Permit d A
- CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
,..4. I DEVELOPMENT SERVICES PERMIT #: ELR2004 -00178
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/23/2004
SITE ADDRESS: 06650 SW REDWOOD LN 290 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Low voltage: Data and telecommunication install.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ESP TECHNOLOGIES
15350 SW SEQUOIA PKWY #300 -WMI 7929 SW BURNS WAY STE. F
PORTLAND, OR 97224 WILSONVILLE, OR 97070
Phone: Phone: 503 628 - 4195
Reg #: LIC 73872
ELE 34- 269CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/23/2004 $75.00 Elect'I Final
[TAX] 8% State Surcharl 6/23/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
through OAR 952-00 .9100. You may obtain copies of these rules or direct questions1 O • • C at (503) 246 -6699.
Issued by • / / L ) Permittee Signature A. '4
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received / / t ' ! i ,90/'7 '.
13125 SW Hall Blvd., Tigard, OR 97223 Pl Review `� 1,1 , or `l
Phone: 503.639.4171 Fax: 503.598.1960 All ; • , i Date/By: Other Pe rmit:
Inspection Line: 503.639.4175 "' Date Ready/By: Juris: E1 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: i -16 ‘ Supplemental Information
' - ^'r= - - •P; :NF_d1. =�'. 4 ,$- ��it, � * 'i'n .4;1[. ^. ;a �, 4 � J .:f a.jL li - ��. i��„ y r
°�'' � ..,, , :� , t •TYPI ,OF WORfc fi ili• a''ti ,, 3 -"� _'i e' l _'LLB ; ,"!`t� ' �0 iIi.f. P><A'lY W .
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
ID Demolition 11 Other: ❑Service over 225 amps, comm'l 0 Hazardous location
, _ S
❑ ervice over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
'" • .-< " EA�GOR3/; OF CON`ST�T�faIiION s a � w A, , :k•
y CPTV-4 of 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2 - family dwelling igiCommercial/industrial ❑ Accessory building ❑S over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family El Master budder ❑ Other:
DOccupant load over 99 persons ❑Manufactured structures or
. : - :: " : :: 7 ...::'- , >,,„' `' .JO$':.SITE_.J1N',ORMATION AND LOCii;E1'.ON r 1 " ,if ❑Egress/lightingplan RV park
Job no.: 4 (4 6 S
�0 0 Job site address: C, Si t x'od P,1 ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: POD - \a - , 0 ( - Z -. 7 The above are not applicable to temporary construction service.
'7. i': -i -:" fE' a• , ' ?F�[ f` L':. ,$1'.`iL'.,Yl�ttR.' ':'' a
Suite/bldg. /apt. no.:99) Project name: fa. irr ( av t11 e.Yc -ral
1 Description I Qty. � Fee. I Total l ..
Cross street/directions to job site: 14t•vr}1 arm New residential single or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less . 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
ks ' ` DESCIXIPTION 4OF'WORI ,. -4 ,.,,
�, .. �. � - • , , , . _;7 _ „. °' , _ Each manufactured or modular
( l �, j dwelling, service and /or feeder 90.90 2
U � � l
C G U Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
:� ''''' .' D PROPERTY OWN ER . ' "' -;❑; TENANT .t':, s, w: ry 7. 201 amps to 400 amps 106.85 2
"''' 401 amps to 600 amps 160.60 2
Name: F- au 6.,(Alcx vJJ ) Cowl i icas, 'CV\.orL - reeLo e. 601 amps to 1,000 amps 240.60 2
Address: G 6, Sp S 12.4.4:‘,4)0006, L�l/\ 5 b Over 1,000 amps or volts 454.65 2
f -- °l L Reconnect only 66.85 2
City/State /ZIP: �D(FL'f'(Ltd I Off ZZ�-( 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
'' '
0 ' 1 '' - ' 4 ' ' • = '® CONTACT PERSQ(■ ' A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
, , ;a. ;• '' ','`a:.. co*r1.A070R :,,,4::,',,!:' , r . .. ;; "'t' ..i. - , ... energy panel, alteration, or -�L� CO
-- rr -- extension. Describe: Page 2 " / ✓' 2
Business name: ES p T. ( vLO . O. i e-5
Address: �01 S (/) 1,.1.4.4z..4\ S L1.) s f� F , Each additional inspection over allowable in any of the above
t Per inspection 62.50
City/State/ZIP: ( Aj t ` l g D )/l. u t ' l..2 ( b c;;\,� Investigation per hour (1 hr min) 62.50
5 0,q- _ a � Industrial plant per hour 73.75 I
Phone:(S'p3) �(� Fax: ( I
- LLEC CAG- 'kEitOr FEES, '. ; ,11' -, ..3!'
CCB Lic.: 9?g� -Z Electrical Lic.: �(- Z,(df(,(,J Suprv. Lic.: 2,2_5?) L r f . � Subtotal - ' °..�
Suprv. Electrician signature, required: ��....G_ Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4 O
t.
Print name: f F F s -- ^` .."— Date: <o ( O
TOTAL PERMIT FEE WO / 0-32-
Authorized signature: This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is'. Building .Penmt_s\ELC- PemutApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
FffiS rttNITIAI,. VOR kONL'Y: 7
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
CO CIALWORK
Fee for each commercial system .$75.00
(SEE OAR 918 - 260 -260) •
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
'a Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other r
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
i:\ Building \Permits\ELC- PamitApp.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection L : (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / 7 ✓ � I AM PM BUP
Location C SID /L P1/ 7 ®U Suite 2-qo MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR 2.DDY"' D b l 78
Crawl Drain
Slab Inspection Notes: Dier i reLCcmr4 SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation r WWII 0,0 58 _ C1-4(4-1_, C1-4(4-1_, Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
F e Alarm
CP Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Please call for reinspection RE: • El Unable to inspect - no access
Fire Supply Line
ADA Date 7 ( (2 y Inspector ` ^� hpwriti,y Ext
Approach/Sidewalk /
Other: /c ti
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL