Permit C ITY OF TI G ARD ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: ELR2006 -00022
'�' �,� II 1 3125 SW Hall Blvd., Tigard, OR 97223 5 - 639 -4171 DATE ISSUED: 1/17/2006
PARCEL: 2S112DD- 007.01
SITE ADDRESS: 15800 SW UPPER BOONES FERRY RD A -300 ZONING: I -P.
SUBDIVISION: OREGON BUSINESS PARK II LOT: JURISDICTION: TIG
Project Description: Data & Intercom.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
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: 2
Owner: Contractor:
PACIFIC REALTY ASSOCIATES TRITON COMM UNICTATIONS, LLC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 1091
PORTLAND, OR 97224 HILLSBORO, OR 97123
Phone: Contact #: FAX 503 628 - 5689
PRI 503- 615 -5800
FEES Reg #: LIC 154665
ELE 34- 648CLE
Description Date Amount
[ELPRMT] ELR Permit 1/12/2006 $150.00
[TAX] 8% State Surchari 1/12/2006 $12.00 REQUIRED ITEMS AND REPORTS •
Total $162.00
•
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 -00 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: s , I �� c Permittee Signature: C
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.
FleStrical Permit A : FOR or1 IC use ONLY
• �� ® Receved
City of Tigard e — � 7 d le_ � Permit No O _._
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
p�
Phone: 503.639.4171 Fax: 503.598.196 A 1 2006 M �t : �- t I Rei Date/B " Other Permit:
Inspection Line: 503.639.4175 J1 - ' Date Ready/By. El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method Supplemental Information
3t i I tPagJtbIUN PLAN REVIEW
. ❑ New construction [Si Addition/alteration/replacement Please check all that apply:
ID Demolition ❑ Other: ❑Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling 12/Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
El 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 0 Egress/lighting plan RV park
Job no.: I. C) Job site address: y1 ❑Health -care facility ❑�►er:
��� s� V,� r` Ut l:eJ t - "� j' Submit 2 sets of plans with any of the above.
City / State/ZIP: 7 L 4 ,,,/ () /Q The above are not applicable to temporary construction service.
/
FEE* SCHEDULE
Suite/bldg./ apt. no.: * 300 Project name: /(,11 4tvw'f 641 /e, ,•cs
Description 1 Qty. I Fee. Total 1 ••
Cross street/directions to job site: ( A .n e.., D � New residential single- or multi- family dwelling unit. •
Includes attached garage.
1,000 sq. fl. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
VO r c e q. Q47 9- hoe /{ z..w it ..w, Services or. feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ 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 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
❑ 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, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax : : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: .• Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
Co 11 extension. Describe: Page 2 2
T
Business name: / i, i to `Pt.•[ //f. -
Address: p a px / G 9/ Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: /./. t /1 60 r 0 '0 9 7/23 Investigation per hour (1 hr min) 62.50
Phone: (sb3) G / 5- _ 5• 'ao / Fax: (s03 62 Y - s d F•9 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: i 3 L S Electrical Lic.: 3I /. `' /(j r Suprv. Lic.: Subtotal / S
Suprv. Electrician signature, required: g 7 0 _g 7 Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: 2��
1� 4 �i�- This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete
Print name: Ail R t) n tin,' ir(e er Date: , 1 / b b • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed
i. \Building\Pennits\ELC- PermitApp doe 12/03 44 615T(IO/02/COM/WFB
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:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
a
❑ Garage Door Opener*
❑ Heating, Ventilation and Air. Conditioning
System*
❑ Vacuum, Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system. $75.00
(SEE OAR 918 - 260 -260) •
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
j.. Data Telecommunication Installation
❑ Fire Mann Installation
❑ HVAC
❑ Instrumentation
Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting* . - •
❑ Protective Signaling
❑ Other
Total number of commercial systems: 2
• *No licenses are required. Licenses are required
for Mother installations
•
\&,admg\Pamits\ELC- PamitApp doc 04 /03
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: L= i_R2006-000 2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/171700(
Phone: (503) 639 -4171 /yaw
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/20 /2006 TIME: 7 : 00AM PAGE: 82
SITE ADDRESS: 1&00 SW UPPER BOONES FERRY RD A -300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME: MA1THEWS GALLERY
DESCRIPTION: Data & Intercom.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: TRITON COMMUNICTATIONS, LLC PHONE #: 503-6
Inspection Request Scheduled For: Date: 1/2W2006 Pour Time:
Cod Inspection Description Confirm # Contact # Message
135 Low voltage 025355 -01 503 -956 -6280 N
Corrections /Comments /Instructions:
AIRS AG
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-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector. cis- Date:/ 2 -0 Phone #: (503) 718- ��%
CITY OF TIGARD - -- -
BUILDING DIVISION PERMIT #: `CLR2ow(10032)
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .)!17/2ij0( -;
Phone: (503) 639 -4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175 F'I �..
INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7 PAGE: tit
SITE ADDRESS: 15000 SW UPPER BOONES FERRY RD A CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME. MAl THEWS GALLERY
DESCRIPTION: Data & Intercom.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #:
CONTRACTOR: TRITON COMMUNICTATIONS, LLC I PHONE #: 503.615. 200
,1 2.0 DI)
Inspection Request Scheduled For: D. te: 1/19/2006 i Pour Time:
Code # Inspection Description -• - '` - % act # Message
136 low voltage 025177 01 I 503 61 , 5,0gt) N
Corrections /Comments /Instructions:
P RANI t ZsC c- ActiC5 Fn
. N seL bR, .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
ice/ FAIL XC L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / / AA, Date: l i ?/ 0 6 Phone #: (503) 718 -14