Permit t '
CITY OF T 1 GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
� i � DEVELOPMENT SERVICES PERMIT #: ELR2003 -00104
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/8/03
SITE ADDRESS: 11308 SW 68TH PKWY PARCEL: 1S136DA -00100
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of data system. Job No. 63595 -101.
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:
BENSON CAPITAL OREGON ELECTRIC CONST /GROUP
1708 3RD AVENUE 1010 SE 11 TH AVE
NEW YORK, NY 10017 PORTLAND, OR 97214
Phone: Phone: 503 234 - 1001
Reg #: LK/3-23425900
SUP 4460S
ELE 26 -95C
FEES Required Inspections
•
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 4/8/03 $75.00 Elect'I Final
[TAX] 8% State Tax 4/8/03 $6.00
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 throuc
Issued by Permittee Signature D/N1 /9 /� /'Gi C1977071
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 INSTALLA TION ONLY
SIGNATURE OF SUPR. ELEC'N D✓✓ /�1 z./ L' r70 DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
04 -08 -2003 10:13AM FROM - OREGON ELEC ESTIMATING +5032313587 T -114 P.001 /002 F -080
L . , -- --
le ,�- -
Ectric3l tie „ '; ' ,�� OFFICE USE ONLY
ilk City of Tigard Date received: y ; • ? Permit no.: ' 2ro r 3 - 44J0
13125 SW Han BIva 1 2003 Proiectfappl. no.: Expire date:
►11.:.: ,:!.;' ‘:,. Phone: (503) 639 -4171. FAX ( 1 Date Wetted: By: Receipt no.:
Internet address: www.ci.tisa TIGARD
24 -Hour Ins on Re
0 182 family dwelling or accesaory ® Commercial/Industrial D Muni-family 0 Tenant Improvement
0 New construction ® additioon/altera • • : • iacement 0 Other: 0 Partial
•i+ar. Si7E II1FC ■RP, =.7b:x
Job Address: 11308 SW 88th - Bid, . No.: Suite no.: Tax ma • lot/account no..
Lot Bloc:1c Subdivision
Project Name: Tigard Data center Description and location of work on premises: - Limited Endergy SKr tem for Data
Estimated Date of com • letion/ins • • r • : -'-
Will co call for i . within 24 hours? Yes No
Job No.: 63595 -101 Fee e_ 9. Total .ap res
mull- faintly per waiting
Business name: Oregon Electric Group unk. Includes moo
Address: 1010 SE 11th Ave. 1garage. 0 he Service
City: PortlandIState: OR 4p: 97214 Ea $ 145.00
33.40 $ -
Phone: (503) 234 -9900 Fax: (503) 234 -1001 1E -mail: weans Enemy., a 2 Peon $ 75.0o $ - 2
B ,. 203 bus. iic. no.: 26-950 unwed Swum Mum•Famay $ 7500 $ - 2
/ 7/.7' '' Each mares non* or
• modular dwelling. Servos
•rna Oraw• Hai- • tr . (=fare) • ..:: _ anNOr rawer $ 90 90 $ - 2
Service or Feeders -
Su .. Elect. Name • "nt :Mark , .4,, License no: 44605 Installation, Alteration Of
RaIocalien:
I'I<C)I •1.1 :I Y ( 0 . ;/I IC i< 200 emus orleee $ 80.30 $ - y
Nam (print Mumps - 400ampe $ 106.85 $ 2
Mailing Addreaa: 401amp3- SOOamps 5 160.60 $ - 2
Calf State: lap: 601ampa- 1000amps $ 240.60 5 - 2
Phone: Fax: J E - mail Over 1o00A or Vole $ 45465 $ • 2
nect Owner Installation: The installation is being made on property 1 own which is RB00" S
not intended for sale, lease, rent, or exchange according to ORS 447, 455, F emporary Service er
Foodats . uation
479, 670, 701. Alteration or Relocation:
Owners • aturrr: Date: 200 a at ass 5 66.55 $ 2
201amps - 400amps 5 100.30 , $ - 2
Name: Over 401amps - 600ampe 5 199 75 $ • 2
13rarlell CIrCalts -Now,
Address: AReraggn co Extension Per
Panel: A. Foe tor blanen
City: State: Zap:
ore= van purchase of sconce
or feeder fee. earn oranen
Phone: Fax: E -mail: drain rum $
8. Fee for branch &cots
W/o(d Purcnese of Service or
Feeder. 1st Branch tin $ 48.85 2
13 Service over 225 amps -comet 0 Health-care facility earn aaakrtal branch orcvit 5 6.65 $ -
0 Sere oe over 320 amps -rating of 0 Hazardous location Miscellaneous • (earvIce or
feeder not included)
182 family dwellings 0 Building over 10,000 square fear four or eace sump er emotion aide S 53.40 $ - 2
0 System over 800 volts nominal more residential units in one Structure Lich San or Outline Licrmne 5 53.40 $ - 2
0 Building over three stories 0 Feeders, 400 amps or more Signal eacua(e) or Llmltee Enemy
Panel Aleration or Ex eneon
0 Occupant load over eta persons 0 Manufactured structures or RV park 1 5 75.00 - 5 75.00 s
0 Egressaighting plan 0 Other.
Each Additional inspection over
the Allowable In myelin°
Above. Per mspcdan
5 6250 1 $ -
Submh 2 sets of plans with any of the above. Investigation fee:
The above are not appficabie to temporary construction service. Opts►
Maim This penult den Permit Fee $75.00
aapfrae as permit is nor Plan review 25% $o=
obtained within 180 des after State Surcharge 8%
has Haan aoeepmd a$
ownakee. Total 581.00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 ,
MST
INSPECTION DIVISION Business Line: (503) 639 -4171
LJ BUP
Received Date Requested • ( /d AM PM BUP
Location / (3o 2 es J3 n`, �^- Suite MEC
Contact Person Ph ( ) 9 ? ' a ( 6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access: - 0 a / o
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In j
Water Service
Sanitary Sewer J Rain Drains '
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS PART FAIL
SITE 0 Please call for reinspection RE: ^ Unable to inspect — no access
Fire Supply Line � \ 6
ADA
Approach/Sidewalk Date U _ Inspector /��J••
Other:
Final DO NOT REMOVE this Inspection record from the job si .
PASS PART FAIL