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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00379 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/3/2007 PARCEL: 2 S 112 DA -008 0 0 SITE ADDRESS: 15115 SW SEQUOIA PKWY 150 ZONING: I - SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG PROJECT: WESTLAKE 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 TELESPHERE 15350 SW SEQUOIA PKWY #300 -WMI 449 SW ALDERWOOD PORTLAND, OR 97224 WEST LINN, OR 97068 Phone: 503- 624 -6300 Contact #: PRI 503- 880 -9412 FAX NA FEES Reg #: ELE CLE118 LIC 149154 Description Date Amount [ELPRMT] ELR Permit 10/3/2007 $75.00 [TAX] 8% State Surcha 10/3/2007 $6.00 REQUIRED ITEMS AND REPORTS 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 obt -in copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: � / 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. a6YONt.Q "CAt(A-616 /04 .-do % ectrical Perri& Application Lamt Approval , s ° ""\. 1 AV, Suite 350, MS 12, Hillsboro, OR 97124, pmt # %GO,' Phone: 503 - 846 -3470, Fax: 503- 846 -3993, Inspection Requests: 503- 846 -3699, www.co.washinaton.or.us TYPE OF WORK PLAN REVIEW ❑ New construction Addition/alteration /replacement ❑ Other: Please check all that apply: ❑ Service or feeder 400 amps ❑ Hazardous locations CATEGORY OF CONSTRUCTION or more where the available 0 Service or feeder 600 amps ormore fault current exceeds ❑ Building over three stories ❑ 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building 10,000 amps at 150 volts or❑ Marinas and boatyards less to ground or exceeds ❑ Floatin buildings ❑ Multi - family ❑ Master builder ❑ Other: 14,000 amps for all other g g JOB SITE INFORMATION AND LOCATION installations. ❑ Commercial -use agricultural buildings ❑ Fire pump Installation of 75 KVA or larger Job no.: Job address: I its-"" ) ' p �� ❑ Emer s ❑ 7 separately derived systeun City/State/ZIP: ❑ Addition of new motor t3 / A �jn� n � ❑ "A," .. ,, "1-2," .1 -3., occupancy / f �� / /�`7 load of 100HP or more Suite/bldg. /apt. no.: / Project name:1 J �f . i A L ❑ Six or more residential units 0 Recreational vehicle parks ✓" ' ❑ Health -care facilities ❑ Supply voltage for more than Cross street/directions to_ic1) site: 600 volts nominal FEE SCHEDULE Description I Qty. I Fee I Total I * Subdivision: I Lot no.: Residential single- or multi- family dwelling unit. Includes attached garage. Tax map /parcel no.: 1,000 sq. ft. or less 150.00 4 DESCRIPTION OF WORK Ea. add'I 500 sq. ft. or portion 42.00 �/ Limited energy, residential U( /C ' /DTI (with above sq. ft.) 60.00 2 Limited energy, multi - family 66.00 2 residential (with above sq. ft.) ❑ PROPERTY OWNER I ROTENANT Services or feeders installation, alteration, and/or relocation / � 1 / 200 amps or less 90.00 2 Name: "[�C S % !/�/�. �vuU /s C 201 amps to 400 amps 120.00 2 Address: /.7 /s' \ l[/ ®SCI �li #150 401 amps to 600 amps 180.00 2 - E 601 amps to 1,000 amps 270.00 2 Y City/State /ZIP: VQ��/ OR 7f Over 1,000 amps or volts 504.00 2 • Phone: ( ) ' C t I Fax: ( ) Temporary services or ft....zrs installation, alteration, and/or relocation Owner installation: This installation is being made on residential or farm property owned by me or a member of 200 amps or less 78.00 2 my immediate family. This property is not intended for sale, exchange or rent. (ORS 479.540(I) and 479.560(1). 201 amps to 400 amps 108.00 2 Owner signature: Date: 401 amps to 599 amps 150.00 2 ❑ APPLICANT I 21 CONTACT PERSON Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with Business name: above service or feeder fee, 8.50 - each branch circuit 2 Contact name: a ,,,, i e B. Fee for branch circuits / y // without service or feeder 60.00 Address: /6270 'e it d', fee, first branch circuit 2 City/State /ZIP: / .. Each add'I branch circuit 8.50 / / l ��v 4 ��� / Miscellaneous (service or feeder not included) Phone: (3) 4e 3 6V / Fax: (93) 6 - 5 - c p.... 6.96 it Each manufactured or modular 102.00 2 dwelling, service, and/or feeder E -mail: r`/41 hd /4i /'s't 6 hfyi/ ,2I ,/ ( Reconnect only 78.00 1 CONTRACTOR Pump or irrigation circle 60.00 2 Business name: �,, , _ . Sign or outline lighting 60.00 2 / �7� Signal circuit(s) or limited - Address: 9 ey� , energy panel, alteration, or r6tTO� // ,7/ Lin t �7 J extension. Describe: /_ City/State /ZIP: L ( (J ^ / 2 Phone: (3V3) ,v 9V7 Fax: ( ) Each additional inspection over allowable in any of the above • /D � /4 " Per inspection 90.00 E-mail: Q / t CCB lie. no.: A � Investigation fee (See compliance) Electrical lie. no.: / f City or metro lie.: Other: Supervising electrician Lee 2659 ELECTRICAL PERMIT FEES signature, required: ..„.."A— // 1, ..1 di , Subtotal Print name: Plan review ( 25% of permit fee) "� - ��� Q 3 S tate surcharge (8% of permit fee) Authorized signature: // / $ TOTAL PERMIT FEE ' �.�.. elf. / _ �, This permit application expires if a permit is not obtained Print name: A I P / r r �J Date: ,O ©i within 180 days after it has been accepted as complete "Number of inspections allowed per permit. Revision 06 /26/06 . CLA'eltaLL CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007.00379 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1002007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 J F '� L INSPECTION WORKSHEET FOR DATE: 2/19/2008 TIME: 7 :01AM PAGE: 6 SITE ADDRESS: 15 SW SEQUOIA PKWY 150 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: WESTLAKE CONSULTANTS DESCRIPTION: Voice and data OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-6241-6300 CONTRACTOR: TELESPHERE PHONE #: 503-080-9412 Inspection Request Scheduled For: Date: 2/19/2008 Pour Time: Code # Inspection Description firm # Contact # Message 199 Electrical final - 6521401 503-969-6832 ` Y Corrections /Comments /Instructions: r 1 \ ET P)s ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: lA tg `'r Date: 1—' v v Phone #: (503) 718-3kLk