holm Date Fy ether Pemut
1 I n r. I) Inspection tine: 503.639.4175 CITY OF TIGARD Dale Rd-By I 0 See Pagc 2 for
Internet: www•tigard- or.gov BUILDING DIVISION Notificdihiethnd: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction 14 Addition /alteration/replacement Please check all that apple tsut itot set:. of plans wateitu. checked below
❑ Service or feeder400 ontps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATECORV OF CONSTRUCTION exceeds 10,000 amps at 150 - volts or ❑ (Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -usc agricultural
❑ 1- and 2-family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- fancily ❑ Master builder ❑ Other: ❑ Fire pump. ❑ las:alla:ion of 75 KNA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. :anger separately derived system
❑ Addition of new motor load of ❑ "T", "F", `I -2' , "
Job nn.: Job site ad .. lOCIFI ' or more_ occupancy.
t 21 O SL.I CRe1 F L ��r ❑ Six or more residential units. ❑ R,xreationnl vehicle parks.
City /State/ZIP: 1 /'^R� , Dck ` 9 2 � 2 ❑Health - care facilities. ❑ Supply voltage for more 11
`1`�` 7 ❑ Hazardous locations. 600 volts nominal
Suite /bldg. /apt. no.: Project name: , . g y G ❑ Service or feeder 60t) amps or more
FEE SCHEDULE
Cross street/directions to job site: , - Description I Qty. I Fee. I Total I '
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Fa. add'( 500 sq. R. or portion 33.40 I
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK. I u Oh above sir it.) 75.00 2
s Limited energy, multi- family 75.00 2
V p 1 C- t iVCf t residential (with above sq. IL)
Services or feeder installation. alteration. and /or relocation
200 amps or less 80.30 2
❑ i'ROPL.RTI OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1.000 snips 240.60 2
Address: Over 1,000 amps or volts 454.65 2
l City /State /ZIP: Temporary services or feeders Installation, alteration, unillor
I relocation _
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
. Owner installation: 'This installation is being made on property that I own %11tich 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, altercation• or extension, per panel
Owner sittnatttre: Date: Fee tin' branch c ireuils with
,\1'l'LIC'- F CON f :K'r PERSON above service or feeder fee. 6.65 2
n p each branch circuit
Business name: eat'N(vh,,. re l (r(L ,
a d � I3. Fee for branch circuits
without service or feeder lee.
Contact name: � & 46.85 2
� 5 first branch circuit
Address: 1 �� t E Each add'l branch circuit 6.65 3
`� - ' - ��" - ` Miscellaneous (service or feeder not included)
City /State/ZIP: ,oRT / C3 9? 2-62-- Each manufactured or modular 9(1.9( I 2
Phone: 9,a32_5414_____944.7 , dwelling. service andlor feeder
( 1 ax . l y o3 x33 _53.65 2 Reconnect only 66.85 i 2 i
E - mail: Pump or irrigation circle 53.40 ! 2
CONTRACTOR Sign or outline lighting 53.40 I 2
Signal circuits) or limited -
13usiuess name: a� �� C'o pia, µKt ear H
t C - energy panel. alteration. or . i
Address: extension. Describe: t Page 2 lv 2
City /State/LIP: Po(31`1. D2 ` c -1 z o 2 Each additional inspection over allocable in any of the above
I r Per inspection I 62.50
Phonc: ( 5 6 3 ) 2:3? ' X31 Fax: (563 ) Z33 Sic, I nves ti gation per hour (1 hr mitt) I 62.50
CCB I sic.: (0 91ZR Electrical Lic.: 3 _ 3 Ti C Suprv. Lie.: t 112LeA Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: QB �_ 0 Subtotal: - 15 m
Print name: P A � ! U � Date: / �_ / 7 -,e14, flan review (25% of permit fee): o±
SR fLr S State surcharge (8% of permit Ice): to
Authorised signature: `���� ' TO'1•AI. PERMIT FEE: 4J(
1
This permit application expires if a permit is not obtained within ISO
Print name: ..f 4c....tj-'f - 'GAS Date: / / -/ 7 .--4,fo days after it bass been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006 -00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/17/2006
Phone: (503) 639 -4171 AV J t ip0111
Inspection Requests (24 Hrs.): (503) 639 -4175 :"- _
INSPECTION WORKSHEET FOR DATE: 12/19/2006 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 12700 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE AGENCY
DESCRIPTION: Voice and Data low voltage.
OWNER: CHC ENTERPRISES LLC, PHONE #: 503- 516..9509
CONTRACTOR: PROCOM COMMUNICATIONS INC PHONE #: 503 -233 -8037
Inspection Request Scheduled For: Date: 12119/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 041261 -01 503-233 -8037 N
Corrections/Comments/Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Elk-2.006-001V 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 . 1 voiloili
_-'!!
Inspection Requests (24 Hrs.): (503) 639 -4175 - ` ..L.
INSPECTION WORKSHEET FOR DATE: 2 1 4 -O,6 TIME: PAGE:
SITE ADDRESS: vZ1 to S U) ?'Pc. I 0 W � . CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Vol Gt ` / 07^ C1
OWNER: PHONE #:
CONTRACTOR: i \�N PHONE #:
Inspection Request Scheduled For: Date: 12- I ti -No Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
% NZ 661'N■ PIFIZVA--- .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 9 V QE3 t--
•
- Date: 1Lt 6c. Phone #: (503) 718-