Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00244
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/18/2008
PARCEL: 2 S 113A B -012 01
SITE ADDRESS: 16260 SW UPPER BOONES FERRY RD BLDG E ZONING: I -
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: CONSUMER CELLULAR
Project Description: Installing (1) protective signal system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: 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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES PHILLIPS ELECTRONICS
15350 SW SEQUOIA PKWY #300 -WMI 1110 NW FLANDERS
PORTLAND, OR 97224 PORTLAND, OR 97209
Phone: Contact #: FAX 503- 227 -4992
PRI 503- 222 -5083
FEES Reg #: ELE 26- 213CLE
LIC 125364
Description Date Amount
[ELPRMT] ELR Permit 8/18/2008 $75.00
[TAX] 12% State Surch 8/18/2008 $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 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 B , Permittee Signature: G /Jj�,/ G�i / /Gf✓
J r./
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 Application -- : FOR OFFICE USE ONLY
,/ ,�► r xl
C1 2 of Tigaard .1 , v Received V�
y b e Date/B Permit No.: `_ r lf
13125 SW Hall Blvd., Tigard, OR 97
ir
r 1 �• Plan Review
oi Phone: 503.639.4171 Fax. 503.598.1960 . 1 Date /Br Other Permit:
TIGARD Inspection Line: 503.639.4175 PA 1 Da R eady /By: Jung• ® See Page 2 for
rn
Inteet: www.tigard or.gov N _ Supplemental Information
'Sit W TYPE OF WO'' ^ 'a PLAN REVIEW
❑ New construction 1:_Si''Addition/alterat s'; c. .4- ment Please check all that apply (submit 2 sets of plans w /items checked below).
'V
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other:
where the available fault current 0 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 ®' 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 derived system.
El Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: f , 2‘,0 _co 6, �, f / \ 1 Six or or more. occupancy
R0. E J ❑ Six or more residential units ❑ Recreational vehicle packs.
City /State /ZIP: 1) v v �v. 9 72z El Health-care facilities ID Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
C ����� / FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I '
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq II) • a, Limited energy, multi- fami 75.00 2
L t (/k-c fed P�� C ) S e_ (_p,t'Y-f, residential (with above sq. ft.)
J 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
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 /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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: 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
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
90.90 2
dwelling, service and/or feeder
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: Master Alarm LLC / Phillips Electronics Signal circuit(s) or limited -
energy panel, alteration, or
Address: 1110 NW Flanders extension. Descnbe: 1 Page 2 75-- 2
City/State /ZIP: Portland OR 97209 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 222 -5083 Fax: (503) 227 -4992 investigation per hour (I hr min) 62.50
CCB Lie.: 125364 Electrical Lie.: 26213CLE Suprv. Lic.: Industrial plant per hour 73 75
- - ' ELECTRICAL PERMIT FEES
.• --jog
Suprv. Electrician signature, required: � Subtotal. 75
��� Plan review (25% of permit fee):
Print name: � Date: 4 5
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE. jp c
Print name: This permit application expires if u permit is not obtained within 180
Date: days after It has been accepted as complete.
• Number of inspections allowed per permit.
I.\ BuildingWermits'ELC- PernntApp.doc 05/23/06 440- 461ST(11/05 /COM/WEB
CITY OF TIGARD -- = a — BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Ti ard, OR 97223 DATE ISSUED: 8118/ Qf )2�4
9 i W200i3
Phone: (503) 639 -4171 A ...
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.. "'I_
INSPECTION WORKSHEET FOR DATE: gJ2 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 16260 SW UPPER BOONES FERRY RD G E CLASS OF WORK:
SUBDIVISION:
PACTRUST BUSINESS CENTER O # . TYPE OF USE:
PROJECT NAME:
CONSUMER CELLULAR
DESCRIPTION: Installing (1) protective signal system.
OWNER: PHONE #:
CONTRACTOR: PACIFIC REALTY ASSOCIATES, PHONE #:
PH � ILLIPS ELECTRONICS 503 -222 -50!33
Inspection Request Scheduled For: Date: 9/23/2008 Pour Time:
Code # Ins ection Description Confirm # Contact # Message
135 Low voltage 075798 -02 503.222 -5083 N
Corrections /Comments /Instructions:
N
N. N's
c
i \N ' \
V\I
a PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �` N66 Date: 9 29 CA Phone #: (503) 718- 1.11110'
— . . . . '
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BUILDING DIVISION PERMIT #: BR2008-00244
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2O08
Phone: (503) 639-4171
�y �,
Inspection qRequests (24 e (24 Hrs.): (503) 639-4175 . * �� °
INSPECTION WORKSHEET FOR DATE: 8/2912008 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 1c260 SW UPPER BOONES FERRY RD BLDG E CLASS OF WORK:
SUBDIVISION: PAcTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONSUMER CELLULAR
DESCRIPTION: |ndaU protective system.
'
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR. PHILLIPS ELECTRONICS PHONE #: 503-222-6085
Inspection Request Scheduled For: Date: 0/2912008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13! Low voltage 074871'01 503-222-5083 N. Y
-
-~~
Corrections/Comments/Instructions:
D�A'
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�-~�"~- ^
PASS 0 PARTIAL APPROVAL El CANCEL 0 NO ACCESS
| | FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
�� �J��Au� �^���Q ����
Inspector: ��~~. x`«"���~��. Date: �� ����^ 1 Phone #: (503) 718- &/�'���