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Permit 1 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT " 1 COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00042 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/26/2007 PARCEL: 1 S136DD -03400 SITE ADDRESS: 11740 SW 68TH PKWY 200 ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG PROJECT: TIGARD TRIANGLE COMMONS Project Description: Building 4, 2nd floor, fire alarm. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC NW PROPERTIES SALEM FIRE ALARM, INC. ATTN: PAUL GRAM PO BOX 12789 P.O. BOX 2206 SALEM, OR 97309 BEAVERTON, OR 97075 Phone: 503- 626 -3500 Contact #: PRI 503- 364 -4566 FAX 503- 3640617 FEES Reg #: ELE 24- 133CLE LIC 76884 Description Date Amount [ELPRMT] ELR Permit 2/15/2007 $75.00 [TAX] 8% State Surcharl 2/15/2007 $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 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 are rth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.2 .6699 or 1.800 :332. . Issue By: v yiki464.4u Permittee Signat e: J� _I -1At % . 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. w F - t l \ �I ' _''ital Permit Apolic Ir FOR OFFICE USE ONLY City of Tigard Received L_ ` Permit No - - / �� = • 13125 SW HaII Blvd., Tigard, OR 97224.1 1 5 2�O Pl an Re-view - _ `" - c. . Phone: 503.639.4171 Fax: 503.598.19Da gy: Other Permit: T t G A R D io Inspection Line. 503.639.4175 1 D op P_ Date Ready/By: hail: la See Page 2 for Internet: www.tigani-or.gov 'LA i Y V I 11 i; , : fied/Method: Supplemental Information r. ' a. if ' ■61.11■1 _ _ _ � ... ti. ro:� 2iid P . i y f le ..., - 4,, ,"� .' —, . _.a*.i. ",a �4i,.:` ✓'. ! '.ff 1 : ❑ New construction J Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition • 1 er. • where the available fault current ❑ Marinas and boatyards. �, All f ; t) , r` le 1 e • 3 . ; ' " exceeds 10,000 amps at 150 volts or ❑ Floating buildings. € ' - - ``' i� ..9,,,,„2.k.. "' `> 1 "`' less to ground, or exceeds 14.000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or ` --, ,. • -• .,: W `. ` .,r -, .., ., A a't z ❑ Emergency system larger separately derived system. `l 0> • 1 a VI s Il` e ,.< s w >k � � � :� •. »-a - �: -� � '? , 4'4' � +� .. ❑ Addition of new motor load of ❑ "A °. "E", ° I.2" "1.3 Job no.: , Z Job site address: ) ) ' - )1.1t, 5 ( ' 1 " ' I- 100HP or more. on ❑ Six or more residential units. ❑ Recreational vehicle parks. Ci / State/ZIP '� 1 ❑ Healthcare facilities. ❑Supply voltage for more than ty ' '� ��� / �' / ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: ) e, ' "'.7_,'17rV< ❑ Service or feeder 600 amps or more. 1 r y Cross street/directions to job site: Des«Iptloa 1 Qty. 1 Fee. Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 I Limited energy, residential 75.00 2 1 A `.. m,MAI :,, s` Obi ) 6 1 71 , `, `4 ? F ^ a ; w• " 1 (with above sq. R) Limited energy, multi- family 75.00 2 v i (� 1 'W - - j r 'T. l Q rO Jyl •1- a y ✓ residential (with above sq. ft.) r Services or feeders installation, alteration, and/or relocation "_ - 3 P 200 amps or less 80.30 2 g ti E j ;, o i o R � 4 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/ State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 1 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with x t r tom; 7tNv e F,7- ', - t , i e ` ' "` above service or feeder fee i....ir x . ''_ r 6.65 2 �z- 1 each branch circuit Business name: , p � v „. �, 4 a t- B. Fee for branch circuits yy _ � without service or feeder fee, Contact name: TES/ f'c+ 1(� S first branch circuit 46.85 2 Address: VO �X 1Z) a l Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/ State/ZIP: Each manufactured or modular 1P.v� D � G! �� -� 90.90 2 dwelling, service and/or feeder Phone: ( ) 1,....t.,5 Fax:: ( ) L �� � ��► -- S� y / 04 (7 Reconnect only 66.85 2 E -mail: ., -.. ( C.r- At (.C) M1 Pump or irrigation circle 53.40 2 v `'� ,f.• _a s ,; ti _ . a � ' ... s.,a mzs a. , ;4 7,1 ; w _ Si gn or outline lighting 53.40 2 Business name: .c..1,104,„‘._ pri4,— Y ,ne■ Signal p nc e i, al er limited- energy panel, alteration, or Address: Pp • AO i WO) extension. Describe: Page 2 15 2 City/State/ZIP: ,t ilA PO- '97 ! Each additional inspection over allowable in an of the above / Per inspection 62.50 Phone: (5) t Fax: ( r 0` . b //.0b/ 3b t' �- �S�v(o F J j � . 7 Investigation per hour (1 hr min) 62.50 CCB Lic.: 7b S61.1 Electrical Lic.: fit-( .1 � Suprv. Lic y0 j 1., Industrial plant per how 73 75 7.1 t ' ` _° a t rc ,U 7. +4 , t ` : 4".1 Suprv. Electrician signature, required: ti Subtotal: 75 Print name: ,/„ L 11 , / Date: Plan review (25% of permit fee): l"`'' • '� f _ J � 7 State surcharge (8% of permit fee): (p plif Authorized signature: /�0` ' / ^ v7 TOTAL PERMIT FEE: - — --- Print name: I mate Thls permit application expires If a permit Is not obtained wl h -' days after It has been accepted as complete. / • Number of inspections allowed per permit. I :\Bulding1Pamits\ELC-PermitApp.doc 05 /23/06 440- 4615T(11/05 /COM/WEB CITY OF TIGARD � e.-----z-,-- BUILDING DIVISION _ PERMIT #: 2 P 0 7 - ©vv 1-/-Z. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 4004 i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: / //v7 TIME: PAGE: SITE ADDRESS: / / 7 LM 4' , /G4 N) CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT TI ON: DESCRIPON: CZ-0 ii TI '7' 11 � It-04'21%7 OWNER: -$1=-',4 PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection ,� ri Description Confirm # Contact # Message Q Corrections /Comments /Instructions: S 'EC Z.-R. ( t)' 4 Q2 flv V N It■L l 6 pc?._ \ -o v._-r 23 —t \ � 4 .I NN '>i v X PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: kt Z?: 1 Date: t b 31 Phone #: (503) 718-100