Permit CITY OF F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00193
DATE ISSUED: 7/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 150 ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: 20/20
Project Description: Installation of low voltage for 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:
OPUS NW TELEDIGIT INC
1500 SW FIRST AVE #1100 PO BOX 22287
PORTLAND, OR 97201 PORTLAND, OR 97269
Phone: 503- 916 -8963 Contact #: PRI 503- 722 -8084
FAX 503- 722 -9914
FEES Reg #: ELE 3- 414CLE
LIC 116188
Description Date Amount
[ELPRMT] ELR Permit 7/8/2008 $75.00
[TAX] 12% State Surcha 7/8/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 suspen• _ - = ore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those es are set fo - in O; •.2- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 2' 6.6699 or 1.800. :t2 344.
//
Issue' 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.
ect ecil Permit Application I• {)R- 0FVI GE- LSi -0 -NI
III City of Tigard 7 �O Permit No: ����Qa /�
° 1 3125 SW Hall Blvd , Tigard, OR 97223 Plan Review
- ei . — Phone. 503.639.4171 Fax 503.598.1960 Date/B Other Permit
T I G A R D Inspection Line 503 639.4175 Date Ready RI See Page 2 for
Internet www.tigard- or.gov Notified/Method Supplemental Information
-
1 TYPE OF WORK PLAN REVIEW
Please check all that apply (submit sets of plans wiitems checked below).
❑ New construction ® Addition/alteration/replacement
❑ Service nr feeder 400 amps nr more ❑ Building over three stones
❑ Demolition ❑ Other where the available fault current ❑ Mannas 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 ® Commercial/industnal ❑ 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
0 Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
I
Job no . Job site address: 16037 SW Boones Ferry Road 1 or more occupancy.
I ❑ Six x o or r more residential units ❑ Recreational vehicle parks
�,lty/State/ZTP• Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
I I ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.. 150 I Project name: 20/20 Institute ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I qty I Fee, 1 Total I •
I New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: it no 1,000 sq ft. or less I 145.15 I 4
Ea. add'l 500 sq ft. or portion 33 40 1
Tax map /parcel no.: Limited energy, residential 75.00 2 I
DESCRIPTION OF WORK (with above sq. R.)
Voice./Data Cabling Limited energy, multi - family 75 00 2
g residential (with above sq. ft) i
Services or feeders installation, alteration, and/or relocation
1 200 amps or less 80 30 2
I
❑ PROPERTY OWNER ❑ 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 i 2
Address: I Over 1,000 amps or volts 454.65 I 2
City /State /ZIP Temporary services or feeders installation, alteration, and/or
relocation
Phone ( ) Fax ( ) 200 amps or less 66.85 ' l
Owner installation: This installation is being made on property that I own which is not 1 201 amps to 400 amps 100 30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 1 401 amps to 599 amps I 133.75 2
Owner signature: Date: I Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with.
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits I
Contact name: without service or feeder fee I 46 85 2
first branch circuit
Address- Each add'l branch circuit 6 65 2
I Miscellaneous (service or feeder not included)
City / State/ZIP: Each uutnufactuied w modular
dwelling, service and/or feedei 90 90 2
Phone: ( ) I Fax.: ( )
Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circnit(s) or limiter(- I
Business name. Teledigit Inc. I energy panel, alteration, or
Address: PO Box 22287 1 extension Descrihe.,(i 1 Page 2 75 00 2
1
City/State/ZIP: Portland, OR 97269 /1 .I ` Each additional inspection over allowable in any of the above I
I Per inspection 62 50
Phone: (503) 722 -8084 Fax (503) 722 -9914 Investigation per hour (1 hr min) 62 50
CCB Lic.: 116188 Electrical Lie.: 3- 414CLE I Su i Lie . 815LEA Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required Subtotal 75 00
Print name: Art Rosado Date: 7/7/08 Plan review (25% of permit fee)
State surcharge (12% of permit fee). 9 00
Authorized signature. TOTAL PERMIT FEE: 84 00
Print name: Art Rosado Date: 7/7/08 This p ermit application expires it a permit is not obtained within 180
days after it has been accepted as complete.
CITY .OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008-00193
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/8/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F.. -..
INSPECTION WORKSHEET FOR DATE: 7/30/2008 TIME: 7:01AM PAGE: 41
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 16037 SW UPPER BOONES FERRY RD LOT #: TYPE OF USE:
PROJECT NAME: FANNO CREEK PLACE
20/20
DESCRIPTION: Installation of low voltage for data.
OWNER: OPUS NW, PHONE #: 503916 -8963
CONTRACTOR: TELEDIGIT INC PHONE #: 503722 -8064
Inspection Request Scheduled For: Date: 7/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 073441 -01 503.819 -9620 ' Y
Corrections /Comments /Instructions: ,X
\ \A
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' N 6 Q) 1 -A - Date: iA l 1 0 Phone #: (503) 718-1-414
CITY TIGARD
- t. A
1 BUILDING DIVISION PERMIT # ELR2008 -00193
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 702008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ''I �-
INSPECTION WORKSHEET FOR DATE: 7/29/2008 TIME: 7 :01AM PAGE: 29
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 150 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME. 20/20
DESCRIPTION: Installation of low voltage for data.
OWNER: OPUS NW, PHONE #: 503- 916 -8963
CONTRACTOR: TELEDIGIT INC PHONE #: 503 - 722 -8084
Inspection Request Scheduled For: Date 7/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 073367 -01 503 - 819 -9620 \ Y
Corrections /Comments /Instructions:
G a vwo ALL wAtI A L P 645 be 4 c( e
1ta'p . (e300.100 .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL jk CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G - I ` ( %e L E — Date: 1 (1c1 Phone #: (503) 718-
•
CITY OF TIGARD .*
B
1 UILDING DIVISION a PERMIT #: ELR2008 00193
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/81)008
Phone: (503) 639 -4171^
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 150 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: 20/20
DESCRIPTION: Installation of low voltage for data.
OWNER: OPUS NW, PHONE #: 503- 916.8963
CONTRACTOR: TELEDIGIT INC PHONE #: 503722 - 8084
Inspection Request Scheduled For: Date: 7/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 072804 -01 503 - 784 -3859 Y
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Corrections/Comments/Instructions:
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►'.1 PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FA L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G---1 Iv 66 Date: 1 Vn 64 t Phone #: (503) 718- 1, "