Permit ,r
CITY OF TI GARD
DEVELOPMENT SERVICES ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00230
DATE ISSUED: 8/12/2005
= --- 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S 112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110 ZONING: I -
SUBDIVISION: PACIFIC CORP. CENTER LOT: JURISDICTION: TIG
Project Description: Voice /Data.
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 AZIMUTH COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI P.O. BOX 508
PORTLAND, OR 97224 WILSONVILLE, OR 97070
•
Phone: 503- 624 -6300 Phone: 503- 639 -0110
Reg #: ELE 36 -94CBE
SUP 2312LEA
•
FEES LIC 145828
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/12/2005 $75.00
[TAX] 8% State Surcha 8/12/2005 $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 9 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: / Permiftee Signature:
v
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 Applicatitotv"\(7
, \ , _,, FOR OFFICE USE ONLY .:
LI r(1.., --_, i ..'
City of Tigard e iv d ./, m ,,,, r r
13125 SW Hall Blvd., Tigard, OR 97223 " " • r^j., c r'' Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 -- '' -'-' /•'‘'2) 4 " , t/t.-.. , : I '' Date/B : Other Permit:
Inspection Line: 503.639.4175 11",
.4191' ' .. -.. Date Ready/By: ISM El See Page 2 for
Internet: www.ci.tigard.or.us (MTV OF TleAPO Notified/Method: Supplemental Information
aitVCTinti*ttTit'i„„ TV,:-.5.AtkgrV.'4 !
0 -New construction 0 Addition/alteration/replacement Please check all that apply:
0
['Service over 225 amps, comm'l (3 Hazardous location
Demolition 0 Other:
o ['Service over 320 amps - rating 0Buildng over 10,000 sq. ft.,
,
ego Yr.lt W
' ''' 4 ii7&§ , :4 ■ " ' , , - . , i t' - ' :, - ' ' 9,.., it . ..'., 1 • .•;,.0.1y,-,',-,..,,.,,..li of 1- and 2-family dwellings 4 or more new residential
0 1 - and 2-family dwelling 14 Cornmerciallindustrial 0 Accessory building ['System over 600 volts nominal units in one structure
OBuilding over three stories ['Feeders, 400 amps or more
El Multi-family 0 Master builder 0 Other:
, .. TO. - 77 70 7)71.7- :- 11 . • ,''--1 . .w-'''W; . - . . [Occupant load over 99 persons C Manufactured structures or
b
- insu WNW '"'
,,, - ElEgress/lighting plan RV park
.
•
0Health-care facility 00ther:
Job no.: Job site address: 14 cp./5-5. A) . su6 IA R
Submit 2 sets of plans with any of the above.
City/State/ZIP: - 6 , 1 fao The above are not applicable to temporary construction service.
,!IM.a.'
Suite/bldg./apt, no.: i 1 0 1 Project name: -...
Description I Qty. 1 Fee. I Total
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: 1 Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.: .
Limi
' ted energy, non-residential I 75.00 2
- "'" -■• ',1( .'. Li - k - ' 'Y-:' '....' •-• ,: 4- V'' ' "-' r "" 4 .A." f' ig l'''' '' • ' Am - .1'■' 1, " •:,' '-• ''
li.p.: e., t.: 't .. w : 1 , t, .-A4 ey j' 494A42,4„:.t.? ', z,tri. ;'■.`;;;;ii,: ‘.::,.<; Each manufactured or modular
dwelling, service and/or feeder 90.90 2
V Ok CO I iPv Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
amps to 400 amps amps 106.85 2
401 amps to 600 160.60 2
Name: STE1 i 1‘)Th itl SO LU-TIOAX :LUC 601 amps to 1,000 amps 240.60 2
Address: 1 7-}qc4 s S.W. So6tic diA PMAJAy , ,z--,,Jc Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: 7764€ 0 0 e C7 722. q Temporary services or feeders installation, alteration, and/or
f relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I
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
7:°, - 4. 1 .7TOSIM:iripi, ; ,,_.:6 Iff-agirzz, : - -' . A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: A. u -R i _ co / nu ,th (km AiS branch circuit
B. Fee for branch circuits
Contact name: 263 ULIf6g without service or feeder fee,
46.85 2
each branch circuit
Address: ea 3oy 34 8' Each add'I branch circuit .
6.65 2
City/State/ZIP: (.)/ LS OA) di i t e- / off 97 o70 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: Ke,3 ) 7q? _ 2 siyf I Fax:: (5 ) (.3C- oa o Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
1;;Wiii-NNIMantirag 1k1"..t Egi4A• energy panel, alteration, or
extension. Describe: Page 2 2
Business name: A 2
rr / 7-0- (04441 GI A) r M izdA/S
Each additional inspection over allowable in any of the above
Address: P 0 . e hIl 5 Per inspection 62.50
City/State/ZIP: 01 L--$ L L E ,e q7o76 - Investigation per hour (I hr min) 62.50
Phone. (3o3) 6 34 _ //0 Fax: (5 ) 6 if -o/ir Industrial plant per hour 73.75
CCB Lic.: / q57 Electrical Lic.: 36 ,..q cte.4 Suprv. Lic.j3/2 LEA- Subtotal
Suprv. Electrician signature, required: B Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: Rke a ( A E: g 6 ate: r g 1 1
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within ISO
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.
iN3uilding\Permiu\ELC-PermitApp.doc 12/03 440
7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00230
1 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005
Phone: (503) 639 -4171 l tip
Inspection Requests (24 Hrs.): (503) 39 -4175 ..' a, ' --
INSPECTION WORKSHEET FOR ATE: 8/23/2005 TIME: 7:05AM PAGE: 61
SITE ADDRESS: 14945 SW SEQUOIA PK 110 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: STERLING COMMUNICATIO -
DESCRIPTION: Voice/Data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300
CONTRACTOR: AZIMUTH COMMUNICATIONS INC PHONE #: 503 - 639-0110
Inspection Request Scheduled For: Date: g/ , ' 2005 Pour Time: •
Code # • - -.= _. escription onfir Contact # Message
135 Low voltage 0140 -11 503- 793 -2906 N
19C\ VA N N L
r ill
Corrections • • mments /Instructio f s:
\
\
l
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C)' Nee 1- Date: I 1_3f O5 Phone #: (503) 718- 2'} 14 .