Permit III
CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: ELR2007 -00417
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2007
PARCEL: 2S113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 300 ZONING: I -
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: PROFESSIONAL LIABILITY FUND
Project Description: Audio /stereo install.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OPUS NORTHWEST LLC SPECTRUM SYSTEMS DESIGN
1500 SW FIRST AVE SUITE 1100 MCGILL SYSTEMS INC
PORTLAND, OR 97201 937 SW 14TH AVE STE 201
PORTLAND, OR 97205
Phone: 503 -916 -8963 Contact #: PRI 248 -0248
FEES Reg #: ELE 26- 1232CLE
LIC 79244
Description Date Amount
[ELPRMT] ELR Permit 11/9/2007 $75.00
[TAX] 8% State Surcha 11/9/2007 $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 qu ns to OUNC at 503.246.6699 or 1.800.332.2344.
i
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.
"Electrical Permit A t r 1•t 1] FOR OFFICE USE ONLY
City of Tigard = I , ..
~ I :te/BY ceived J l q Q Permit N`� •J _op Li/7
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
C Phone 503.639 4171 Fax: 503.5 0 /g Other Permit
Date y.
T I G A R D Inspection Linc: 503.639 4175 0 9 2 001 Date Ready /By Suns El See Page 2 for
Internet. www tigard-or eil Y Notified/Method. / Supplemental Information
11 v� apply REVIEW
❑ New construction A• i 1 ` • IU
Please check all that ly (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
❑ I- and 2- family dwelling ❑ Commercial /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 denved system
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
pp Q 100HP or more. occupancy.
Job no.: Job site address:
16 S. • 1,,p ' L .GS �L1 //�C ❑ Six or more residential units ❑ Recreational vehicle parks.
��1t,d,�
/ , � � n " 7 7 J ❑ Health -care facilities ❑ Supply voltage for more than
City/State /ZIP:
5 IS 11- 97273 Z ❑ Hazardous locations 600 volts nominal.
/ l ❑ Service or feeder 600 amps or more
Suite/bldg. /apt. no.: .?;10 Project name: ?.d c5S �.v / ( �qii /r
Cross street/directions to job site: Description FEE SCHEDULE
J P 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'I 500 sq ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq ft ) 75 00 2
1 f / Limited energy, multi -family
S �� 'i,,,0,1-4.11/40 / IAT►rl'N - q i i s1S. residential (with above sq ft ) 75 00 2
S ervices 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
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 /Slate /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66 85
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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: 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'l 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: S .rte D t
d . Signal panel,(al t alteration, tion, or
n -( r!S / e / , energy panel, aletion, or
Address: 9 37 S (,,V , 19)-1--) s I t 0 r extension. Describe: Page 2 L--"
City/State /ZIP: 7 vt - iAvf., Da. 9'7 20.c Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: (6 -- 03) 249 _ 6u., e, Fax: (9,3 ) 27q ^ 760 Investigation per hour (I hr min) 62 50
CCB Lic.: yY Electrical Lic.: 2 - /23ZCICSuprv. Lic.: ( / /276 ( ,ES Industnal plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 7�f S71
Print name: �R� D / ) 9 -0 Plan review (25% of permit fee)
�' 4.7' 3f State surcharge (8% of permit fee). h.00
Authorized signature: /�� TOTAL PERMIT FEE. if po
/ /_ ' Date: / This permit application expires if a permit is not obtained within 180
Print name:
„/ CV f 3 f! ' �^ p f O / . days after it has been accepted as complete.
• Number of inspections allowed per permit
P\ Buddmg\Permiis\ELC- PermitAppdoe 05/23/06 440.4615T(II /05 /COM/WEB
J .r
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
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
Aci s ___ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ 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 \Bwldmg\Permits\ELC -Perm tApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007•00417
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1119/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 71141t
INSPECTION WORKSHEET FOR DATE: 4/11/2008 TIME: 7:01AMi • PAGE: 30
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 300 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: PROFESSIONAL LIABILITY FUND
DESCRIPTION: Audio/stereo int -tall.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503 - 916 -8963
CONTRACTOR: SPECTRUM SYSTEMS DESIGN PHONE #: 248 -0248
Inspection Request Scheduled For: Date: 4/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Law voltage 068223-02 503.312-5105 Y
1C\ q FW
Corrections /Comments/ Instructions:
/-
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,
A /
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X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 05 ^• Date:'il 1110 Phone #: (503) 718 Z ,