Permit '' CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
,_, jii 4 c DEVELOPMENT SERVICES PERMIT #: ELR2005 -00019
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/31/2005
SITE ADDRESS: 15495 SW SEQUOIA PKWY 100 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: L
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: THERMOSTAT. X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES PROTEMP ASSOCIATES INC
15350 SW SEQUOIA PKWY #300 -WMI 9788 SE 17TH AVE.
PORTLAND, OR 97224 PORTLAND, OR 97222
Phone: Phone: 503 233 - 6911
Reg #: EiilB- 23876063CRE
LIC 38868
SUP 2613LEP
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 1/31/2005 $75.00 Elect'I Final
[TAX] 8% State Surchart 1/31/2005 $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 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
ilf.CEIV
Electrical P .rmit lication FOR OFFICE USE ONLY
city of Tigard AN 3
'
Date/B ed — D 5' I Permit No. / ' ___000 I
13125 SW Hall Blvd., Tigard, O 4{�'3(�F TIGARD Plan Review `� �,
Phone: 503.639.4171 Fax 5034898./ 9b�6
75gUILD DIVISION ' i+ p 4 Other Permit:
G
Inspection Line: 503.639.41 ■ �' Date Ready/By: tnrb: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 11(I - Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction LkAddition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
['System over 600 volts nominal units in one structure
El 1 - and 2- family dwelling LJ Commercial/industrial ❑ Accessory building
❑ Multi - family Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: $Sy' Job site address: / S y S 5 ' � � S' v Uoi ❑Health care facility DOther:
y Submit 2 sets of plans with any of the above.
City/State /ZIP: / ;_f.A ®A,-e-- The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: go rY)q Project name: S'eC.Uiii y CO, La 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 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
L t✓ d 11 / 1 e. etic o j I'll v w r w Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 . iZ.
PROPERTY OWNER . ❑ TENANT 201 amps to 400 amps 106.85 ail
401 amps to 600 amps 160.60 2
Name: / A 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
ja APPLICANT I CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each
Business name: �� I "f• �SS QG ,e 5 branch circuit 6.65 2
B. Fee for branch circuits
Contact name: 4 ,(, j cam — A J N , 4 , , without service or feeder fee, 46.85 2
Address: re- each branch circuit
9 7 O O E_ / ? ( /9 //- - Each add'l branch circuit 6.65 2
City/State /ZIP: P6A7—L �1).... 0 A . ,e_ 9 72Z.,L Miscellaneous (service or feeder not included)
Pump or irrigation circle I I 53.40 I I ,2,
Phone: 6)3 ) 6 C / g 1 I Fax: : 6:03 23 g' ) 4 , Sign or outline lighting 53.40 2 .
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or i ti
extension. Describe: Page 2 - *2-
Business name: S 41 #P49, e,` _
Address: Each additional inspection over allowable in any of the aboye�
Per inspection 62.50
City/State /ZIP: Investigation per hour (I hr min) 62.50
Phone: ( ) I F ax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic : .: ��!! Suprv. Lic. c� , S -
�� I�6 � Electrical Lic •CIO � �� � I Su p � 1 y 82e4 Subtotal
Suprv. Electrician signature, required: �4 Plan review (25% of permit fee)
Print name: Y , �,(� �� Date: /... 0--0 S State surcharge (8% of permit fee) b -
TOTAL PERMIT FEE �� no
Authorized signature: 34 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: A R. 0 C L ( t) ./G.,._ Date: / 0- • Fee methodology set by Tri- County Building Industry Service Board i
•• Number of inspections per permit allowed. - t
■
i:\Building \Permits \ELC- PermitApp.doc 12/03 440- 4615r(l0 /02/COM/WEB 1
1
CITY OF TIGARD , - •
•
BUILDING DIVISION PERMIT #: ELR2005-00019
13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 1/3112006
Phone: (503) 639 -4171
A
�� , lhkl llll
,�
Inspection Requests (24 Hrs.): (503) 639 -4175 l- ° s__..
INSPECTION WORKSHEET FOR DATE: 3/21/2005 TIME: 7 :10AM PAGE: 57
SITE ADDRESS: 15495 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: SECURITYCO,INC.
DESCRIPTION: Low voltage to stat.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 -233 -6911
Inspection Request Scheduled For: Date: 3/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 'S , ry NI L, 002297 -02 503 - 519.6199 Y
Corrections/Comments/Instructions:
54.-5)-(c
C' (-----
1
FA-ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4`'A-%"`� Date - aZ ( `)‘--, Phone #: (503) 718 -
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR2005 -00019
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005
Phone: (503) 639 -4171 . u �� o
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:08AM PAGE: 1
SITE ADDRESS: 15495 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: SECURITYCO,INC.
DESCRIPTION: Low voltage to stat.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 -233 -6911
Inspection Request Scheduled For: Date: 3/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002599-02 503-519.6199 Y
Corrections /Comments /Instructions:
•
l] PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: en ' 6 (( Date: 7I Z O+ Phone #: (503) 718-