Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 00066
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/20/2013
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15115 SW SEQUOIA PKWY 100
Project: Language Line Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: (1) low voltage for Data Telecommunications
Contractor: WEST SIDE ELECTRIC CO INC Owner: PACIFIC REALTY ASSOCIATES LP
1834 SE 8TH AVE ATTN: N PIVEN
PORTLAND, OR 97214 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/20/2013 $75.00
12% State Surcharge - Electrical 03/20/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
-VAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
APPuc44i7vtil
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
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.
2013 -03 -19 01:18 WEST SIDE ELE RJ.0 15037360677 » 5035981960 P 2/3
LIectrlca! rermit Application EIVE I I t,It t f1 , 1 I/ 1 I a: ()NI
City of Tigard Received 3/ aU ( 3_ s'' Permit No.: g2,..12. a0! 3 - o (o(P 1
13125 SW Hail Blvd., Tigard, OR 97223 MAR 1 9 2013
Plan Review
' • Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
6U") 6f,L")! 3.. 0005!
I i ; A p i. inspection Line: 503.639.4175 CITY OF TIGARD pate feady/By: t fd See Page 2 for 1
Intcmct www.tigard-or.gov �� D Noti(cd/Method: 5v Supplemental Information
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`-75 • <.� «s +t?'s:'' Ytr'::. .
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,...; ..0..F. • :. ,..11 i° i� .7eX Iiiii:e/14/Q ,Y. };, z L ".:::r : {v`a.r. J�4, ; °,. Ir Y :ere. ',.,::e`�:e+Yp'4...4.64 :'4dYW, r .
0 New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items etrodccd below)
❑ Service or tbeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available butt current ❑ Marinas and boatyards,
. ,c N ' : ?'''f - r i.7y V ,�ti "` `"' '1 s ,g a "r4:jit 'tip , t`r :l ... ; exceeds 10,000 amps at 150 volts or ❑ Floating build
w t, :lc
�+'� f �Y.`: �, °� Y `�'`� . k� � Y
,J► �J'.w TRnY � 1 i �.� � ��i r, 'Y
[] 1 - and 2 dwelling Commercial/industrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
Y g 0 Accessory building amps for all other installations. buildings.
❑ Multi - family 0 Master builder I Other: ❑ Fire pmtp. ❑ tnttatlation of 75 KVA or
�L'F ' + +e{' .w•n - . ae ;'r r �,, : (�Emergencysystem. larger separatelyderivedsystem.
i,. • 1 ' Ai r '-' t'' �7 er' y H Y -; 4 0T Y uri ..3;�. y.:
,�-'�
� ' °;, • � "z - ,. ..., v C �i�' s +r. � �� r: .:... " sr '$ :: . 0 Addition of new motor toad of Q "A", "E 1.2 ", "I-; ",
Job no.: 3 (2 l f ,- Job site address: s// c s'i,,� (�< uviea /]
I OOF� w more. oce+P�Y•
J / �f7it� 0 Six or mare residential units. ❑ Rocreational vehicle panes
City/State/ZiP: 7j f c p (// / 7Z- 7 ❑Health care fkcitities. ❑Supply voltage for more than
� ❑ Hazardous locations- 600 volts nominal
Suite/bldg./apt. no.: dW I Project name: (.4"///,‘,4:09 C m. , J 0 J /u ,. z J :: O Service or (coder 600 amps or more. .. t ctions to ob site: / � ''y ? x rr ilLE ` :,
J neseriprbn I ()is: h. I ' Pee. I; i
Cross street/dir : TON i
New residential single- or multi- family dwelling omit 1
Includes attached garage. i
Subdivision: I Lot no.: 1,1100 sq. it or less 168.54 1 4
Tax map /parcel no.: Ea. add'1500 sq. ft. or portion 33.92 I
Limited energy, residential
�X' .. yyv�� en 75.00 2
_ley , . J:' 7cit 1 \. ll'F� y D E . 7 I� `e a l : 1+• '� = 1 +• ' (with above S
` ri. ft.)
u ,C < � � ,
... -aerYM cm4_ :�'i ci ^iY.,l�:�!�7^ns�Fif.J;,o..vx'm� s
� Limited energy, multi-tinnily 75.00 2
e-47 • t at //i c . residential (with above sq. It)
Services or feeders imetallatlon, alteration, and/or relocation
200 amps or less 100.70 2
? �' . *r :q 7 �� le r_ '_ r I 4.04; .- T .� f f . �. y 201 amp to 400 am 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps 1° 1,000 amps 301.04 2
Address: Over 1.000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/o
relocation ,
Phone: ( ) Fax: ( ) 200 amps or less 59.36 , I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps t 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new alteration, or extension, panel
Owner Signature: 1)ate: A. Fee for branch circuits with
� r `r�'+ . s.; .. ,,, . , - • ;, y , ° .� +• "s?P-, �' -yt;. f; n_ .�r. Y•� above seNice or feeder fee, 1
�.y . .0jay '1& .e_WA Si '� _s ;i :'=4 41
742
,;1 a z jE S I
.;o�.. ..,: , .>r �, ,a�1x,•. , i ,�:._._.�. .... ...�,�. ,_r ,•. ,,M: eaehbranchcircuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not Included)
CI /SfateJZIP: Each manufactured or modular 67.84 2
tY dwellinkservice and/or feeder
Phone: ( ) 1Fax :: ( ) Reconnect only 67.84 2
Pwnp or irrigation circlo 67.84 2
E -mail: Sign or outline lighting - 67.84 2
:` } . .I r . :, 4.i �g wi i lL? ti e C�� r {� r "f PratirN e ) ie
" : � ,., " � , V'.''�� � ��� +nx�,�dti! Y:�- :��•i:� i-�i.;�''�t''�,._ il�� ��_. Signal cireult(s) or Iimrtadtnergy
ry -J el alteration, orextearsion. .::e 2 7'. 2
Business name: West Side Electric Co., Inc. ins.
Each additional inspection over allowable in any of the above
Address: 1834 SE 8' Ave. Additional inspection (I hr min) 66.25 / hr
City/State/ZIP: Portland/OR/97214 Investigation i plant ( 1 hr m) 78.18 / hr
_ Industrial plats (I hr min) 78.18/ hr
Phone: (503) 231 -1548 Fax: (503) 736 -0677 inspections for which no fee is 90.00/ hr
specifically listed (' /: hr min)
CCB Lie,: 13306 Electrical Lic.. 26 -135C l Suprv. Lic_: 4654 -S ,,' ". ='1 s, A_"i_aIMAIr< = _:
Subtotal: '7
Suprv. Electrician signature, requi ,. Plan review (25% of permit fee)::
Print name: Randall F Roberti Date: 3// 9773 State surcharge 02% of permit fee):
-- TOTAL PERMIT FEEL___3 Ll
Authorized signature: Tole permit applitedon expires if a permit is not obtained within 180
I — days after it has been accepted as complete.
Print name: I }ate: _ • Number of inspections allowed per permit.
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I:& ri] dlfg l?umitaLC- PermllAPP,da07101110 __,,__LL
2013 -03 -19 01:18 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 3/3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Bur Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ other.
B OR Y ':" 7 .
Fee for each commercial $75.00
system
(S b;E OAR 918- 309 -0000)
Check Typc of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
M Data Telecommunication Installation
❑ Fire Alarm Installation
❑ IIVAC.
❑ Instrumentation
❑ intercom and Paging Systems
❑ Iandscape Irri Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other..
Total number of commercial systems: l
*No licenses arc required. Licenses are required
for all other installations
E lluiIdiusTemubiELC- ramiiApp.doe 07RWWW10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15115 SW SEQUOIA PKWY 100, TIGARD, OR,
97224
Commercial - Electricial Limited Energy
135 Low voltage
03/22/2013 00:00
ELR2013-00066
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15115 SW SEQUOIA PKWY 100, TIGARD, OR,
97224
Commercial - Electricial Limited Energy
199 Electrical final
03/29/2013 00:00
ELR2013-00066
PASS - No C of O
Violation Summary:
Inspector Contractor