Permit a CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00293
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 • DATE ISSUED: 11/30/2006
PARCEL: 2 S 112 D D -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
Project Description: Voice /Data. PETORCARD
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 TELEDIGIT INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 22287
PORTLAND, OR 97224 PORTLAND, OR 97269
Phone: Contact #: PRI 503- 722 -8084
FAX 503- 722 -9914
FEES Reg #: ELE 3- 414CLE
LIC 116188
Description Date Amount
[ELPRMT] ELR Permit 11/30/200E $75.00
[TAX] 8% State Surcha 11/30/200E $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 obtain 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.
FOR OFFICE USE ONLY
1. Electric Permit Applicatiol� V ED - - - —
1ty, f Tlpard 0 2006 Received �� PPrmitNo/� /� ��
�' o n1 o � 3 DatcBy: // 3 /� a� - Vl� �� 3
I N V 1' S :ir v of .a Tigard, OR 9 7223 N
u ,., , ,, .,.. Plan Review
Other P er r ^�t :
Phone: 503.639.4171 Fax: 503.598..1960 ...f TI,GARD Oate(BV'.
inspection Line: 503.63`9.4175 (j Jun, E1 See Page 2 for
T G A R D DIVISION
Date Rcad y B y _ I I
I tv
nternet: ww.tigard- or.gov BUILDIN Notified/Method: I , I Supplemental Information
I TYPE OF WORK PLAN REVIEW
f Please check ant 'fiat apply (subr.:it 2 sets of plans w /items checked below). I
I ❑ New construction jJ Addidon/aiterationirepiacemenl I , ,
❑ Jef VI.e Of feeds 400 mfiip of LIIJfe Li Builditie, vvel duct .toile..
I ❑ ^ U Other. I where Inc available fault current U Marinas and boatyards.
` CATROORV O,R CONSTRUCTION exceeds 10,000 amps at 150 volts or U Floating buildings.
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
I U I- and 2- family dwelling Ej Commercia[/wdustrial ❑ Accessory building amps for all other installations. buildines.
I r a ,r _ 1.: I .1- I--1 r..n .1 _ . 1 1_ __ i (_l Fire pp�nr f1 tmt fit) ntinn o f 75 KV k or
U avlunrtuut U I'vlastter builde U vut Emergency system. 0 E,, e. . large; separately dewed system
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ `A ", `E', `I -2 ", l -3 ",
Job no.: Job site address: 15575 SW Sequoia Parkway
1001W or more occupancy.
q ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: g ar / State/ZIP: Tl OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
Tigard, ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 160 Project name: Petrocard ❑ Service or feeder 600 amps or more.
I I FEE SCHEDULE
Cross streeUdlrections to job site: L Boones Ferry Rd Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'! 500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential tr1
75.0
DESCRIPTION OF WORK ( I (with above sq. ft) I I I I
I I limited energy, multi - family I I
I Voice/Data Cabling I I fes id en ti a l (,,;f,, abo sq. ft I ) I 75.00 I 1
I 1 1 Services or feeders installation, alteration, and/or relocation
200 amps or less I I 80.30 I 12
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/7.TP: Temporary services or feeders installation, alteration, and/or
I Phone: ( ) j lax: ( ) L 200 amps or less j 66.15 j i
1 Ow ner installation: This installation is being made on pi opel iv that i own which is not 1 20 amps to 400 amps I I 10030 I 2
I intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670..and 701. 1 401 amps to 599 amps I 1 133.75 1 2
I I ;ranch circuits - new, alteration, or extension, per panel
I Owner signature: Date: - - I A F for britnch circuits with I I I
u APPLICANT I u CONTACT PERSON I above service o lewder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.R5 2
■ I i mail: I j Pump or irrigation circle I 1 53.40 1 2 I
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Teledigit Inc energy panel, alteration, or
Address: PO Box 22287 I
I extension Describe: l I Page 2 i 75 1 I
I I 1
City / State/ZIP: Portland, OR 97269 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 722 - 8084 Fax: (503) 212 - 2249 Investigation per hour (1 hr min) 62.50
I I r 7, w.: i t ..1 cr h I 73.7 I
LLD Lie.. 116188 LCU1G<31 Lll;.. 3-414CLE Sapp /. Lie.. O1JLL' H i " °'° r "" 1 I ,� I -,
- - - - - -- 1r LL — - - - I 4 yy y ELECTRICAL PEith'il i' FEES
Suprv. Electrician signature, requi -. i - - Subtotal: 75
Print name: Art Rosado Date: 11/30/06 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 6
Authorized signature TOTAL PERMIT FEE: 1 81 I
This permit application expires if a permit is not obtained within 180
Print name: Art Rosado I Date: 11/30/06 days after it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION c p ERMIT #: ELC200l -Q0648
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2006'
Phone: (503) 639 -4171 , wf l '; , I
� i
Inspection Requests (24 Hrs.): (503) 639 -4175 _�_ I ..
INSPECTION WORKSHEET FOR DATE: 11/29/2006 TIME: 7:04AM PAGE: 16
SITE ADDRESS: 15675 SW SEQUOIA PKWY 160 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: pETROCARD
DESCRIPTION: Electrical TI - (10) branch circuits
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503.698 - 3417
Inspection Request Scheduled For: Date: 11/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical Final 040389-03 503-969 -5262 N
Corrections /Comments /Instructions: 1
7
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Y 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6� ( Date: 1 2 0 Phone #: (503) 718- 2IA)
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: ELR2006.00283
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/2006
Phone: (503) 639 -4171 /ltd: ; '
Inspection Requests (24 Hrs.): (503) 639 -4175 44- P' ..
INSPECTION WORKSHEET FOR DATE: 12/8/2006 TIME: 7 :01AM PAGE: 27
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: PETRRCARL)
DESCRIPTION: Voice /Data. PETORCARD
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: TELEDIGIT INC PHONE #: 503-722-8084
Inspection Request Scheduled For: Date: 1202006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 040850-01 503-722-8084 Y I
Corrections /C /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: f N be Date: I a 0 (14 Phone #: (503) 718- 14