Permit v �� ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00117
TicnK� 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5 /16/2008
PARCEL: 25101 BD -00300
SITE ADDRESS: 08015 SW HUNZIKER RD ZONING: I -L
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: PERFORMANCE CONTRACTING
Project Description: Data telecommunications in printer room.
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:
LOSLI, E HOWARD TRUSTEE AND SAFE TECHNOLOGY GROUP INC
SEABROOKE, CAROL ET AL 6400 NE HWY 99
BY PERFORMANCE CONTRACTING, IN SUITE G #375
CHARLOTTE, NC 28217 VANCOUVER, WA 98665
Phone: Contact #: PRI 360 - 699 -2130
FAX 360 - 719 -1527
Reg #: ELE 79CLE
FEES LIC 173731
Description Date Amount SUP 4272LEA
[ELPRMT] ELR Permit 5/16/2008 $75.00
[TAX] 12% State Surch 5/16/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 503.246.6699 or 1.800.332.2344.
Issued By: g i - Permittee Signature: Q ",,,,
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
, .
.,;_ 'Electrical Permit Applicatio , �, h > . 1 � 1: OR c)II I(�1 t 1 1'clNl # � � , .
City of Tigard Received �/ / , / permit No.L - R 200P— 6O//
A,� Rec iv iii
' a 13125 SW Hall Blvd., Tigard, OR 97 229tAY 16 2008 Plan Review Other Permit:
° ' �:`
t� v - Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
I I-, A
'' Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: luris. � Supplemental eP for or m ation
as. ::.�.; =.�. Internet: www.tigardor.gov BUILDING DIVISION 77(:;--• Notified/Method:
TYPE OF WORK PLAN REVIEW
® New construction ❑ Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION • exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑
Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ",
I 100HP or more occupancy.
Job no.: Job site address: 8015 SW Hunziker Rd ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: PCI Printer Room ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: North of 72 °a on Hunziker Description 1 Qtr. 1 Fee. 1 Total 1 *
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
- Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: - Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
- Limited energy, multi - family
75.00 2
Voice /data cabling residential (with above sq. ft.)
- Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
- each branch circuit .
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit -
Each add'I branch circuit 6.65 2
Address:
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Safe Technology Group Inc energy panel, alteration, or
1 75
Address: 6400 NE Hwy 99 Suite G375 extension. Describe: Page 2 2
City/State /ZIP: Vancouver WA 98665 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (360) 699 -2130 Fax: (360) 719 -1527 Investigation per hour (1 hr min) 62.50
CCB Lic.: 173731 Electrical Lic.: CLE79 Suprv. Lic.: 4272LEA Industrial plant per hour _ 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: a,o_,.yo A t Subtotal: 75
Plan review (25% of permit fee):
Print name: Jason Sweet Date: 5 -16-08
State surcharge (12% of permit fee): 9
Authorized signature: TOTAL PERMIT FEE: 84
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELFt j0OR -001 17
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/16/2(108
Phone: (503) 639 -4171 d �
Inspection Requests (24 Hrs.): (503) 639 -4175
_dpi
p
INSPECTION WORKSHEET FOR DATE: 0120/2008 TIME: 7:02AM PAGE: 4
SITE ADDRESS: 08(115 SW HUNZIKER RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PERFORMANCE CONTRACTING
DESCRIPTION: Data telecommunications in printer room.
■
OWNER: L.OSLI, E HOWARD TRUSTEE AND, PHONE #:
CONTRACTOR: SAFE TECHNOLOGY GROUP INC PHONE #: 360-G99-2130
Insect Request Scheduled For: Date: 60 20 Pour Time:
e # Inspection Description Confirm t act # Message
199 Electrical final 07167" 1 60-699.2130 N
Corrections /Comments /Instructions:
� .. . '' •a A - t /w . / l. 1 _/ -' -
i
I ■. L-1 a e - - ,— it . .?''
X45 /4/19-14e2t/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
1 FAIL n CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: �� Date: 0/1„,Z
Phone #: (503) 718 -
CITY OF TIGARD • _
BUILDING DIVISION PERMIT #: E;LR2003 00 i 17
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Fi16 /2O0f3
Phone: (503) 639 -4171 i;ql� �
Inspection Requests (24 Hrs.): (503) 639 -4175 "L .
INSPECTION WORKSHEET FOR DATE: 512012008 TIME: 6:59AM PAGE: 44
SITE ADDRESS: 08015 SW HUNZIKER RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PERFORMANCE CONTRACTING
DESCRIPTION: Data telecommunications in printer room.
OWNER: t_OSLI, E HOWARD TRUSTEE AND, PHONE #:
CONTRACTOR: SAFE TECHNOLOGY GROUP INC PHONE #: 360-699-2130
Inspection Request Scheduled For: Date: 5/20/ Pour Time:
Code # Inspection Description C nf # Contact # Message
135 Low voltage • 070126 -01 360-608-1709 N
Corrections /Comments /Instructions:
42, P' ' I I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
7 FAIL n CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: G- ( OW 1 -6 Date: 61 Phone #: (503) 718- 2HL
-., .