Permit v T 1
t�
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY
RESTRICTED ENERGY
r y. �i �k DEVELOPMENT SERVICES PERMIT #: ELR2003 -00190
13125 SW Ha Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 7/3/03
SITE ADDRESS: 11308 SW 68TH PKWY 1ST FL PARCEL: 1S136DA -00100
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: Telecommunications.
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: : X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP
KEY LLC, THE 1010 SE 11 TH AVE
BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214
WORCESTER, MA 01615
Phone: Phone: 503 234 - 1001
Reg #: L503- 234200
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/3/03 $75.00 t`' 4,3 A'1.- -
[TAX] 8% State Tax 7/3/03 $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 ) C
' a-& —ti — •
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: 1 7/60
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JUL -02 -03 10:59 FROM- T -519 P.001 /001 F -399
• -- • 22--- ' / 7 e -
Eiectrical Permit Applicatio • OFFICE USE ONLY
i. f, Date receive -3-03 Permit noJ2,05- txJ /
City of Tigard s - � � •
• •, 13125 SW Hall Blvd G Project/8W. no.: Expire date:
. .i4j, i i� ;. Phone: (503) 639-4171, FAX: (503)1960 2003 Date issued: By :'¢,t1_ Receipt no.: .
Internet address: www- ci_tigard•or.us Case file no.: Payment type:
rr��
24 -Hour Ins ection Re tie 7'+�Q U Mu16 family Cl Tenant Improvement
L
152 family Dwelling or accessOrY �Q
0 New construction '�fdtlhld gaits ❑ Other. • ❑ Partial
JOB SITE INFORMATION
Job Address: 11308'SW 68th Parkway ' _ Bldg. No. Suite no.; Tax map/tax lot/account no.:
Lot Block: _ Subd'nrlslon
Project Name: Prot/ tlgard Data Center ,Dascription and location of work on premises: Low voltage telecommunications
Estimated Date of completion /inspection:
Will ou call•for• inS' - ction within 24 hours? Yes ❑ .NO ❑ • Project Contact K le Coo • r (503)649 - 2169 Phone
CONTRi APPLIC:+i ION FEE SCHIMULE
no.
Fee (ea.) Total inr
Job No.: 63595-104 re; • -' -sing e
multi-family per dwelling unit
Business name: Oregon Electric Group includes ettsehed garage.
Service lnciuded;
Address: 1010 SE 11th Ave- 1000egftorIo . S 145.00 $ - 4
City: PortiandiState: OR Zip: 97214 Ea Addl500 SF or Proton '$ 33,40 $
Phone: (503) 234-9900 Fax: (503) 234 -1001 1E-mail: Umitod Energy,1 & 2 Family $ 75,00 $ - 2
CCB no.: 203 Elea bus, lic_ no.: 26-95C umito EnTh. MumfamiH $ 75.00 $ - 2
CI /metro lies NO.: ,
Each manufactured home or
.o,,,_,, Ai.', .
modular dwelling. ScrService r L " te 712J2003 analarfeeder. -
$ 00.90 $ 2
' 7 Service or readers •
Su . . " /r Cense no: 4460S tnttagation, Alteration or
Relocation:
PROPLRT' O`A/N9R 200amasorless $ 80.30 5 - 2
Name (prim:
Z01 amps - 400amps $ 105.85 $ - 2
'
Mailing Address: _ 40lampa- 600aros $ 160,80 $ - 2
City State: 'Zip: 601amps- 1000anps 3 240.60 _ $ - 2
Phone; Fax; E-mail Over 1000A or Volts $ 454.65 $ 2
_ 86.85 $ 1
Owner Installation: The installation Is being made on property I own which is T e ry�s or 3
not intended for sale, lease, rent, or exchange according to ORS 447, 455, Feeders • brstanauon,
479, 670, 701. Alteration or Relocation:
Owners s'. nature: _ Date: _. - 200 am or less 3 88.85 $ - 2
ENGINEER 201amp4 - 400arnps S 100.30 $ - 2
Name: over401arnps • 600arnpa $ 133.75 $ - 2
branch Circuits • New.
Alteration or Extension Per
Address: Panel A. Fee for branch
City: State: Zip: _ cigars rs with purchase of seMCa
orfeeder fee. eadlbranch
Phone: Fax: E - mail: dretdt , $ so $ _ - 2
B. Fee for branch circuits wrout
Purchase or Service or Feeder.
P I - 1st er iich Ckt $ 48.85 $ - 2
❑ Service over 225 amps -comrr O Health -care facility Each additional branch drcuit $ 6.65 $ -
0 Service over 320 amps -rating of ❑ Hazardous location MiaeoOaneous • (Woolen or
feeder not Included)
162 family dwellings 0 Building over 10,000 square feat four or Each puma or Megan circle S 53.40 $ _ - 2
0 System over 600 volts nominal more residential units in one structure Each Sign or Outline LI60dntl $ 53.40 $ - 2
0 Building over three stories ❑ Feeders, 400 amps or more Signal Cbouit(s) or united Energy
PPM! Alteration or Extension'
O Occupant load over 99 persons CI Manufactured structures or RV park 1 $ 75.00 $ 75.00 2
❑ Egress/lighting plan 0 Other: - pesaipseen
_ _Submtt2 setsof p lans with any of the above. _ ,
��The aboveare not appl teable• to temporaryonstruction s ervice. _ Each Additional inspection ewer
I rho Allowable In any of tiro -
Hoc all Jmre01r�4ns xa�pt txedt • 9>m°O i+n` On Inn, WO
xo, N _ yhis 0, t appil„tion Above. Per inspection
® VISA a M AS ...,,RD ifaparmftrstrot $ 82.60 $
1 Card Nobe24' a77.7063 04/06 oba within leo days owe bhveregation fee:
�ii4 white owes tun ateePfedas com0iete.
1 tier. _ . d dh
der=ervrtonCard � Permit Fe e $75,00 i ( /
$81.40 Plan review 25% $o_oo !,
gnat= gnat= a te ' � r• J der Amount _J State Surcharge 8% $6.00 9 j
Total _$81.0
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:,C503) 639 -4175
INSPECTION DIVISION Business Line: (503) 139 - 4171 MST
BUP
Received Date Requested ° ( AM PM BUP
Location 1/ 3e O lD 0 ' " Suite MEC
Contact Person Ph ( ) X '49 -aC.3' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR 3 -00 r d
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall Nailing
Dryll N
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
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
F' = Alarm
T FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call fo reinsp-ction RE: / 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date i Untie Ext
Other:
Final DO NOT REMOVE this Inspection record om the j site.
PASS PART FAIL