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Permit CITY O F T I GA R D RESTRICTED ENERGY I ELECTRICAL PERMIT - II DEVELOPMENT SERVICES PERMIT #: ELR2002 -00062 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/8/02 SITE ADDRESS: 09000 SW WASHINGTON SQUARE RD HOTEL PARCEL: 1S126BC -01500 SUBDIVISION: EMBASSY CENTER ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Add 2 computer cables from data room to front office. 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: PORTLAND HOTEL ASSOCIATES CONNECT TELECOM LLC BYRETS 4990 SW FAIRMONT DR. 100 SPEAR ST STE 1440 BEAVERTON, OR 97005 SAN FRANCISCO, CA 94105 Phone: Phone: 503 - 356 -9750 Reg #: LIC 144533 ELE 2746JLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 4/8/02 $75.00 2720020000 Elect'l Final 5PCT CTR 4/8/02 $6.00 2720020000 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 -0080. You may obtain copies of these rules or -ct questio • r UNC at (503) 246 -1987. Issued by s6AA./4 44,4 _64 L1ifity 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application A. Date received: g ?J---- Permit no.: ' #0 - ,,6 F ,jy, :,.l I City of Tigard Project/appl. no.: Expire date: ' City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Dateissued: :.,,') Receiptno.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: • Land use approval: TYPE OF PERMIT • ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement 0 New construction j . Addition/alteration /replacement ❑ Other: ❑ Partial • JOB SITE INFORMATION . - . • Job address: 94 6j lee4s� _ . /1-) Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdiv• ion: Project name: I Des ription and location of work on premises:Apo of Cev90,7,- ltfi.Bic° r Estimated date of completion/inspection: rte_ r r.• - _ , N• .0 '• • Ce._ . CONTRACTOR APPLICATION - . FEE SCHEDULE . Job no: Fee Max //� Description Qty. (ea.) Total no. insp Business name: 6��P`z /� «� Qm L ` New residential - single or multi-family per Address: y s'D ,54) )--",),( ,v 7 /2 dwelling unit. Includes attached garage. City: L5El�!/�.ae State: ,� ZIP: 9 74)r'5— Service included: Phoneip3 4754 Fax :Z, V/- 244 maiI: 1000 sq. ft. or less 4 CCB no.: 7 / 4 /4(533 I Elec. bus. lic. no: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /. etro lic. no - Limited energy, non- residential 2 /��'--- . 4// y Z Each manufactured home or modular dwelling •Ign e o supervising electrician (required) D to Service and/or feeder 2 Sup. elect. name (print)*L ' , z ,-5 Licenseno•L7 tiov 4 Services or feeders — installation, alteration or relocation: • PROPERTY OWNER 200 amps or less 2 Name (print): fjr)g,955 / 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 9501 /!) s4/0�j7Op -,--e /?‘) 601 amps to 1000 amps 2 City: ,4 7142,41,0 JState:0,c I ZI 9/z.2 3 Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installatioa, alteration, orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit' 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEAV (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial ❑ Health -care facility ' Each pump or imgation circle 2 ❑ Service over 320 amps -rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more * Descnption: D4 ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional Inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other. Per inspection I I I I Submit sets of plans with any of the above. Investigation fee ‘. The above are not applicable to temporary construction service. Other n Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ` 4: 0 0 ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 6 • OD Expires accepted as complete. TOTAL $ St I. Ov Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6/00 /COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total st, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ 201 amps to 400 amps $106.85 2 Vacuum Systems`. -- 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only • $66 85 2 • Temporary Services or Feeders - TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133 75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, .. see "b" above. n Audio and Stereo Systems Branch Circuits � New, alteration or extension per panel I I Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 p Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ' ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62 50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ I I Other 8% State Surcharge $ / Number of Systems 25% Plan Review Fee See Plan Review" section on $ * No licenses are required. Licenses are'required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees $ Z5+ Xv ❑ Trust Account # 8% State Surcharge $ to , Total Balance Due $ 6al 00 All New Commercial Buildings require 2 sets of plans. i:\dsts\forms \elc- fees.doc 08/30/01 CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY 4 *"‘ i DEVELOPMENT H BMENT r So SERVICES 639 -4171 DATEESSU 4/8/02 002 -00062 SITE ADDRESS: 09000 SW WASHINGTON SQUARE RD HOTEL PARCEL: 1S126BC-01500 SUBDIVISION: EMBASSY CENTER ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Add 2 computer cables from data room to front office. 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: PORTLAND HOTEL ASSOCIATES CONNECT TELECOM LLC BYRETS 4990 SW FAIRMONT DR. 100 SPEAR ST STE 1440 BEAVERTON, OR 97005 SAN FRANCISCO, CA 94105 Phone: Phone: 503 - 356 -9750 Reg #: LIC 144533 ELE 2746JLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 4/8/02 $75.00 2720020000 Elect'l Final 5PCT CTR 4/8/02 $6.00 2720020000 Total $81.00 EX-r''':'*,:Ell IL This Permit is issued subject to the regulations contained in the Tigard Municipal e, State of OR. Specialty Codes rip and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work 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 -0080. You may obtain copies of these rules or .' -ct questio vo UNC at (5 246-1987. Issu ed by AA/ ,/� �� Issued by �/ Permittee Signature �� ii� 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 F3, SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day N BUP - Building Permit ELC - Electrical Permit Inspection Description Date Passed By 4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling _ Gas line Engineered soils — Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final Final inspection PLM— Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab 4 Inspection Description - Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer • Fire alarm final Rain drain Storm drain _ Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin/Manhole SWR - Sewer Permit Engineered soils -I Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01