Permit f : .+,�` . n CITY OF F T I G A R D
ELECTRICAL RESTRICTED ENERGY PERMIT
° a COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00152
TIGARD" 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/21/2007
PARCEL: 1 S 135BB - 00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I -
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HEMCON fi4
Project Description: Low voltagae for fire alarm. .
�
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HEMCON MEDICAL TECHNOLOGIES PROTEC INC
10575 SW CASCADE 720 NE FLANDERS
TIGARD, OR 97223 PORTLAND, OR 97232 l
Phone: 503- 245 -0459 Contact #: PRI 503- 235 -4000
FAX 503- 235 -0363
bQ g
FEES Reg #: ELE 215CLE
LIC 55414 3 . JO I 0% y
Description Date Amount
[ELPRMT] ELR Permit 5/21/2007 $75.00 1
[TAX] 8% State Surcha 5/21/2007 $6.00 REQUIRED ITEMS AND REPORTS 0
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 Q
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon l �
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these V
rules or direct quest,ions to OUNC at 503.2 6.6699 or 1.800.332.2344. --, . -
Issued By: ` J j — + �� j Permittee Signature: 6• ,
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.
•
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: a.Eg67-03! REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date I By ✓ Code I Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit .
/
255 Wtr proofing basement walls \ 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry .4 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
•
810 MFG- Structure set -up MEC- Mechanical Permit
280 Insulation 605 Post /beam mechanical _
•
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
_ 299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
.910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
•
920 • • Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in •
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain 1
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205. Footing 399 Plumbing final
•
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
_ 495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building \Forms \InspCard- AOP- Blankdoc 02/02/07
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 , COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00152
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/21/2007
PARCEL: 1 S135BB -00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I - P
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HEMCON
Project Description: Low voltagae for fire alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HEMCON MEDICAL TECHNOLOGIES PROTEC INC
10575 SW CASCADE 720 NE FLANDERS
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 503- 245 -0459 Contact #: PRI 503- 235 -4000
FAX 503- 235 -0363
FEES Reg #: ELE 215CLE
LIC 55414
Description Date Amount
[ELPRMT] ELR Permit 5/21/2007 $75.00
[TAX] 8% State Surcha 5/21/2007 $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 quessions to OUNC at 5032 .6699 or 1.800.332.2344.
Issued By: ) Permittee Signature: (2S
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
Cit City of Tigard �LVrE0 Received QO / / f / / /
y g � _ Date/B : PermitNo.1_.... -_gy .... I00 7S'
a 13125 SW Hall Blvd., Tigard, OR 97223 • • , Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960V S 1 ' Date /By: Other Permit:
Inspection Line: 503.639.4175 � ®/ p ® Date Ready/By: lures El See Page 2 for
TIGARD Internet: www.tigard- or.gov WV t lt� "�� Notified/Method: Supplemental Information
ViLDIWP DiiiiSIW
TYPE OF WCR 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 li Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump, ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", ' l - 3 ",
I 00HP or more. occupancy.
Job no.: Job site address: ,fie(.) 5 5 C' frez.-c .4toti, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 9 7 2 Z 3 (3V ❑ Health -care facilities. ❑ Supply voltage for more than
7 � {� r ❑ Hazardous locations.
600 volts nominal. Suit Idg. /apt. no.: 3 v Project name: ( -)tr`e h ❑ Service or feeder 600 amps or more. FEE SCHEDULE
Cross street/directions to job site: ms s ; „ .G f...,,4, , Description 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'l 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
Limited energy, multi - family 75.00 2
.A.6( et2 / e Ke-?-h .,( , 57 s-e+� residential (with above sq. ft.)
/ Services or feeders installation, alteration, and/or relocation
Lou) 14 / .e A 4. Pt R R� iiJ 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 I
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'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
Signal circuit(s) or limited -
Business name:
Pleb 44- e-. . energy panel, alteration, or
Address: ZO Nf F1� �� Pi extension. Describe: Page 2 2
City/State /ZIP: perN e4".1— tDle..-- 93 - 2 3 Z Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( J) 7 7 S _ + O Fax: (ID) ) 2 3 5- ON 3 Investigation per hour (I hr min) 62.50
CCB Lie.: S5-1•I 41 Electrical Lie.: 3 ¢-21,8 -0 Suprv. Lie.: 7s-4 L E4 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Md zr7 Subtotal:
4' ) / Date: s - �7., - 0 ` Plan review (25% of permit fee):
Print name:
/v' r k e I ft./dd Q CJ c'1 t i State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE: g1.00
This permit application expires if a permit is not obtained within 180
Print name: /(f� Date: r /L/ t., days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermnApp 05/2 /0 / J I f 440- 4615T(I I /05 /COM/WEB
Jeanne Temple
jo X30
From: Debbie Adamski
Sent: Monday, March 10, 2008 3:31 PM
To: Jeanne Te
Subject: Hemco BUP2007 -00273 & ELR2007 -0015
With Dianna's permission . ese two permits by limitation as the work was done and inspected under other
permits(BUP2007- 00383 /ELR2007- 00291). Chip told the general he needed to take care of these and this was the
solution we came up. I will let Chip know so he can proceed with finals.
Debbie Adamski
City of Tigard
Building Permit Technician
503.718.2450
1