Permit ELECTRICAL PERMIT -
C ITY O T I CAA R D RESTRICTED ENERGY
�1k DEVELOPMENT SERVICES PERMIT #: ELR2005 -00047
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/10/2005
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110 PARCEL: 2S112AD -01000
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Expansion of existing intrusion alarm system. Job No. 5905
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ACTION TECHNOLOGY SYSTEMS
15350 SW SEQUOIA PKWY #300 -WMI 835 SE 17TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: 503- 624 -6300 Phone: 503- 231 -1992
Reg #: LIC 157630
ELE 26- 775CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 3/10/2005 $75.00
[TAX] 8% State Surchari 3/10/2005 $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 folio es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
through • • R 952- 01- 100. You may obtain copies of these rules or direct questions to OUNC at (50G) 246 -6699.
Issued •■ Permittee Signatur
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.
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.
FEB -06 -1900 23 : 47 g� 1 G P.01
1 . lect i ti ical Permi - ► on FoR OFFICC 1_ SE: ONLY
5
. City of Tigard `� C.) 2�� v e d . _f!o 6� �� Perm" 1 HO.:
='s 13125 SW Hall Blvd., Tigard, OR 97223 • E r Oa) e/7
; • Phone: 503.639.4171 Fax: 503.598.1 p - T 1G" (,1 , l •: Review o PcrmiPermit:
www`oi 503.639.417 5 C1 O 0 1\1 15 r i .� r� 1J y I - El See Page 2 for
8 01 1 • Notieed/Method: / i C' S upplemental Information
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❑ New construction X Addition /alterittion/rcplacement Please check all that apply:
OemOliilon ❑Other: ❑Service over 225 amps, conun'l ❑Hazardous location
. .�•;,,• , - ,�, : , . : _ _ _ Over 32f1 amps — rating ❑Huildno over
� f, +,a1 ;,. ,._,._: :.-• ,.: >:ei:� .. ..: .....:.:::.::::. r. , .... . .. - ' . , mu,:nf.,r::...n.u: e, x:r, n . Y ...._. r tY 10,000 s R.,
��:�' :+, ��t '3ir� ... . .� - r. '� _ -- ti�, r �' -'�. ,,r. ,. -.__, ��w,;.: , ,a.C; ;' f t- and 2 •familydwellings Qorm
. ....� .,... - :. ...:,... ', . • ° " . t , ::, - +i' or more new residential
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi-family ❑Master builder Other: ❑ building over three stories ( Feeders, 400 amps or more
a ..... , , u ,,,, occupant load over 99 persons [Manufactured structures or
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#. - ,,:e,r::... -.: z?.ar *.;::`rr.:.. „ r, „ -- ❑gress /ligh
...... - -• ... .... ,r i'7;1w b „1.f,l,rw::�_ �..,,k,.� ling plan park
P
' Job no.: 5905 riob site address: 14945 SW Sequoia Pkwy #110 pH
ealth -care facility Dothcr:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97224 The above arc not applicable to temporary construction service.
. ' •Suite/bldg. /apt. no.: Project name :Sterling - _ _E /i - _...... '• .,,- ,...... •• _... . >. ... , . . ... ... _.
• Dacelptloe Qty. Fee 7•eal
Cross Street/directions to job site; New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sy. tt or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. f. or portion 33.40 1
Tax m8 arcel no.:
Limited energy, residential 75.00 2
A/P • ; ....,,,,.•.,. �- energy, non-residential 75.00 2
. l'' ., , .. , , ,,, ,...,, ... .. .....::... n ° -._� r � ,. Limited en
',I ' ,11!' ? `'1 . w,C :_. ; l ; / 14
- . ; . , :�;: - _._+,� .•s.'. = ::. - . ` ::,::. ,_ _ , -._ . - ,. o >< r , s iit'4l,:��c'l�!Il�j� = ?il� � ` Each manufachand or modular
expansion of existing Intrusion Alarm system expansion s service rs installation, feeder 90.90 2
- _ Services or feeders instaallation, alteration, and/or relocation
200 amps or less 80.30 2
•
r fit c t
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„r ? , -' •,. e !ll)@ � � ; : : : .. ` �r�''= - ':+_ ` �a � ,ia •.1,1; � t �� t `�
.,. ,.,:, tt4�.Y: . .t�•, -'•. ) r.cr,.r.•..,- .....,:: r.:...:- c' a :,,;rl�'' nT. 7� " ]i ': f :.::: : .r:..:.. .,. 401 amps to 6 106.85 2
/ 14/ 1 •` •,
00 amps 160.60 3
Name: 1'Lt,,)►.4, 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
.j Reconnect only 66.85 2
:Coy /State/ZIP: Temporary services or feeders installation, alteration, and/or
; Phone: (spa) 6 — I Fax: ( ) relocation
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 salt, lease, rcnt, 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
;; F , :
, . 'a_,_.., ; =14 " {r 'ti, ; A. Fee for branch circuits with
iiiliE1
i ' ii(p _ .... t. . 1 �1,i 11 � b d a L. :;' .pis I �� • k :• . 1 1!,.
� � service or feeder fee, each 6.65 2
'Business name: branch circuit
B. Foe for branch circuits
:Contact name: without service or feeder fee_
each branch circuit 46'85 2
Address: Each add'I branch circuit _ 2
City/Statc/ZIP: Miscellaneous (service or feeder not icluded)
Phone: ( ) g am; : ( ) Pump or img ion circle 53.40 2
Sign or outline lighting 53.40 2
'E-mail: . Signal circuit(s) or Iimited-
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' �r�i� if�d' �; �+: �,. � •::;::s,,;,���,�.. -- =. _( ��,,,,,, ��C-.:. 95: l,Cflp1St)�n���.':�t�1;f�ll�;;% till ;ll���.11,_ ;:t.�,__.�5,,.,j;,., �.Yp
/ ext ar Describe: 1 Pie 2 75.00 2
: : :Business name: Action Technolo S stems ILC . -
Addr�SS, Each additional inspection over allowable in any of the above
83 SE 17th Avenue Per inspection 62.50
City /State/ZIP: investigation p hour ( 1 hr min) 62.50
Portl d, OR 972 4
Industrial plant per hour 73.7
- Phone ( 503) 231 -1992 Fax: ( 503 231 -1402
;_'::::;= EF.Ef"( RYGal::: f*?Vfft .. IZ?ES! . • .
CCB Lic- :157630 j Electrical Lic2. 775CLE Suprv. Lie.: 579LEA Subtotal 75.00 _
; Suprv. Electrician signature, required: I Plan review (25% of permit fee)
Slate surcharge (8% of permit fee) 6.00
:; ; = name: Steve and Date: 3/10/05
/ / r TOTAL PERMIT FEE 81.00
...•••• !. . Authorized signature: Q This permit application esp'ren et a permit is not obtained within ISO
days after it pine been accepted as complete
• Fee mcthodolo sea by Tri -Count Bull Industry Se.,rium Board
P rint name: Rena Kirkland Datc: 3/10/05
• ry r d
• Number of iasnecttorac per permit allowed.
. tt�+il4in Pere �.c- Paa,nnnvo.dOe 12103 aeo461sr(iobuco�tnvte