Permit C ITY OP TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00192
" B�I� DEVELOPMENT Tigard, .639 -4171 DATE ISSUED: 7/14/2005
PARCEL: 2S112DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 190 ZONING: I -P
SUBDIVISION: PACIFIC CORP. CENTER LOT: JURISDICTION: TIG
Project Description: Data /telecommunication.
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 SERVICE COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI 4120 SE INTERNATIONAL WY A -109
PORTLAND, OR 97224 MILWAUKIE, OR 97222
Phone: 503- 624 -6300 Phone: 503- 723 -6415
Reg #: LIC 90175
ELE 3- 365CLE
FEES SUP 1127JLE
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 7/14/2005 $75.00
[TAX] 8% State Surchari 7/14/2005 $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 952001 -0100. You may , stain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: � ,, Permittee Signatur_ e x
OWNER INSTALLATION ONLY c
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.
Eiec ical Permit Appli V FOR ,
FOR OFFICE USE ONLY
City of Tigard " / 7/1% Da y /(1/0 5/ ,fie Permit No.. 1 � S- -Go /9y
13125 SW Hall Blvd., Tigard, OR 97223 ' - ' 4& Plan Review
/ �,ra a r
Phone: 503.639.4171 Fax: 503.598.1960. , _ , ° - . :4 , . e _ Ready/By: ()thy Permit:
Inspection Line: 503.639.4175 Date
/By: 1/4.,,,, ' _ Date ReadyBy: 1� - ® See Page 2 for
�a.��,r -% ,, ■
� n�;,
Internet: www.ci.tigard.or.us E)U'Lt�1 ;` :o� °i .)iVi �'V�;_ - Notified/Method: *==r / Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition /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
❑ 1- and 2- family dwelling gr Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
El Multi - family ❑ Master builder ❑Other: ['Building over three stories [Weeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/li plan RV park
Job no.: Job site address: ❑Health -care facility ['Other
/S 92s sWJ S g vo%q )44-149 l ubnrit 2 sets of plans with any of the above.
City/State /ZIP: /�2��N d.. m2 977 y The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: / 96 Project name: 7 �� < ,4� — FEE* SCHEDULE
Description I Qty. I Fee. I Total **
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 .. „:�5 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
�iQZ /Tz� S�
i■ -t J� /19T Services or feeders installation, alteration, and/or relocatio
` 200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ 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 OT volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) 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 I 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,
Address:
each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone:
( ) I Fax : : ( )
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: 1:i41 MU J /C47) ..i _Tit.G -
Address: Each additional inspection over allowable in any of the above
y /a?o SE ?../I ,i/e 7 cAI 9L G�/9�/ / 9/ a9 Per inspection 62.50
City/State /ZIP: LvA...;2_- j O/. 97aaa Investigation per hour (I hr min) 62.50
Phone: (j) 7 6 , . s --- I Fax :�) 7 - ? _ y7� Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 9 75- Electrical Lic = ..z e -A.._- Suprv. ic.: /� 7e J Subtotal . 7 .3 -7- 0 0
Suprv. Electrician signature, required: �i �!` Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: � a � Date: 6.
� ����� 7 " /��� TOTAL PERMIT FEE d/
00
Authorized signatur This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete
Print name: .e. !i /21/6-- Date: 7 43 7 ass --- • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Pennits\ELC- PennitApp.doc 12/03 440 -4615T(10 /02/COM/WEB
r
,,-CITY OF TIGARD
BUILDING DIVISION . PERMIT #: ELR2005 -00192
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2005
Phone: (503) 639 -4171 :fN,dNa�g�,; I
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' �+�- `'I c.
INSPECTION WORKSHEET FOR DATE: 7/18/2005 TIME: 7:07AM PAGE: 63
SITE ADDRESS: 15495 SW SEQUOIA PKWY 190 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: OREGONIAN EXPANSION
DESCRIPTION: Data/telecommunication.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #: 503-624-6300
CONTRACTOR: SERVICE COMMUNICATIONS INC PHONE #: 503 -723 -6415
Inspection Request Scheduled For: Date: Pour Time:
P q 7/18/2005
Code # Inspection Description Confirm # Contact # Message
e " - . • e 011588 -01 503.723.6415 N
Corrections /Comments /Instruc ' • ns:
G
PASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: X Date: 7-- i c P 'aJ Phone #: (503) 718-