Permit CITY T I G R D ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00416
TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2007
PARCEL: 2S113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 ZONING: I -
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: OREGON STATE BAR
Project Description: Audo /sterep
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OPUS NORTHWEST LLC SPECTRUM SYSTEMS DESIGN
1500 SW FIRST AVE STE 1100 MCGILL SYSTEMS INC
PORTLAND, OR 97201 937 SW 14TH AVE STE 201
PORTLAND, OR 97205
Phone: Contact #: PRI 248 -0248
FEES Reg #: ELE 26- 1232CLE
LIC 79244
Description Date Amount
[ELPRMT] ELR Permit 11/9/2007 $75.00
[TAX] 8% State Surcha 11/9/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 503.246.6699 or 1.800.332.2344.
Issued By: � � Permittee Signature: .
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:
Cali 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 Application y " �e ' � ° ; ar ", 1 o of cE USE ONLY 1 4 r y
khr` •1 , • • t ^Sii;+TRS:r a4 aitgr.+JNJ�1iit it _ ' O'r144' i i r .,,' -i
-t Received
City of Tig ard r DateB 7011e,, 66 Permit No 0 �� d 0 �
11111
a 13125 SW Hall Blvd., Tigar :, • Plan Review
' • C Phone: 503.639.4171 Fax: 503 :" 'a 1 y Other Permit:
A. Inspection Line: 503639.4175 ate Ready /By: kris. ® See Page 2 for
,; Internet: www.t or.gov �/n� VE 1 » ate/BY:
• otified/Method: Supplemental Information
. 1 ? flw . 1 01/7 PLAN REVIEW
71 New construction l�_ � q tiller con �p t Please check all that apply (submit 2 sets of plans w /items checked below):
❑ • emOlitlOn ❑ • t � " e /tell a
1 C.1 ❑ Service or feeder 400 amps or more ❑Building over three stories.
� ` where the available fault current ❑ Marinas and boatyards.
• exceeds 10,000 amps at 150 volts or Floating buildings.
CATEGORY OF CONSTRI ❑
less to ground or exce eds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accesso b uilding amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A', "E ", "I 2 ", "I - ",
Job no.: Job site address: X13 7 S ; •,� G,� I or more. occupancy.
i QtL 1 ` ❑ Six ix or or more residential units. ❑ Recreational vehicle parks.
El
facilities
❑ Hazardous locations. ❑ Supply voltage for more than
City/State /ZI 1 � Or `l 7 73 600 volts nominal.
Suite/bldg. /apt. no.: 00 Project name: Q S4/., ❑ Service or feeder 600 amps or more.
` FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, i
, residential 75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
//I) Limited energy, multi - family
N 5 4S , yam / 5 'I residential (with above sq. ft.) 75.00 2
1 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
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 .2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
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
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add] branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR • ' _ Sign or outline lighting 53.40 2
Business name: s, , , S Signal panel, or limited-
��t . u M y S rh S Pe C., e ) � energy panel, alteration, or
extension. Describe: Page 2 •2
Address: 932 s , i 9 11, du it ( 1
City/State/ZIP: C� OA_ Cr 7 Each additional inspection over allowable in any of the above
ry 1 VAT (..-0 ~ ° � Per inspection 62.50
Phone: (4- )) Zys .- oz vg , Fax: 93 ) /a7( 7' 1/q Investigation per hour (1 hr min) 62.50
CCB Lic.: 7 LI N Electrical Lice—i21 et( Suprv. Lic.: i Industrial plant per hour 73.75
i vt, ELECTRICAL P ERMIT FEES Suprv. Electrician signature, required: 1 ' ./ Subtotal: X 75 ,O (7 / SC ) ` Date: Plan review (25% of permit fee):
Print name: J W /IA/7 iJj�•. hQI �� "U9 '�7 State s (8% of permit fee): L - 0 0
Authorized signature: A ` .. TOTAL PERMIT FEE: W li p This permit application aspires if a permit is not obtained within 180
Print name: �io-v 1J„ il( Date: u _09,07 This after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC - PermitApp.doc 05/23/06 440 -4615T(II /05 /COM/WEB
4 .
Electrical Permit Application - City of Tigard
Page 1- Supplemental Information
LIMITED ENERGY PERMIT FEES: •
[,RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: •
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
udio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for Al other installations
I: \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I LR2t)0700416
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/11/2008 TIME: 7:01AM PAGE: 31
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 CLASS OF WORK:
SUBDIVISION: FANN °) CRE:EK PLACE LOT #: TYPE OF USE:
PROJECT NAME: OREGON :STATE BAR
DESCRIPTION: Audo /s1ere :p
OWNER: OPUS NORTHWEST LLC, PHONE #:
CONTRACTOR: SPECTRUM SYSTEMS DESIGN PHONE #: 248 -0248
Inspection Request Scheduled For: Date: 4/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13 6 Lora voltage 068223-01 503.312 -5105 Y
Corrections /Comments /Instructions:
PASS PARTIAL APPROVAL n CANCEL NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G --.- �,Q, j Date: I II di Phone #: (503) 718- 1"44