Permit C ITY OF TI CARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00058
"�'4W6� DEVELOPMENT r SERVICES O -639 -4171 DATE ISSUED: 3/17/2005
PARCEL: 2S112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110 ZONING: I -P
SUBDIVISION: PACIFIC CORP. CENTER LOT: JURISDICTION: TIG
Project Description: Voice and 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 -94CLE
SUP 2312LEA
FEES LIC 145828
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 3/17/2005 $75.00
[TAX] 8% State Surcharl 3/17/2005 $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 95„,1101-0100. You may / ain copies of these rules or direct questio - ' U ► 03- 246 -6699.
Issued By: A _ i _ _ ! , Permittee Signature:
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.
.rlectricalYer:iiit A lication FOR OFFICE USE ONLY
r =' Received
+ /
City of Tigard f L Date/B 17 e 5 8 fi Permit N° l-r'P „,,,,( 00 4
13125 SW Hall Blvd., Tigard, OR 97223 Plan Re
Phone: 503.639.4171 Fax: 503.598.1960 • 44 ' 5 40411': Date/By: Other Permit:
Inspection Line: 503.639.4175 / •` 2005 Date Ready/By: 1 ,�-- El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 7 /et Supplemental Information
CITY OF TIGARD
. . , . - VISON • - _ - ' - •., 'PLAN _- °,:` ”` -: >,
❑ New construction E Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑Other:
['Service over 225 amps, com'I ['Hazardous location
. ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
' CATEGO Y "OF .CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
JOIE SITE INFORMATIbN. AND LOCATION . `. RV. ark
n ❑Egress /lightingp1an P
'I '45 s -w <�Y ❑Health -care facility ['Other:
Job no.: Job site address: 1445 ! , Submit 2 sets of plans with any of the above.
City/ State/ZIP: I C D / 9 T b Z The above are not applicable to temporary construction service.
FEE *. SCHEDULE': ::,.<L .:1.°- -.
Suite/bldg. /apt. no.: ( 0 Project name: S7�L1� 2 CC3, " ,
I 1 _ Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: RI q FIT AC (P_OSS rRoM 146/4E-90br 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
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non - residential 75.00 • 2
.'', •` ' DE SCRIPTION -O F ' WORK
. Each manufactured or modular
- ' / � j�� dwelling, service and /or feeder 90.90 2
�/ (/ Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑. - =PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
. 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
-
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 l _
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
B APPLICANT • ' ❑ CONTACT PERSON A. Fee for branch circuits with
•' service or feeder fee, each 6.65 2
Business name: branch circuit
z B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'l 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-
CONTRACTOR energy panel, alteration, or
/ n� , extension. Describe: Page 2 2
!
Business name: 1" U MUTl -{ CO M ► CA'n64
Address: ( i511-0 5'(,J w�. .R' 5'K wow Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: .7UALA - s o 1 OR 61-06 2 Investigation per hour (1 hr min) 62.50
Phone: ( ) 6. 9 -r2(/ O Fax: (56-5) 6 ? q— oft Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: ` ( - t SSie Electrical Lic.: *21.E Suprv. Lic.: i — U Subtotal �4 —
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: S. -- v Date: y (7 ._ /Z State surcharge (8% of permit fee)
r TOTAL PERMIT FEE ' / -'
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.
i:\ Building \Pemrits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLX:• : • . --
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:
COMMERCIAL WORk ONLY: ,r. ,
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
'ata Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: /
*No licenses are required. Licenses are required
for all other installations
is Building \Pamits\ELC- PermitApp.doc 04/03
CITY OF TIGARD ` .
BUILDING DIVISION PERMIT #: ELR2005 -00058
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/17/2005
_III- (503) 639 -4171 �°m
Inspection Requests (24 Hrs.): (503) 639 -4175 ° `111.
INSPECTION WORKSHEET FOR DATE: 3/18/2006 TIME: 7:24AM PAGE: 79
SITE ADDRESS: 14946 SW SEQUOIA PKWY 110 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: STERLING COMMUNICATIONS
DESCRIPTION: Voice and Data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 - 6300
CONTRACTOR: AZIMUTH COMMUNICATIONS INC PHONE #: 503 - 639-0110
Inspection Request Scheduled For: Date: 3/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002132 -01 503 - 793 -2906 N
Corrections/Comments/Instructions:
Nt
C (=J
PS PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3 — /8 - O5 Phone #: (503) 718- .2 y