Permit 4 CITYOFTIGARD
ELECTRICAL PERMIT -
RESTRICTED ENERGY
1I DEVELOPMENT SERVICES PERMIT #: ELR2003 -00095
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/28/03
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 520 PARCEL: 1S126BC -01506
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage access control.
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:
INSTRUMENTATION: OTHER: ACCESS PNL X
TOTAL # OF SYSTEMS: 1
Owner: Contractor: •
PORTLAND OFFICE ASSOCIATES SELECTRON INC
BY TC PORTLAND, INC 7225 SW BONITA RD
8930 SW GEMINI DR TIGARD, OR 97224
BEAVERTON, OR 97008
Phone: Phone: 639 - 9988
Reg #: MET 00002446
LIC 64341
ELE 26- 497CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 3/28/03 $75.00 Elect'I Final
[TAX] 8% State Tax 3/28/03 $6.00
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 questions to OUNC at (503)
:::: /1
010#112;_ J(/ bit& ,, - iii Permittee Signature a/lO,( f L(y 3
OWNER INSTALLATION ONLY 1
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 Ap
�H Date received � Permit no
AV`•4111*. City of Tigar Pio�ect/appl no Expire date
City of Tigard Address: 13125 SW Hall Blvd , a , QR103723 Date issued By Receipt no
Phone: (503) 639 -4171 (VI
Fax: (503) 598 -1960 CITY OF TI GARD Case file no Payment type•
Land use approval: ? )ILDING DIVISIOM
TYPE OF PERMIT
•
❑ I & 2 family dwelling or accessory b Commercial /industrial U Multi- family ❑ Tenant improvement
❑ New constriction Addition/alteration /replacement U 0 U Partial
. - ;. .axs . . --'4. • JOB SITE INFORMA.TiOrf'r '. • E . .
Job address: Qp p Sy,1 Wei - s Zi. Ti r d Bldg. no. Suite no5� Q.x map /tax lot/account no.:
Lot: Block. ' Subdivision.
Project name InVt.S - , 4- Description and location of work on premises: Ipw Wiz
e_ at..c.es Chit eul
Estimated date of completion/inspection:
�. ; ------- -._.y ; CONTRACTOWAPPL -,• - --..-FEE- SCHEDIALE r - __.
Job no: 53-173 - Fee Max
Business name: Sek �yv 1vL Description Qty. (ea) Total no. insp
t New residential - single or multi- family per
2`_
Address: 1E 'E J �Iifnr - ?.,q . dwelling unit. Includes attached garage.
City : .\-Vav I State: OZ I ZIP: Cr / ),?}} Seniceincluded:
Phone. 5 5 I Fax: 553 - 1All. I 1 E - mail: 1000 sq ft or less 4
y 1 I L, _ 14 q, � Each additional 500 sq ft or portion thereof
CCB no.: tv Elec bus. tic. no: Z
Limited energy, residential 2
li
/
Cit metro e. no.: 2-�t`�'�,�'
City/metro b �T�■... Limited energy, non - residential , -
.4111talWrAn ,. 31AO) Each manufactured home or modular dwelling
' ignaturc : fipervis ng a - ctrician (required) Date • Service and/or feeder 2
r `,� Senices or feeders- installation,
Sup elect name (print) 1O -e)(- Il License no a J
alteration or relocation:
'PROPERTY OWNER .: -, 200 amps or loss
Name (print): 20 1 amps to - )0 amp 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: [State: I ZIP. Over 1000 amps or volts 2
Phone: I Fax: 1 E -mail: Reconnect only 1
Owner installation. The installation is being made on property I own Temporary servicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to installation, 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: State: ZIP: B Fee for branch circuits without purchase
Phone: Fax: E of service or feeder fee, first branch circuit 2
Each additional branch circuit
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of I &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings U Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel.
Li System over600 volts nominal more residential units in one structure alteration. or extension' � -/ --
❑ Building over three stones ❑ Feeders. 400 amps or more •Descnption
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other Per inspection I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all tunsdicuons accept credit cards, please call tunsdicuon for more information Notice This permit application
Permit fee . .. . .. $ 15 ibO
U 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%) .. $ (c.. bb
Expires TOTAL . . $ ) .
accepted as complete
Name of cardholder as shown on credit card
Cardholder signature Amount 440 4015 (Mxv('(1.Ni
CITY OF TIGARD 24-Hour •-
t BUILDING • Inspection Line: (503) 639 -4175 MST
1NSPI_CTION DIVISION Business Line: (503) 639 -4171,
BUP
Received Date Requested l AM PM BUP
Location - S h� Suite Sa D MEC
Contact Person w Ph( ) 7 O - 6;2.1 PLM
Contractor l ► � C cn - Ph ( ) ace?' - 0 a SWR
�/
BUILDING Tenant/Owner /' 77 I1 ELC
Footing
ELC
Access:
Ftg Drain ccess: ELR 3 - d v O
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors l ` _ D L`" , V „ _
Ext Sheath/Shear �� /�-{� .CJ�1� �-r � a�(•e-
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam • /
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole •
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
❑ Please call for reinspection RE Unable to inspect - no access
Fire Supply Line
ADA
Approa h/Sidewalk Dat _ Inspector Ext
Other:
Fi - � DO NOT REMOVE this inspection record from the j/ site.
PART FAIL