Permit „az--
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
AA, DEVELOPMENT SERVICES PERMIT #: ELR2006 -00023
+L '�I II 13125 SW Hall Blv Tigard, OR 97223 503 -639 -4171 DATE ISSUED: 1/17/2006
PARCEL: 1S136DD-00200
SITE ADDRESS: ” 11560 SW 67TH AVE 100 ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 004 JURISDICTION: TIG
Project Description: Limited energy for voice and data. Job No. 50093
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:
JOE GREEN INVESTMENT CO COMMUNICATIONS INSTALLATION SERVICE
PO BOX 1 31015 SW MAGNOLIA AVE
DONALD, OR 97020 WILSONVILLE, OR 97070
Phone: 503 970 - 2927 Contact #: PRI 503- 682 -5043
FAX 503- 682 -5613
FEES Reg #: LIC 158076
ELE 37- 686CLE
Description Date Amount
[ELPRMT] ELR Permit 1/12/2006 $75.00
[TAX] 8% State Surcharl 1/12/2006 $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 wi I's 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to ollow rule- -dopt- • by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throw: h OAR 952 -01 110 S. ru may obtain copies of these rules or direr uestions to OUNC a 03- 246 - 66$9.
Issue By: i -�I .LJ���l., " Permittee Sig nature:ur •
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.
Jan 13 06 01: 28p CIS, INC
t; 11Y OF TIGARD 503 6825613 p . 1
, ....• _.,• ---- ...a...v •rt.n. ovs)400/110%.1
tA001
Electrical PenflitAptlitECIE IVE 1 n1;(1:,:, •
* (4 0 City of Tigard . ti: 1 Recei•al i
/ 0 0 lit Posit N ga406t .
13125 SW Hell Bad., Tigard, OR 97223 .1AlV i 3 200,
Phone: 503.639.4171 Fax: 503.598.1960 ',. i , . ', 1W/Illillerillillia Wag Permit .
•
inspection Line; 503.639.4175 CITY OF TIG , , y..4 '' L age rattiwumboi —
wrmi s . , „ Storage tow eke
Iota= uruntritigard.a.us BuitpiNG IIIvisirm
:.',...: ''. :1' :•"-! .'...- ..i•r 'Ain OP-WORK ., .!'•:••: :.. ' . '.:, • 2 . , .. 2, :':• ., •:,..;' :‘..;: 7 [>. • :.,•-•• ••••,...::':'•;.:,:•:••‘...;......viltrettatinv:7;•: ::::
.40 .2ritew construction
Q AdthtionAtterationill :placanent Man etude all that apply:
Demo litiOn 'Othe CiServiCe over 225 arm, cantos, Cnianardons location
— ..... 0
.-'' •
0
OService over 320 amps —rating 0Buildng ova 10,000 sq_ ft,
• ., . •-• ..i,:: :t• . '. . ...:. :.:. CidECOBV OP ' . .. 1,. : • •-• ' . •;•• .• 1. ',.'.....' '.. • . of 1- and 2-11emilydwe1lings 4 ear more new residential
13 1.. and 2-famlly d;elling,Ereommereialiindustri. hi 0 Accessory building OSystan over 600 vela nominal units te One Amu=
OBung ova dine stork* preeders. 4 00 alults er mere
El multi-family a Mester builder 0 Other:
ClOccupast load ova 99 persons Cilklanutestured structures Or
, • ; •:. f i •••.% • ...: ... t. . 1 ;PACOON :::.....' .. •.:;.: • - ' ..:: • ',. ', aE m Rv park
EiOthec _ •
. jth twi ' : 5CZ: 2 ?3 1 klb site addieSS: i/T&C e.) 67 741 .4 . sub„Lbrinal:"Lea.fert..ith,ofe,..b.. :
City/State/ZIP: f, 6/2 97 z-Z..-5 The above are not applicable to teniperary conarnaion savice.
.;:c • , ."-:' ..!:
Suite/bldg./apt. nu: / 1..ovi Project name: rp: . :
i .—,It
, ,, Onwriptlea i tter. I era i Tad I '-
Cross sweetidircetiOris tojob si!LG New residential single- or ronhi &miring unit.
Includes sualebed garage. -
1.000 5 or lea 145.15 4
Subdivision: 1 Lot no.: Ea. addl 500 sq. it or nation 33.40 , 1
Limited mew, residentie - 75.00 ' 2
Tax map/pared no.:
Limited energy, nungssideasinl . 75.00 2
D*WnoN 0F W�I II Ehn00tIcd or modular
_____da ; — dwelling service andfor hoax _ 90.90 2
Services or feeders installa6oh, alteration, and/or Moulin
ZOO amps or las 80.30 ,._ 2
.. "•• : ":, . 43:1**iii ,.., : .•:••., feb s .....,...• .• •.... 201 amps to 400 amps 106.85 1
401 amps to 600 amps 160.60 2
Name:
601 snips to 1.000 am 240.60 2
.
A,ddress: Over 1.000 antis or volts 454.65 2
'Reconnect only 66.55 2
CIty/StateiZIP:
Taapararyserrices or feederelastallatiom alteration, and/or
Phone: ( ) I Fax: ( ) ram:oleo
, 200 imps in km , 6635 1
(haler Installation: This installation is being made on 1 i•ropaty that 1 own which is not 201 to 400 100.30 2
intended for sale, lase, rent, or acchange, acanding to 4 :11tS 447, 449, 670, and 701. 401 amps 1o600 amps 133.75 2
Owner signature: ... Date: Bawdy ciseirib - new, alteration, or extension, pr panel
i '':!• : .': ... * . ' .. : ' . • "::: .:. . I . ' ' ..t . '' :1.coNrAci '. • '•::•: A. I'M far blanch CirCehi W°
service-or feeder fec melt
6,65 2
Business munt burnt ciratit .
B. Pas fa branch circuits
Contact name:
. without service or feeder fee.
46.05 2
Addre first branch circuit
ss:
_ Each-addl branch circuit 6,65 2
,
City/Stater/IP.. lithcellaaeons Mendes or fader not included)
...
( ) Fax (
Pump ea irrigaliat circle 53.40 2
J Phone: : : )
Sign ris outline lisdrting 53.40 2
E-mail: Simi cirruit(s) or limited- , r-
'" :. . .:!;:..'); • "::" ''....',: ..:•.?.. • i>. ' VONTRACTOR ..", ''; . . ": ;,- ' : . :.:. ''..'. - .• '''.:: :.:'. ...,'.:'. . letteIg Panel, altceetien. et .
citcnsion. Dentibc 1 Page 2 75 2
Businessarne: ... .
grab eddltional inspection over allowable in nay of dee above
_.../
Pa in3stetion _ 02.50 ,
w z, City/StatelZW:/// 4,/ 7 _/ C2 7 - 1....40.., boar it br mho 62.50
.
■...t( Phone: ffoK.,,sa-
''3 ::r,) tc eZ—___ . ; i 5 Mi aerial plant per boor 73.75
--.--,.." • .. .. • -.. .. zuscrutc41.4atuarsimawn;;•.::, •:-";•,!,,•-
Lic.:560 -- 7 'Electrical Lit.: v e:64;1 a . . Lit: _ Z g ' Subtotal 6 —
! - 7, -- -
.
Super. Electrician signature, leglirttd: ' v ,.„ V/ 0 Plan review (25% of penult fall -----
• ••-r
)
' Print name: p - I" . • ,—.. ,7 Date: /___/ '
State soakage pm or Oa
Ar „
TOTAL PERMIT FIE 'it, /
Authorized signature: /7 5r-...1, Ilds watt application mhos if a wait Is oar obssised within 150
days after a am be oterptell es ample.
Print name: i ----e— ,, z25 c:211 ,...., , •Dare: --( ...as. _ •.. Foe o teettercen ca br Sawa •
IMMiternsipmnicAle.C•remkApp.tba IWO) aso.esisztiotatossverta
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI..R2M6•00023
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/17/2006
i
Phone: (503) 639 -4171 '
Inspection Requests (24 Hrs.): (503) 639 -4175 ‘4:"' �'�. .
INSPECTION WORKSHEET FOR DATE: 5/W2006 TIME: 7:07AM PAGE: 92
SITE ADDRESS: `I1!.;Go SW 67TH. AVE 100 CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: REMTECH
DESCRIPTION: Limited onorgy for voice and data. Job No. 60093
OWNER: JOE GREEN INVESTMENT CO, PHONE #: 603 - 970.2927
CONTRACTOR: COMMUNICATIONS INSTALLATION SERVICE PHONE #: 503 - 632 -5043
Inspection Request Scheduled For: Date: , 5/13/2006 Pour Time:
• • - • Inspection Description Confirm # Contact # Message
199 EIec:liic: al trs -<! 023422 -01 603-4131-01319 N
Corrections Comments /Instructions:
. _ t 4 F1Zz ellikt I v.:
t
N AL F•zi ct. IZSIA I ea
01 . w . N 20 0 E 11 Q- 00
&_
X PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ( -' 1; N Q C� L-L Date: '04 Phone #: (503) 718- 1.-gg4'
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELR200(.000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/17/2OO
Phone: (503) 639 -4171
Inspection 'Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 515/2006 TIME: 7:10AM PAGE:
SITE ADDRESS: 1'1560 SW G7TH AVE 100 .CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 001 TYPE OF USE:
PROJECT NAME: REM TECH
DESCRIPTION: Limited energy for voice and data. Job No. 50093
OWNER: JOE GREEN INVESTMENT Co, PHONE #: 503970 -2927
CONTRACTOR: COMMUNICATIONS INSTALLATION SERVICE. PHONE #: 603-632-5043
Inspection Request Scheduled For: Date: !",,5,/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 029246 -01 503 -481- 0313 Y
Corrections /Comments /Instructions: 41\
N (C7 R,%
F dl\)P.
n PASS 1 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gikt 'vQ4� Date: 9' Phone #: (503) 718 - 21"/0
CITY OF TIGARD /;'
BUILDING DIVISION PERMIT #: ELR 00E ;.000 :6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •1/17/20U;
Phone: (503) 639 -4171 / 0.1,,�AG
Inspection Requests (24 Hrs:): (503) 639 -4175 11L
INSPECTION WORKSHEET FOR DATE: 2J9/2O66 TIME: ,7:001v1 PAGE: 62
SITE ADDRESS: 1 P.560 'SW G7TH AVE 100 CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: RE.MTECFI
DESCRIPTION: Limited energy for voice and data. Job No. 50093
OWNER: JOE GREEN INVESTMENT CO, PHONE #: 503-970-2971
CONTRACTOR: COMMUNICATIONS INSTALLATION SERVICE PHONE #: 503-682-5043
Inspection Request Scheduled For: Date: 2/9/2006 Pour Time:
Code # Inspection Description Confirm.# Contact # Message
135 Low voltage
CV65 503.401-0819 Y
. Corrections /Comments /Instructions: t .
t'sya.\.)\) i . ( P zi c3c
vo t,o N F L F &L 7" I 61%61 it v)M
Ci(ts 6 Etti5A) Q o i .,
• ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ,' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: met m Date: 9 Phone #: (503) 718- _�t