Permit A:\ CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00085
' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/13/2005
PARCEL: 2S 112DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 250 ZONING: I -P
SUBDIVISION: PP1996 - 048 LOT: 002 JURISDICTION: TIG
Project Description: Data & Voice.
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 CACHE VALLEY ELECTRIC COMPANY
15350 SW SEQUOIA PKWY #300 -WMI 9315 SW NIMBUS AVE
PORTLAND, OR 97224 BEAVERTON, OR 97008
Phone: Phone: 503- 431 -6600
Reg #: LIC 148222
ELE 26- 1135CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/13/2005 $75.00
[TAX] 8% State Surcha 4/13/2005 $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: 2 Permittee Signature: _ -e, @ �•Q
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.
04/12/2005 13:40 FAX 425 424 9966 CACHE VALLEY ELECTRIC 001
04/12/.2006,,„1 69 FA 5035981960
CITY OF TIGARD Z 001
FOR OFFICE USE ONLY
Electrical permit ii. 1' EO ` 0 perntitON,: : M 00, `� •
City of Tigard R' 97223 10 Plan Review other P Ie
f 3125 5 Hap Blvd., Tigard. 0 . '1- ,'.,1; Date/B : ® See Page 1 far
Phone: 503.639.4171 Fax: 903 598,I� 1 'i I Datetteady/By Supplemental information
�L�. D /By:
Inspection Line: 103.6 .or.us5 IOWD
Interact w ww,ci,cigard.or.us _ :` •
Im7 . : Please c all t hat opp1Y: • ❑ `• :.1 lion/alteration/replacement ['Service over 225 amps, cotnm' l ['Hazardous location
ES New construction rating ❑ u ,000 sq. R.,
❑ Other: ❑Service over 320 amps — g Bildng over 10,000 u il morosaw x ,000 sq. l
12 Demolition • . '. , . , of 1 and 2- family dwellings 4 or T w r
n �EOO)<tY ".Og'`CDB? (]System over 600 volts nominal
Accessory building suuure
❑Building over three stories ❑Peesiers, 400 amps or more
EJ 1 -and 2- family dwelling ®ComtneroiaVlttduslrial CI ❑O P p�Om ❑Manufactured suvctures or
❑ Master builder ❑ Other ecrl tort load over 99 RN park
❑Mufti- family • • . ❑6gr�uhng Plan .
JOB SITE. iN80RMATiO1V' AND '[eOC 1 ❑1i�th-0aze facility ❑Other.
1b1 JOi) Site address: ( $ttJJ eau) �he' Submit 7_ sets of plans with say of the above.
Job no.: T he above are not applicable to temporary cOaSmIction service.
Giry/statel "L1P: -. , ,. .r_ ?aa :' : FEE!.$ .. '......
Suite/bldg./apt. no.:
a5 CD Project name: die . ,: _is e1 J "1::i -1 Deseripdea I ' QY !:± Total [ ..
Ct .' ? 2 M e • New residential single- or multi- family dwelling unit.
Cross street/directions to of site: vw includes attached garage 4
1,000 sq. R or less 145.15.
En. add'1500 sq. It. or portion 33.40 I
Subdivision: Tot no: Limited energy, rcsidendal MI 75.00 2
Tax map/parcel no.:
Limited clergy. non - residential 75.00
DESCR(p'IZON OF WORK • Each manufactured or modular 90.90 2
dwelling, service and/or feeder
e , _ t! • . 1 ri, , 1 Services or feeders installation, alteration, and/or relocation
_l �C . , I ., ten.! 80.30 2
200 amps or less
v D \c-� • Iil'�C'G1�1CX‘ 201 amps to 400 amps _ 106.55 2
❑ TENANT 401 amps to 600 amps r 160.60 �
ID PROPERTY OWNER
601 amps to 1,000 amps 240.60 • 2
2
Name: O ver i amps or volts 454.65 Address: Reconnect only
66.85 2
Temporary services or feeders installation, alteration, and/or
City/Siate/7•IP: relocation
133.75 2
Phone: ( )
Fax: ( ) • 200 amps or less 66.85 I m
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 stops
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 , s to 600 a mps _ 100.30 2 Owner signature: — Date: _ Branch circuits — new, alteration, or extension, per panel •
A Fen for branch circuits with • ❑ APPLICANT ❑ CONTACT PBRSOIiI service or feeder fee, each 6.65 2
branch circuit
Business »elate: B. Fee for branch circuits
without service or feeder fee, a 6 . 5 2
Contact name: each branch circuit
Each add'l branch circuit 6.65 2
Address:
Miscellaneous (service or feeder not included)
City/State/ZIP:
or irrigation circle 53.40
Phone: ( ) P ax: : ( ) Sign or outline lighting
53.40 Signal circuit(s) or limited -
E -moil: energy panel. alteration, or Page 2 �
CONTRACTOR extension. Describe:
Business 'name: _ - • !' • ■ l
� ._ Cap •
Each additional Inspection over allowable its any of the above •
Address: 3 -- - • A Pcr Inspection 62.50
a QO Investigation per hour (I hr min) 62.50
City/State/ZIP: � � s �R� � 16 f_ lndusttial pleat per hour 73.75
Phone: � .(O CO Fax: ( (0024' l4 5�
ELECTRICAL' PERMIT FEES"
. Suprv. Lie.: a 0131.0" Subtotal — 15.00
CC13 Liz: � 4 :6 � - _
Suprv. Electrician signi _
����� plan review (25% permit fee)
titre, required: rte°
T State surcharge (8% of permit fee) C. Do
• Print name: • r - d i MIA \ a. Date: -12 -0s"
TOTAL PERMIT FEE S (, 0 0
This perm es it application expires it permit Is not obtained *moo 180
Authorized signature: days atter It has been accepted as complete
Date: • Fee memodology set by TO-Cou e y Building e Industry Service Board
Print name: "• Numtw of inspeatlons per p
ue4l51 el i INtgicon /W tiB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00085
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2005
Phone: (503) 639 - 4171 0 -a�fil lll�l
Inspection Requests (24 Hrs.): (503) 639 -4175 �-
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 93
SITE ADDRESS: 06650 SW REDWOOD LN 250 CLASS OF WORK:
SUBDIVISION: PP1996 -048 LOT #: 002 TYPE OF USE:
PROJECT NAME: HOUSEHOLD FINANCE
DESCRIPTION: Data & Voice.
OWNER: PACIFIC REALTY ASSOCIATES, C..2 PHONE #:
CONTRACTOR: CACHE VALLEY ELECTRIC COMPANY PHONE #: 503-431-6600
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 004548 -01 971 - 235 -9448 N
Corrections/Comments/Instructions:
c r
)4 1 )
.
1! PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: 5 2--- A 5--- Phone #: (503) 718 -