Permit 71 y CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 00328';,,'
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/5/2008 'f y ;�r.
PARCEL: 1 S136CD -00500
SITE ADDRESS: 08050 SW PFAFFLE ST 100 ZONING: C -
SUBDIVISION: PACIFIC CROSSROADS CORP LOT: JURISDICTION: TIG
PROJECT: FBR
Project Description: Installing data telecommunication 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:
PFAFFLE OFFICE LLC CONNECTIONS NW INC A WASHINGTON CO
915 NW TORREYVIEW LN 2501 NE 170TH CT
SUITE 375 VANCOUVER, WA 98684
PORTLAND, OR 97229
Phone: 503- 647 -5416 Contact #: PRI 360- 772 -0494 .
FAX 360- 326 -1586
•
Reg #: ELE - CLE143
FEES LIC 179928 •
Description Date Amount
[ELPRMT] ELR Permit 12/5/2008 $75.00
[TAX] 12% State Surch 12/5/2008 $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: � taltkA Permittee Signature: i I r
1 YI g �, _ � L 1 l .. 1 •
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.
a To: Electrical Permits Page 3 of 6 2008 -12 -05 22:50:53 (GMT) 13603261586 From: Tom Jensen
• ,
ECEW Electrical Permit Applica on FOR OFFICE USE ONLY
DEC 0 5 2(1 Received ��
illg City of Tigard ^ le 0 ` • • . 0 a
13125 SW I tall 131vd.,'figard, OR 97223 li Plan Review
C Phone: 503.639.4171 Fax: 503.5 j�Oy O TI(► D
ate/By. Other Permit: � e 0034 /_
T I GA RI) Inspection Line: 503.639.4175 ��//�• �� Oflhlel ' -le Ready /Ry: JuriF • 0 Sao Page 2 for 7 10
Internet: www.tigard- or.gov SI M —DING Y ,! Nutired/Mcnxrd. 1 � C- Supplemental Information
+.:. .. : i ',% - ..TYPE OF :WORIC;': - , -. - �; ; ' PI,ANNNVIM e w' `: ' - }; -
j8 New construction ❑ Addition /alteration /replacement Please check all that apply (salami, a sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition 0 Other:
where tits available fault cerreet ❑ 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 CO Corrunercial /industrial ❑ Accessory building amps rot all olhel installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of KVA or
... - .. - ❑ EOM system. Isrger separately derived system.
::: ': ' `_ _ JOB'SITE,IIFORMATION AND LOCATION ; _ , motor "E","1 ••1 - 3"
.. ❑ Addition of new ❑ "A",
Job no.: 868 Job site address: 8050 SW Pfaffle 17011P occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks
City /State/ZIP: Tigard, OR. 97223 ❑ Health -care facilities. ❑ Supply voltage for more tictlt
❑ Horatdoru locations. 600 volts nominal.
Suite /bldg. /apt. no.: too Project name: Wealth Management ['Service or feeder 600 amps or more.
FEE',SCIIEDULE
Cross street /directions to joh site: Hall Blvd and Pacific Hwy Description ) Qty. J Pee. I Total l •
New residential sinele- or multi - family dwelline unit.
Includes attached garage.
'
Subdivision: Lot no.:
1.000 sq. ft. or less 145.15 1 j 4
Ea. add'l 50(1 sq. ft. or ',onion 314(1 I 1
Tax map /parcel no Limited energy, residential 75.00 1 2
DESI RIPTION; OF - WORK„ (with above sq. 111
Limited energy, multi - family
Datacom work only residential (with above sq. a.) 75.00 2
Services or feeders installation, alteration, and/or relocation
.„`_ ::_,.:: .. .... _
200 amps or less 80.30 2
j
?;.,,❑;'PROPERTY; OWNER;', ®; TENA - ' ; > : : , ;_ : . 201 amps to 400 amps 106.85 I 2 _
Name: Wealth Management 401 amps to 600 amps 160.60 j 2
601 amps to 1.000 amps 240.60 ; 2
Address: 8050 SW Pfaffie Over 1,000 amps or volts 454.65 j 2
City /State /ZIP: Tigard, OR. 97223 'Temporary services or feeders installation, alteration, and /or
relocation
Phone: (NA) Fax: ( ) 200 amps or less 66.85 j I
Owner installation; This installation is being made on property that ! own which is not 201 amps to 400 amps I00.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 I 2
Branch circuits — new, alteration, or extension, Per panel
Owner signature: Date: A. Fee for branch circuits with
®'`APPLICANT ' = 0 CONTACT "PERSON);; above service or feeder fee, 6.65 2
� � each branch circuit
/ Business name: Same Igo t wS B. Fee for branch circuits
tniihnu/ service or feeder fee,
Contact name: T Jensen 46.85 2
that branch circuit
Address: 2501 NE 170' Court Each addi branch circuit 6.65 2
Miscellaneous (service or feeder not Included)
City /State /ZIP: Vancouver, WA. 98684 Each manufactured ur modular
90.90 I 2
dwelling, service and /or feeder I
Phone: (360) 7720494 Fax: : (360) 3261586 Reconnect only 66.85 j 2
E -mail: tjensen @connectionsnw.com Pump or irrigation circle 53.40 i 2
' : • v :`;=" r` :i' =: :,:_ i. 2, : :- CONTRACTOR -..: <.' :. '- ,,. -_ Sign or outline lighting 53.40 I 2
Il k Business name: Connections NW Inc, a Washington Corporation Signal circuit(s) or limited-
energy panel, alteration, or
Address: 2501 NE 170' Ct extension. Describe: 1 Page 2 75.00 2
City /State /ZIT': Vancouver, WA. 98684 Each additional Inspection over allowable in any of the above
Per inspection 62.50
Phone: (360) 7720494 Fax: (360) 3261586 Investigation per (tour(! lir min) 62.5(1
CCB Lie.: 179928 Electrical Lie.: C • 143 Suprv. Lic.: 8591J Industrial plant per hour 73.75 1
_. , "'ELECTRICAL PERMIT :: '
Suprv. Electrician signature, required: Subtotal:
Plan Icview (25% of permit fcc):
Print name: Tom Jensen Date: 12/5/08
State surcharge (12% of permit tee): 9.00
Authorized signature: err, - TOTAL PERMIT FEE: 84.00
Print name: Torn Jensen / Date: 12/5/08 This permit application expires if a permit is oat obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I \ Building \Penaits \ELC- PnmitApp.dac 0523/06 450.4615T111/Oi /COM/WEB
To: Electrical Permits Page 4 of 6 2008-12-05 22:50:53 (GMT) 13603261586 From: Tom Jensen
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*
O Burglar Alarm
• Garage Door Opener*
El Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
E Other.
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
• Audio and Stereo Systems
O Boiler Controls
E Clock Systems
• Data Telecommunication Installation
Li Fire Alarm Installation
El HVAC
• Instrumentation
E Intercom and Paging Systems
E Landscape Irrigation Control*
El Medical
O Nurse Calls
E Outdoor Landscape Lighting*
O Protective Signaling
O Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:1DAildiosVermits\ELC-PcnnitApp.doe 03/33/06
CITY 0.F TIGARD
4
BUILDING DIVISION
PERMIT #: Et.R`)008-00328
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12672008
Phone: (503) 639-4171 :r t
Inspection Requests (24 Hrs.): (503) 639-4175 .....„,_,.. i -....
INSPECTION WORKSHEET FOR DATE: 1/9/2009 TIME: 7 PAGE: it)
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Installing data telecommunication system.
OWNER: PFAFFLE OFFICE LI.C, PHONE #: 503-647-f116
• CONTRACTOR: CONNECTIONS NW INC A WASHINGTON CO PHONE #: 360-772.0494
Inspection Request Scheduled For: Date: 1/9/2009 Pour Time:
Code # Inspection Description — Confii'm Contact # Message
199 Eledlical final 079552-06 503-201-5718 N
1
Corrections/Comments/Instructions: \ /
/
,\
a PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n AIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: CTI" OW L.. Date: 1-' C I '9 Phone #: (503) 718- 144
CITY OF TIGARD A .
BUILb'9NG DIVISION PERMIT #: 3-
Ll_I�aOf - tt� 0Ci.= i8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /215/2008
Phone: (503) 639 -4171 !�
Inspection Requests (24 Hrs.): (503) 639 -4175 P'�_�'L
INSPECTION WORKSHEET FOR DATE: 1/B/2009 TIME: 7:01Ai+ PAGE: 11
SITE ADDRESS: 08050 SW PFAF:FLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FI3R
DESCRIPTION: Installing data telecommunication sytern.
OWNER: PFAFFLE OFFICE LLC, PHONE #: 6,03- 647.60
CONTRACTOR: CONNECTIONS NW INC A WASHINGTON Co PHONE #: 360472-0494
Inspection Request Scheduled For: �, 1 /9/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 070552 -05 603- 201 -5716 N
Corrections/Comments/Instructions:
►! PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 1 v o e L.,E Date: i • • 1 Phone #: (503) 718- f Vilth
CITY QF TIGARD
BUILIANG DIVISION • PERMIT #: FL10008-00328
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 12/Y2000
Phone: (503) 639-4171 71:01t.
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/22/2008 TIME: 7:00AM PAGE: . J
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
•
DESCRIPTION: Installing data telecommunication system.
• • OWNER: PFAFFLE OFFICE LLC, PHONE #: 503-047.5,116
CONTRACTOR: CONNECTIONS NW INC A WASHINGTON CO PHONE #: 360-772-0494
<6
Inspection Request Scheduled For: Date: 12/22/2008 \-1 Pour Time:
Code # Inspection DesCription Confirm # Contact # Message
135 Low voltage 079185-01 503-201-5718
WIN eDvQ-C
Corrections/Comments/Ins ructions:
•
•
• .<1 LIJ PARTIAL APPROVAL • .0 CANCEL • El NO ACCESS
FAIL Ei CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector:
1"j Date: /2 2 - 2 - - Phone #: (503) 718-