Permit It CITY OF TIGARD
U1 ELECTRICAL RESTRICTED ENERGY PERMIT
` ' COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00068
IGARD DATE ISSUED: 3/24/2008
iT
I 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113AB
SITE ADDRESS: 16280 SW UPPER BOONES FERRY RD BLDG E ZONING: I - L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: EARTH ADVANTAGE
Project Description: Installing (1) low voltage data telecom. system.
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:
PACIFIC REALTY ASSOCIATES DRISCOLL COMMUNICATIONS
15350 SW SEQUOIA PKWY #300 -WMI P.O. BOX 33402
PORTLAND, OR 97224 PORTLAND, OR 97292
Phone: Contact #: PRI 503 -515 -2065
FAX 503 -255 -4685
FEES Reg #: ELE 26 -1 16CLE
LIC 119620
Description Date Amount
FELPRMTI ELR Permit 3/24/2008 $75.00
ITAX! 12% State Surch 3/24/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
I By: l ` ✓ `�� rmittee Si natur � / �
OWNER INSTALLATIO Y
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
� � ° >$ t .`" -;Ma,a v �' " T r
Electrical Permit Application . r- s k FOR oFE10E'USE oivl Y
y fib, `� : : =r' � - C � �l '� �'�'
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City of Tigard tom, 1 Date Rece v t
° i 13125 SW Hall Blvd., Tigard, OR r Plan Review
St' II Phone: 503.639.4171 Fax: 503. '' 8.1960 + Date/By: Other Permit: t 1/ ' c F 46
=T G t,, APR D: Inspection Line: 503.639.4175 MAR 2 4 '2 J Date Ready /By: luris: BI See Page 2 for
.. ...-. . Internet: www.tigard- or.gov D Notified/Method: Supplemental Information
TYPE OF t`I`I �F T1 I �� vI S'�1� PLAN ::REVIEW
❑ New construction RAddition /alt l l ra Gnt 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
JOB SITE INFORMATION AND LOCATION ❑ Emg larger separately derived system.
/ ❑Additieron oency f ne m otor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: j G i n ft - J, / eyry S s �� Six or or more residential R occupancy.
t + 0 or more residential units. ❑Recreational vehicle parks.
City/State /ZIP: / #, f ��%�' yt, /' ❑ Health -care facilities. ❑ Supply voltage for more than
/ f / �1 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: r-- Project name: r l 1 ❑ Service or feeder 600 amps or more.
'FEE SCHEDULE
Cross street/directions to job site: Des 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'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family
f _ 40, //i/c tlG�A7.9 G!/ /4 /4../&d residential (with above sq. ft.) 75.00 2
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: /C �cy &/mod` 401 amps to 600 amps 160.60 2
194 601 amps to 1,000 amps 240.60 2
Address: 76 ') ,f d,ey�/e r rm./cs _ / /1,I> /()r/4' Over 1,000 amps or volts 454.65 2
City /State /ZIP: / 0 401 ,per c»') 9 ,,9 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (5 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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, , r 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'I 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
•
Signal circuit(s) or limited -
Business name:
,0,e ,..5 ,.,0 Cep •fl ma,..0 /cAT i energy panel, alteration, or
ote
Address: 49 OQx _' extension. Describe: / Page 2 7 , 2
City/State /ZIP: , y-, 4v,Q .4j(17.4 ' 97"07 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( - 52,e „,?0,j,_,5
o T Fax: (f'? ) or,...cZ ' 6 y 7 J Investigation per hour (1 hr min) 62.50
CCB Lic.: 1r7 ,� p Electrical Lic. :e4L6 , ,` ' S uprv. Lic.: Industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES
gl
Suprv. Electrici n ature, required: z�� . 0 � ^u Subtotal: 71,6
Print name: \j�SK,� iii /✓ -co�.4 Date: .3� �� ,,D�
Plan review (25% of permit fee):
�� State surcharge (12% of permit fee): 9
• Authorized signature: TOTAL PERMIT FEE: -� Ll
This permit application expires if a permit is not obtained with 18 dS - '
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COiM/WEB
Electrical Permit Application - City of Tigard
Page 2 - 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
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL-WORK'ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting* •
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06
•
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELP:M06.O0CI58
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2001
Phone: (503) 639-4171 „,'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 :�. -I_.�
INSPECTION WORKSHEET FOR DATE: 4/16/2008 TIME: 7:01AM PAGE: 20
SITE ADDRESS: 16260 eiW UPPER BOONES FERRY RD BLDG E CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: EARTH ADVANTAGE
DESCRIPTION: Installing (1) low voltage &Aa telecom. wtAern.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DRISCOLL. COMMUNICATIONS PHONE #: 503
Inspection Request Scheduled For: Date: 4 /1812008 Pour Time:
Code # Inspection Description , Confir"m # �. Contact # Message
193 Electrical final . 068579 -01 \\ 503-616-2065 N
Corrections/Comments/Instructions: /'
f
O �) ( 5- "
(2-10 �da S Avtk
•
Ili
/
gm PASS U PARTIAL APPROVAL ❑ CANCEL 1 I NO ACCESS
_ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CY Nqe L Date: 9 (Id , Phone #: (503) 718- 1/M.
CITY OF TIGARD -
BUILDING. DIVISION ' " ' PERMIT #: ELR20013.00068
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/200'x3
Phone: (503) 639 -4171 to
Inspection Requests (24 Hrs.): (503) 639 -4175 �_� 1
INSPECTION WORKSHEET FOR DATE: 3/2812008 TIME: '/:01AM PAGE: 18
. SITE ADDRESS: 16280 SW UPPER E300NES FERRY RD BLDG L CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: EARTH ADVANTAGE
E
DESCRIPTION: Installing (1) irxdv voltage awt a telecom. system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: E)1RISCOLL COMMUNICATIONS PHONE #: 503-'152065
Inspection Request Scheduled For: Date: 3/28/2008 Pour Time:
Code # ° Inspection Description Confirm #� Contact # Message
135 Low voltage 067491 -01 503.515.2065 N
Corrections /Comments /Instructions:
PAS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
D FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t?" a 14 Z LIE Date: 3 .151 O't Phone #: (503) 718- 2416•