Permit C ITY OF TIGARD ELECTRICAL PERMI
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2004 -00302
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/28/2004
SITE ADDRESS: 06650 SW REDWOOD LN 105 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Voice & data 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 NETVERSANT CASCADES INC
15350 SW SEQUOIA PKWY #300 -WMI 9740 SW NIMBUS
PORTLAND, OR 97224 BEAVERTON, OR 97008
Phone: Phone: 503 646 - 0533
Reg #: ELE 34- 589CLE
LTC 150328
SUP 2903LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[TAX] 8% State Surchari 9/28/2004 $6.00 Elect! Final
[ELPRMT] ELR Permit 9/28/2004 $75.00
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 3.12 Q p
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
09/27/2004 09:13 FAX 503.641 6613 NetVersant Cascades, Inc I1001 •
•
El lectric -ai Per Yli(t A,�D ' IVE , , OR: UrF[C. : „ ONL
t
City of Tigard d /j ''� aq f Permit No.: �(,, a)l.i'69.0 0 -
13125 SW fiat! Blvd., Tigard, OR 97223 SEP ( Plan Review Other Permit C b 302.
Phone: 503.639.4171 Fax: 503.598.1960 '� 2UU " '' ^f ir ' V ,' ` j Date/Br
�' Date Keady /By:
Jung: la See Page Z for
Inspection Line: 503.639.4175 CITY OF TIGA ; — Nodfied/Method_ ) V Supplemental Information
Internet; www.ci.tigard.or.us _...
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❑ New construction Xf Addition/alteation/replaCement Please check all that apply:
❑ Demolition ❑ Other. _
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ee over amps, conin ous location
r . :::,:=' ,;;;.° ;t:lr... �:. , .,„ r ; ;r „"„ � 1 7 � . g. ; p a ,r .. r _ 1 ❑ emgs 4 or more new residential
sre 10,000
idential
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i'.y .•r nr .. .r. � .: r:. ads
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building ❑ of "nd 24E* dwll System over 600 volts nominal units in one structure
❑ Multi farm7y Master builder [] Other ❑Building over three stories ❑Feeders, 400 amps or more
persons or
• .,:. -..:, . ........ ,� r-: ,...,.: ,. r � �;r ,.. Manu acutrnd structures
, FR:;2 6 :,rr;' r:.•.r.,r, ii•:. y'�, � r_r�ni, {ii;; {::iii? '�i' "ASS:. tin p
.' �`•'+” �, ��� • •, C.±. ;�...- :•�!:�:.,�:ri E c �PF� S lan RV park
'�flT;CO .
Job no_: O 107.0 441•- J s ss (�(0 SW '' nn .. -- np .❑Health - eare facility ❑Other" �y %01 LeU Submit 2 sets of plans with any of the above.
City /State/ZIP: 44 la..H O R /r72,2 The above are not applicable to temporary canstruction service.
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Suite/bldg./apt. no.: tO S Project name: e o0.X 1 (M[ ; •t...:. ..'. $r :,:. " :. ;: ,:::,..:::::
t Description I Qty. Be i Tatal
Cross street/directions to job site: New residential single -or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft or less • 145.15 4
Subdivision: I Lot no.: Fa• add'! 500 sq. ft. or portion 33.40 _ 1
Limited energy,
Tax map /parcel no.:
-.. ..., .:, ...: 75.00 2
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Limited energy, no non-residential
S u'!i:�9V� 0..0:e • '- ,,r..... C- , '• ::� ,tOk#b tl :�''' . • i `% lice ' , ('1`'..'+
,. .r.. .: , r..,,r<:...,. „::;- r�,:•s.,1rS.' ..,..,,.'...:, .:r:., ; -”' ...... . �jn, 'It;::; �. _x: Each manufactured or modular
dwelling, service feeder _ 90.90 2
Vol e., D aka Car 1 • n Services or feeder installation, alteration, and/or relocation
200 amps or less 80.30 2
106.85 2
..,:....•• . ..._ .:. ` . ..._......_... a: ac,,: :.r.•r::. :,:r:v,:;;: ^ ". ....r..`••g !:T `�. ....._. 401 6 00 160 60
Name: 1 amps to amps 2
Name: i40(, se 1 n C . s 601 amps to 1,000 amps . 240.60 2
Address:_( (0 5D S W ken , jel aQ . S uric 0 s- Over 1,000 apps or volts 454.65 2
Recomect emly 66.85 2
City/State/ZIP: %+(etht" 1 t CE et �] 2- 2 Temporary services or feeders installation, alteration, and/or
-
Phone: (0 ` Fate (503 ( 0 ° - 1 91] ? 20loaation
3 ) 4124 – � � 4 1 � � - z00 amps or Tess 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
yc "i•.' <ar`.`' :'::� ':f:t:` '' i s =iii= A. Fee for b circuits wit/i
;�:t:rr >
.r.r...,., �`1'.,,;� , RI IG'AL�4 T,:; :.�':: '= '�:•ri.4'+�.,'��I'�;5'ra) - '.G(1)!FF�.4�;R� �;pl�i;i:i�;;�_
se rvice or ranch f ee d er ee, eac 6.65 2
Business name: branch circuit
B. Fcc for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-rna.th Signal circuit(s) or limited -
::1'.r�, 1-�'v _ •i•4.^r % .. t _.� :�Yu W �f,�. •I S t �. :41.'•r.. � 1:...ri�. ::1:!� •'
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Business name: Ne�FU¢r - • ';:,,,rn . extension. Describe: l Page 2 • see. 2
Address: 9 t�ef O Zw A �V i Iiii 4 a Each additional inspection over allowable In any of the above
I �+ l Per inspection 62.50
ci ty /5tate 41); Z ••ea v,.2' f 'O,... r
� E c l 90 0 g Investigation per hour (1 llr min) 62.50
Phone: 3 )(Wu, , OS 5 I Fax' (503) b Yt - Ce G r 3 Industrial plant hour hour r� 73.775 ,
g I Electr Lic.:3�.6 c up "; !':� :;jF p �?' r' #. =h: z.,.
CCB Lic.: 190 a Suprv. Lie.: 3 I Z - LE � .- .. subtotal 1S. �
Suprv. Electrician signature, required: ' f ft –,. ` o Plan review (25% of permit fee) /v/
D ate: State Surcharge (8% of permit fee) . d p
Print na �. � ._ • q � - 0 — _
', d , -. ,- TOTAL PERMIT FEE g I. Ore
That peradt soorkaean rx if a p ia tat dbtalaed widen tiro
Authorized signature; diva a1� it um bee a ocean) m ootaplets
• vet: memotsiaterwgby To-comfits 8uitd :•g tnd.w�r 5or.. - 13a+d '
D4nte: •• 141IIC■ at inspeed00 per penal allowed.
Witt
4a0•46trKtoiotcAt B
CITY OF TIGARD 24 -Hour
BUILDING Inspection_LI e:. (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received k)/cf, e Rested 5 M PM BUP
Location la b ��✓" /�=��- I • `mite /O MEC
Contact Person = r' ' Ph ( 503 ' 90 — i v ZO 7 PLM
Contractor f 41rA,Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: p
3
Ftg Drain ELR ��
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear I .....
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall Cad ) '4
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
Service
Rough -In
UG/SI
ow Voltage
ire Alarm
46 PART FAIL
0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line — b � -16M 41-E,346titY ADA Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL