Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00177
'' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/24/2006
PARCEL: 25101 DC -04601
SITE ADDRESS: 07409 SW TECH CENTER DR 150 ZONING: I -P
SUBDIVISION: TECH CENTER BUSINESS PARK LOT: 002 JURISDICTION: TIG
Project Description: Voice & 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:
WATUMULL PROPERTIES CORP ORE -COM TELECOMMUNICATIONS
621 SW MORRISON SUITE 800 13826 S. MEYERS RD. #2127
PORTLAND, OR 97205 OREGON CITY, OR 97045
Phone: 503- 223 -3171 Contact #: PRI 503- 381 -7281
FEES Reg #: ELE 34- 691CLE
LIC 152834
Description Date Amount
[ELPRMT] ELR Permit 7/24/2006 $75.00
[TAX] 8% State Surcha 7/24/2006 $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 ' not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to • •w rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-0110 You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: � J�£1� Permittee Signature: V L
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.
•
Electrical Permit Auulicati n V bbbeee��� FOR OFFICE USE ONLY
City of Tigard I `. L/ Permit No.: eAg 6 " 7 Dal
a 13125 SW Hall Blvd., Tigard, OR 97223 JUL 2 200 Plan Review
: C Phone: 503.639.4171 Fax: 503.598.1960 Date(B . Other Permit:
T I G A R D Inspection Line: 503.639.4175 a ` l \ or ilk) .. Supplemental See Page 2 for
Internet: www.tigard- or.gov V n g . V , Supplemental Information •
• TYPE O11 PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling grCommercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E" "1 -2 "1 -3
Job no.: Job site address:' L� C C I00HP or more. occupancy.
l� J fE H� N { L i� �+� ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: I / 6 f,Rk ' DP—. on Z . ❑ Health -care facilities. ❑ Supply voltage for more than
� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: SAM MCI) I CA ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: / fio -7 1 NI ,i' ir no L 1)--Z. Description 1 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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
\/12t •tt P A G444/.. iLr& residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ 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 /StatelZlP: 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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: DR, M -rE��-0 e i er gyc� circuit(s) alor teration, o, or
- co /� - S p, . Sign el, alteration, limited-
Address: I r5 sib S(EyQa 1I IV 2.1 Z1 extension. Describe: Paget 2
City/State/Z1P:•e,a..) cert o X Each additional inspection over allowable in any of the above
r Per inspection 62.50
Phone: Kp ;) S$ (. 7,62)11 Fax: 403)6;7- '114 3 Investigation per hour (1 hr min) 62.50
CCB Lic.: 16 ,9 3 Electrica c•:3 - 6 4 :11 ai Suprv. Lic.:3q g'7 Lig Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ' Subtotal:
A Plan review (25% of permit fee):
Print name: 3> 9 ,. I E YL Date: 7 Z
.. .. State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE: 1 'O
Print name: Date: This permit application expires if a permit is not obtain within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit
I:\ Building \Permits\ELC- PmnitApp.doc 05/23/06 4104615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
El Audio and Stereo Systems* •
El Burglar Alarm
❑ Garage Door Opener* ' '
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems* ,
El Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system . • • °
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls :
❑ Outdoor Landscape Lighting*
.
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: \Building\Pcmib\ELC- PamitApp.doc 03/23/06
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR200 6-00177
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ...... P :_..
INSPECTION WORKSHEET FOR DATE: 8/21/2006 TIME: 6:58AM PAGE: 21
SITE ADDRESS: 07409 SW TECH CENTER DR 150 CLASS OF WORK:
SUBDIVISION: TECH CENTER BUSINESS PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: SAM MEDICAL
DESCRIPTION: Voice & Data.
OWNER: WATUMULL PROPERTIES CORP, PHONE #: 503-223-3171
CONTRACTOR: ORE COM TELECOMMUNICATIONS PHONE #: 503 -381 -7281
Inspection Request Scheduled For: Date: 8/21 /2006 Pour Time:
Co. - : Inspection Description Confirm # Contact # Message
199 Electrical final 035308 -01 603 -381 -7284 N
Corrections /Comments /Instructions:
31 y1
Di
,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: eTh f`U V 4 L 1v Date: $' 24 ' bb Phone #: (503) 718- 2.114
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2006 -00177
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7024/200G
Phone: (503) 639 -4171 ApwIlI
Inspection Requests (24 Hrs.): (503) 639 -4175 F...
INSPECTION WORKSHEET FOR DATE: 7/31/2006 TIME: 7 :06AM PAGE: 34
SITE ADDRESS: 07409 SW TECH CENTER DR 150 CLASS OF WORK:
SUBDIVISION: TECH CENTER BUSINESS PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: SAM MEDICAL
DESCRIPTION: Voice & Data.
OWNER: WATUMULL PROPERTIES CORP, PHONE #: 503-223-3171
CONTRACTOR: ORE - COM TELECOMMUNICATIONS PHONE #: 503 - 381 -72.61
Inspection Request Scheduled For: Date: 7/31/2006 Pour Time:
C• • - # Inspection Description Confirm # Contact # Message
Low voltage 034068-01 503- 381 -7284 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cl I) �+ Date: 1 1311 Phone #: (503) 718- 2