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Permit
• 't= ' * ELECTRICAL PERMIT - CITY TIGA R® RESTRICTED ENERGY ,,t ?�I� J DEVELOPMENT SERVICES PERMIT #: ELR2001 -00107 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/12/2001 SITE ADDRESS: 09455 SW WASHINGTON SQUARE RD A -15 PARCEL: 1S126C0 -01107 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of voice and data cabling only. 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: PPR WASHINGTON SQUARE LLC JENTRONIX COMPUTER CABLE PO BOX 21545 SYSTEMS SEATTLE, WA 98111 12009 NE 99TH ST BLDG 14 STE 1 VANCOUVER, WA 98682 Phone: Phone: 690 - 254 -9228 Reg #: LAC 0067258 ELE 37 -392CL FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 04/12/2001 $75.00 2720010000 Elect'I Final 5PCT CTR 04/12/2001 $6.00 2720010000 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 direct questions to OUNC at (503) 246 -1987. , Issued by i .,, _2� - _ l am Permittee Signature 11 / . 1 - / . ' 'fa _ /A _ i If 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 04/11/01 WED 13:00 FAX 503 598 1960 Cl ' OOFF IGARD VII 002 i, 7\ \' Electrical Permit Appl cats 1- • Date received: i ©0 Permit no.: __l o l -00 • .._11 '. _ .Iii D City of Tigard Pro ect/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tig:ad, OR 97223 Date issued: By: Receiptno.: )'hone: (503) 639 -4171 APR 1 2 LO (503) 598 -1960 ' . Case file no.: Payment type: COMMUNITY DEVELOPN use approval: _ TYPE OF PERMIT • 0 1 & 2 family dwelling or accessory ` .inntercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Additon/alteration/replacement U Other: 0 Partial JOB SITE 1NFORMA1 ION Job address: I u , ,�; . _, , %,',. 6, ,e,,, Bldg. no.: Suite no.:,4 /5 Tax map /tax lot/account no.: _ Lot: Block: Subdi sion: Project name: 4 .!_ �/� Q `i , Description and location of work on premises: 41 . . ! �' �/�� ei > 0 Estimated date of corn uletion/ins'ection: I . 4 , CON I ItAC"I Olt r 1PPLi (A l lO ' FEE SCHEDULE Job no: Fee Max N Business name: /� � ._ .4 / � jl L , lacscrivtIon Qty. (ea.) Total no. hop $! New taidentlal - single ormaid per Address: :_ar/J�I L7 q S� / � ' - 'r dwelling unit. Includes attached garage. City: / 0 EMM ZIP:q Serfioelnduded: Phone5002s'y9Z20' Fax: 36420 .' il: . efon & 1000 sq 0. or Less 4 CCB no.: 67 'Elec. bus. lic. no: ✓e/ xaasl Each additional 500 sq. A. or portion thereof Lim ited energy, residential 2 2 City /metro I no.: 5/00 37 39e) CCE_ Limited energy, non•residential 2 I/l�A��� S d� manufactured manufaered home or modular dwelling Signature of pervising electrician (required) D e Service and/or feeder 2 Sup. elect. name (print): pp f. Li:ense no: , =4T Services or feeders - installation, alteration or relocation: Pi401'1 14 OWNER 200 amps orless 2 Name (print): 201 amps to 400 amps 2 Mailing address: 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: State: 1:IP: Over 1000 amps or volts 2 Phone: Fax: E -mail: Reconnect only 1 Owner i nstallation: The installation is being made on property I own Temporary services or feeders - -- which is not intended for sale, lease, rent, or exchang: according to installation, alteration, orrelotstlon: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am . s 2 LNG1 N EER Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: ( State: 12 ': B. Fee for branch circuits without purchase Phone: I Fax: E of service or feeder fee, first branch circuit 2 PLAN Itt•.% I «1. (Please check all that .ipplt) , Misc .(Servlceor f ee d er no t inciaded): 0 Service over 225 amps - commercial O Health - care reedit: • Each pump or irrigation circle 2 0 Service over 320 amps - rating of 1&2 0 Hazardous location - Each signor outline lighting 2 familydwellings 0 Building over 10,( 00 square feet four or Signal errcuit(a) or a limited energy panel. O System over 600 volts nominal more residential us dts in one structure alteration, or extension` ? �� 2 O Building over three stones O Feeders. 400 amps or more *Description: O Occupant toad over 99 persons 0 Manufactured sou :tures or RV park Each additional inspection over the allowable In any of the above: O Egress/lightingplan O Other: Per inspection I I I I Submit _ sets of plans with any of the :Move. Investigation fee The above are not applicable to temporary mortar :dim service. Other \ `Not all jurisdictions reap, credit cards. please call jurisdiction for more Mks merlon Notice: This permit'application Permit fee $ _ 7,` x • O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ — Explr:s accepted as complete. TOTAL $ Si Name of cardholder as shown on credit card S Cardholder signature Amur et 440 evon L'OM) 04/11/01 VIED 13:01 FAX 503 598 1960 CITY OF TIGARD 0 003 v,„ Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total I Check Type of Work Involved: Residential - per unit 1000 sq. tt or less $145.15 _ 4 n Audio and Stereo Systems Each additional 500 sq ft. or portion thereof 533 40 1 n B urglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 n Garage Door Opener' Services or Feeders n H eating, 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 Installation, alteration, or relocation TYPE OF WORK INVOLVED - COMMERCIAL ONLY 200 amps or less $66 85 _ 2 Fee for each system $75.00 201 amps to 400 amps _ $100.30 2 (SEE OAR 918 -260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: • see "b" above. Branch Circuits ❑ Audio and Stereo Systems • New, alteration or extension per panel ❑ a) The fee for branch circuits Boiler Controls with purchase of service or feeder fee. ❑ Clock Systems Each branch circuit $6.65 _ 2 b) The fee for branch circuits Telecommunication Installation without purchase of service or feeder fee. n F ire Alarm Installation First branch circuit $46 85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation . Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 _ Signal circuits) or a limited energy ❑ Intercom and Paging Systems panel, alteration or extension $75.00 Minor Labels (10) $125.00 _ ❑ Landscape Irrigation Control' Each additional inspection over I ❑ Medical the allowable in any of the above • Per inspection $62.50 Per hour $62.50 ❑ Nurse Calls In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees: n P rotective Signaling Enter total of above fees - -$ 8% State Surcharge $ _ l 1 Other 25% Plan Review Fee Number of Systems See "Plan Review" section on $ front of application _ * No licenses ate required. Licenses are required for WI other Installations Total Balance Due $ Fees: ❑ Trust Account IV Enter total of above tees $ ___________ _ __ 1 8% State Surcharge $ 4 - QV Total Balance Due $ n t 00 i:ldstslforrrslelc- fees.doc 10/09/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24ur Inspection Line: 639 -4175 Business Line: 639 -4171 BUP _ Date Requested -Z ' AM PM BLD Location G Z/.5 514 (414 Sy, Suite i� -/' MEC Contact Person D Ph 2 7 Z - 957 - v PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR / Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing _ Firewall Fire Sprinkler Fire Alarm �. Susp'd Ceiling / -/ Roof Misc: • Final PASS PART FAIL PLUMBING - • Post & Beam 2 Under Slab Top Out Water Service Sanitary Sewer Rain Drains • Final PASS PART FAIL MECHANICAL - - Post & Beam Rough In Gas Line Smoke Dampers Final P ART -- FAIL LEST • Rough In UG /Slab • mow Vol a ire arm ' *ASS PART FAIL . - • Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection: Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA _ Approach /Sidewalk Date Other -25 Q/ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.