Permit A '‘ CITY OF T I GAR D ELECTRICAL PERMIT -
RESTRICTED ENERGY
; DEVELOPMENT SERVICES PERMIT #: ELR2003 -00182
�-' " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/25/03
SITE ADDRESS: 11308 SW 68TH PKWY 2ND FL PARCEL: 1S136DA -00100
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: LE panel for fire alarm.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP
KEY LLC, THE 1010 SE 11TH AVE
BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214
WORCESTER, MA 01615
Phone: Phone: 503 234 - 1001
Reg #: LS03- 2342000
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/25/03 $75.00 Elect'I Final
[TAX] 8% State Tax 6/25/03 $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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699. i'
Issued by 611. %� /�._ I .IA Permittee Signature
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: z/I OD 5
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
ji:lectrical Permit Application OFFICE USE ONLY
City of Tigard Date received: Permit no.: jo3 -a 6 --
k. s�, 13125 SW Hall Blvd ' Project/appl. no.: Expire date:
, Phone: (503) 639 -4171, FAX: (503) 598 -1960 ' Date issued: By( (Receipt no.:
Internet address: www.ci.tigard.or.us Case file no.: Payment type:
24 - Hour Inspection Re • uest 503 - 639 - 4175
U 182 family dwelling or accessory L'i Commercial/industrial U Multi- family ❑ Tenant improvement
❑ New construction El addition /alteration/re • lacement ' ❑ Other. . ❑ Partial
JOB SITE INFORMATION
Job Address: 11308 SW 68th Parkway Bldg. No.: ' Suite - , , . Tax map /tax lot/account no.:
Lot: Block: Subdivision
Project Name: Tigard Data Center Description and location of work on premises: LE panel for fire alarm
Estimated Date of completion /inspection:
Will ou call for ins • ection within 24 hours? Yes ❑ No ❑ Project Contact Bob Polk (503) 546 -6007 Phone
CONTRACTOR APPLICATION FEE SCHEDULE
' ax no.
Job No.: 320 6S - Description Qty Fee (ea.) Total insp
NOW residential- single or
multi- family per dwelling unit
Business name: Oregon Electric Group Includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. 1000 sq. ft. or less $ 145.00 $ - 4
City: PortlandlState: OR Zip: 97214 Ea Addl 500 SF or Portion $ 33.40 $ -
Phone: (503) 234 -9900 Fax: (503) 234 -1001 1E-mail: Limited Energy, 1 & 2 Family $ 75.00 $ - 2
CCB no.: 203 Elec. bus. lic. no.: 26 -95C Limited Energy, Multi- Family $ 75.00 $ - 2
City /metro lic. No.:
Each manufactured home or
modular dwelling. Service
Sga • . , 'ta • � . IP at- . 6/24/2003 and /or feeder. $ 90.90 $ - 2
! Service or Feeders -
Su • lect. Nam - ► • rint. ; r License no: 4460S Installation, Alteration or
Relocation:
PRO! 'EPT(OWNER 200 am's or less $ 80.30 $ - 2
Name (print): 201amps - 400amps $ 106.85 $ - 2
Mailing Address: 401amps - 600amps $ 160.50 $ - 2
City State: 'Zip: 601amps - 1000amps $ 240.60 $ - 2
Phone: Fax: 1E-mail Over 1000A or Volts $ 454.65 $ - 2
1
Owner Installation: The installation is being made on property I own which is Reconnect Only $ 66.85 $ -
or
not intended for sale, lease, rent, or exchange according to ORS 447, 455, Temporary - I Services
Feedeers rs nstallation, ,
479, 670, 701. Alteration or Relocation:
Owner's si nature: Date: 200 am s or less $ 66.85 $ - 2
201amps - 400amps $ 100.30 $ - 2
Name: Over 401amps - 600amps $ 133.75 $ - 2
Branch Circuits - New,
Address Alteration or Extension Per
Panel: A. Fee for branch
City: State: Zip: circuits with purchase of service
or feeder fee, each branch
Phone: Fax: E -mail: circuit $ 6.65 $ - 2
B. Fee for branch circuits W /Out
Purchase of Service or Feeder.
PLAN REVIEW 1st Branch Ckt $ 46.85 $ - 2
❑ Service over 225 amps -comrr ❑ Health -care facility Each additional branch circuit $ 6.65 $ -
❑ Service over 320 amps -rating of ❑ Hazardous location Miscellaneous - (service or
feeder not Included)
1 &2 family dwellings ❑ Building over 10,000 square feet four or Each pump or irrigation drde $ 53.40 $ - 2
❑ System over 600 volts nominal more residential units in one structure Each Sign or Outline Lighting _ $ 53.40 $ - 2
❑ Building over three stories ❑ Feeders, 400 amps or more Signal Circuits) or Limited Energy
Panel Alteration or Extension'
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park _ 1 _ $ 75.00 $ 75.00 2
❑ Egress/lighting plan ❑ Other: *Description:
Each Additional Inspection over
the Allowable In any of the
Above. Per inspection
$ 62.50 $ -
Submlt 2 sets of plans with any of the above. Investigation fee:
The above are not applicable to temporary construction service. Other
Permit Fee $75.00
Notice: This permit application Plan review 25% $0.00
expires if permit Is not State Surcharge 8% $6.00 d'
obtained within 180 days after it $81.00
has been accepted as complete. Total
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: ' (5d3) 639 -4171 MST
BUP
Received 1 /•� Ji'1 Date Requested_ 1 (/2(e/0 - M PM BUP
Location 0 y ea w / Suite . MEC
Contact Parlor I Y 1 ( h — LM
Contractor Ph ( ) nn SWR
BUILDING Tenant/Owner ELC
Footing
Foundation EL
Ftg Drain Access: I Z
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
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
- m
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date j,// ns I ecto I . /l. Ext
Approach/Sidewalk p � r
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
•