Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
3-11 COMMUNITY DEVELOPMENT Permit#: ELR2013-00251
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2013
Parcel: 2S112DA01400
Jurisdiction: TIGARD
Site address: 15350 SW SEQUOIA PKWY 220
Project: Tetra Tech Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Data telecommunications
Contractor: PACIFIC NETWORKS INC Owner: PACIFIC REALTY ASSOCIATES
16869 SW 65TH AVE, STE 373 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-645-4000 PHONE: 503-624-6300
FAX: 503-352-0202
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/10/2013 $75.00
12%State Surcharge-Electrical 10/10/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 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 952J1.81-0090. You -y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: J Trie Permittee Signature: OA/
i
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.
: J lL \
ectricat Permit pgl ca : :;z
City of Tigrd xx�ay /p[�l l.3 44 °°'e x°.`SZA20/3 -DO,
SS/
13125 SW,Hall31 d. Ti gamOR 97223
OCT 9 2013 •pl R vig„
. ' : 503.718:2439' P .503.598.196rr0�� , ,R;,: ' other ozo/3 aa3/•c:t Internet:-ww i.tig gov75 �o V Cl U u 0�]�s L No Imid . Su See Page 2'for
•e�:li 91 : �. �� Pf? tatal Information
New construction Additionialteratioll/replacement Re le ohxk.all th.at apply(submif xsets of plans a items ohocked below):
Demolition Other: 1DSczvice of fcedcr.400'amps'or more D Building over three stories,
.- ❑ whale the available fault oarrent {]Mmriaas,aad boatyasda,
• CAThGORle•Of.GONSTRUCITON` • . .eaCeeds 10,000 amps at.150 volts or []:Ploanag buil4ings.
toss to ground;or mecda 14,000 EI.Coatmercial•use agricultural
1-and 2-family'dwelling III CommcrcisUiridtisnial 0 Accessory building amps for all other instafations. '. buildings.
Multi-family [],Master builder ❑•Other: . . 171Vre pump• Q Installation of 75 K VA or
. ❑Emer®rncY system. larger separately derived system.
.JOB f51TFr'II!1 1TOPT ARID:I:OiGATI!ON: .Q Addition of new eaotor load of t3"A";"1i',"1.2",•"14",
100HP or more. occupancy
no.: • Job site address'��3;0 5
t,/�e9� A er k Wy D Su or more reedentlalonits. 'D Recreational vehicle pats_
ty/State/ZIP: �; r c/ C e q 7 e1 2/ • D Health-cart&ci ifies. . D Supply voltage for more than
n
O Haratdout locations, • 600 volts nominal.
ite/bldg./apt.no.: .„a 0 I Project name: US ervice.or 5eoder 600 amps or more
oss street/directions to job site: Daoiyeien .FEES y;I.E
J Shy; I. Ail I rete1 1
• New resldendal,single-or moltii-family dwelling unit.
Includes attached garage.
bdivision: Lot no.: 1',000 sq:1t orless 168.54 4
Ea.add l.500 sq,:ft orportion 33:92 1^
X map/parcel no.:
Limitcd..eneigy; dtstgal 75.00- 2
• DES ON-OF:'WOIiK • (with aboye.sq.ft).
�`' (� 1 -LZasion, àTre1oeation ed energy,multi-thmily 75.00 2
PQ LfdWI I °��ifov►7mUh�c 04 itoL, b 6�/age
. ‘41/-4," 200'ampsor.fess . (00:70. •. 2
❑ PROPERTY OWNER '1 • ❑ ItNM'T 201 amps to 400 amps .133,56 2
40i amps Lu;:500 amps 200.34.. 2
rme: .
601:amps To.,1;0d0 amps 301.04 2
IdrCSS: Over 000 amps or.volts . . 552:26. 2
tY/ �; Temporary servlcesor:feeders ifastallation alteration,and/or
relocation
one:( ) Fax:( ) amps or less— 59.36 1
fvner installation:This installation is being made:on:property that I own which is not 201 amps to 400 amps 125.08 2
ended for sale,lease;rent,or exchange;according to:ORS 447,449,670,and 701. 401 amps w 599,amps 1 S4 2•Branch cirettiia=new;alteration,or extensisi on,per panel.
,Parer signature: Date: _ A.Fee for brancli'ciioiits frith .
❑ APPLICANT above service.or fender fee,• :.❑.GiDNTACC PER59N each branch Circuit 742 2
isiness name: 8..Feefor•lxsnch'citcuits,wtrhout
service or feeder•fpe,fast 56.18 2
intact name: • bran&ein:uit . •
• •Each add'l•bpiucli circarit 7.42 2
idress: •. Miscellaneous(serAte or feeder:pot included .
13eeh Manuthc4>red:i modular 67,84 2
ty/State/ZIP: •dwelling,service and/or feeder
•one ( ) Fes;:( ) Reeermectonly •. 67.84 2
Ppmp..orirrigiltion circle 67.84 2
•mail: fl cf 0 el o(2 e(n e-t w o r •4 0 raj Sign or oudine'llgiuing 67.84 '2
1 GE'VIRAGFOR Signalcit+cUit(s)or limited-energy
hsinessname:
at, 1G �J{1�►-corks /.• Jiang],alteration;or,to msion. . . 'Page2 2
7 E ach:adiditloilai-inspectioen0ver alowable ha any of the above
idress: Qiq 7 / .2-, * 773 Additibittil,:inspectlon(iluridn) 66,25/hi
lbZ 7 A�P Invcstigaiion(l 471min) ' 66.25/hr•
ty/State/ZIP: Lake 0. tr g. p . • i '?7 6 s Industria1.plaet(1 hr,.min) . .78.18/hr
one:( j3 ) .!��'–1400 Fax 6o3 ) 3c01- f�,2.0 pZ 1dsPectioris for afiach/no fee is • 90.00/hr
"LB Lic_: '�({q. ' Electrical' ' -: , :•7 . I Sum.Lic.:• Q rJ Et F li:A ;YERMI'1' ..
t speeificallr.lis L.
spry.Electrician signature,regui -, . �_• ubtomi: ` ��
Plan review(25%.of permit fee):
int name: N/ / r d er°. pate: i�'_ 'ci ._1. S petmit foe}: f 9,8Q
ithorized sign ' ' '. > 7 150 /•. TOT,A L T FM: ��,/oo +/
'nfis'.permtt atipllc3HOd�e=picas ate petmit;as not nbta�ed wifLin
ibOilftag4 ..beat accepted as comp1et
intnamie:. J/C / l� r�, � D - :r �3. a xonibeso'ncpec psaliowe4i,isi>amit• .•
ildinQWamita\ELGPa'nhApp.doc 57(01/10 / .440-461$Tgt/05/CQMIWEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15350 SW SEQUOIA PKWY 220, TIGARD, OR,
97224
Commercial - Electricial Limited Energy
199 Electrical final
2013-12-12 (null)
ELR2013-00251
FAIL
Noun@pacnetworks.com
Violation Summary:
Inspector Contractor