Permit CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
�t DEVELOPMENT H BMENT Tigard, � 639 -4171 DATE PERMIT ELR2004-00380
- 13125
SITE ADDRESS: 14945 SW SEQUOIA PKWY 150 PARCEL: 2S112AD -01000
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Adding 16 telecommunication outlets to existing system.
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 C3 COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI 10950 SW 5TH
PORTLAND, OR 97224 SUITE 110
BEAVERTON, OR 97005
Phone: Phone: 503 643 - 1922
Reg #: MET 00004740
LIC 117658
ELE 24- 373CLE
FEES SUP Ftgli i1i d Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 12/21/2004 $75.00 Elect'I Final
[TAX] 8% State Surchar€ 12/21/2004 $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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by G Gu-e—. 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
E A e e v i i i c a I Permit ABiEU I ° E D FOR OFFICE USE ONLY
Received
City of Tigard r Date /B : ..)1 G
: DEC Permit No' , / "-66 35'6 13125 SW Hall Blvd., Tigard, OR 97223 21
2 UU4 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 4 "• i � i Date/By: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIG ' ' " m y- a Date Ready/By: luris: Ed Page 2 for
Internet: www.ci.tigard.or.us '� Notified/Method: ( \ Supplemental Information
BUILDI VISION PLAN REVIEW
TYPE F O
❑ New construction lig Addition/alteration /replacement Please check all that apply:
❑ Service over 225 amps, comm'l 0 Hazardous location
❑ Demolition 0 Other:
OService over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I and 2 family dwellings 4 or more new residential
❑ 1 and 2 family dwelling [Er Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Buildin over three stories ❑Feeders, 400 amps or more
❑ Multi - family 0 Master builder El Other:
DOccupant load over 99 persons OManufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑ Health -care facility DOther:
Job no.: 1 0 6 Job site address: / le f !fir SL,J Se ur7 /q s t/,' Submit 2 sets of plans with any of the above.
City/State /ZIP: 7767.A..) � ' ole Q 72 2 y The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: / FEE* SCHEDULE
I Proj name: �r c6{2/ � �• W . Pete - f- - Description I Qty. I Fee. I Total I '•
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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
./44gt a - A, /e/feaAUNQ0,:....4bn O.`/Pi 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 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
❑ APPLICANT I ❑ CONTACT PERSON 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,
each branch circuit 46.85 2
Address: 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 -
CONTRACTOR energy panel, alteration, or
extension. Describe: / Page 2 [ / 2
Business name: C3 Communications, Inc. J
Address: 10950 SW 5 Street, Suite 110 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Beaverton, Oregon 97005 Investigation per hour (I hr min) 62.50
Phone: (503) 643 -1922 Fax: (503) 643 -1203 Industrial plant per hour 73.75
q -1-a� - ELECTRICAL PERMIT FEES*
CCB Lic.: 117658 Electrical Lic.: 24373 CLE Suprv. Lic.: 994LEA Subtotal 7 S`
Suprv. Electrician signature, required: : Lv .` Plan review (25% of permit fee)
Print name: ry kvc Date: /Z Gy State surcharge (8% of permit fee) 6 ` / / TOTAL PERMIT FEE iY, 0 U
Authorized signature: . C - /‹. U (1,74 This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: Te /0%■ Date: /Z / / • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Permits\ELC•PermitApp.doc 12/03 440- 4615T(I0 /O2ICOM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Ling :_(503) 639 -4175 MST
INSPECTION DIVISION " Business Line: (503) 639 -4171
BUP
Received Date Requested / — / AM PM BUP
Location / Suite / S -10 MEC
Contact Person � � Ph ( ) F 4 q - /9S1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR Apo 3gb
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: r
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
Fire Alarm
7r . ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
0731 PART FAIL
SITE fl Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date \ \ u \ fro �/C�
L \ � � S Inspector \- d ry I Ext
Other:
Final DO NOT REMOVE this Inspection record the job site.
PASS PART FAIL