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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/5/2007 PARCEL: 1 S 136DD -03400 SITE ADDRESS: 11740 SW 68TH PKWY 250 ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG Project Description: OHCA Low voltage (intrusion 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: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PNWP LLC SECURITY CO INC 6600 SW 105TH AVE. STE.175 15495 SW SEQUOIA PKWY #100 BEAVERTON, OR 97005 PORTLAND, OR 97224 Phone: Contact #: PRI 503- 968 -3300 FAX 503- 968 -3398 FEES Reg #: ELE 37- 1054CLE LIC 161567 Description Date Amount SUP 941 LEA [ELPRMT] ELR Permit 1/5/2007 $75.00 [TAX] 8% State Surcha 1/5/2007 $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 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 or 1.800.332.2344. Issued By: _Zc � wagg Aa>,c t&p_ 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: 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. Electrical Permit Applicat o) E IVED , '' ' FO USE ON ,' .. ;. f 4,. ,.. 11 City of Tigard .�.� d 2001 DateBy: 7d1 615 Permit No "y 0000 q 1 3125 SW Hall Blvd., Tigard, OR 97223 L 1 Plan Review G Phone: 503.639.4171 Fax: 503.59( OF TIGARD Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By: Juris: 0 See Page 2 for Internet: www.tigard- or.gov Notified/Method: 13D0DDD000000AD0fo rmation TYPE OF WORK PLAN REVIEW 1 New construction ❑ 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 ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "I -3 ", Job no.: Job site address: 11.14.fo 61t Ark 100HP or more. occupancy. �7 3 �p 0 Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 'jj y �, 062 a �t 1�y ❑ Health -care facilities. ❑ Supply voltage for more than _ ❑ Hazardous locations. 600 volts nominal. Suite/bIdglapt..no.: Project name: OR I /A ❑ Service or feeder 600 amps or more. " FEE SCHEDULE Cross street/directions to job site: DAyl'yytay 4 .,, iW . Description 1 Qty. 1 Fee. 1 Total 1 • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi- family 75.00 2 k igtVAI &11---04 residential (with above sq. ft.) - Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 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: ( ) Fax: ( ) 200 amps or less 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 ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, first branch circuit 46.85 2 Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: HSM Electronic Protection Services (HSM Security) Signal circuit(s) r ration, d - energy panel, alteeration, , or Address: 15495 SW Sequoia Parkway Ste. #100 extension. Describe: 1 Page 2 75.00 2 City /State /ZIP: Portland, OR 97224 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 968 - 3353 Fax: (503) 968 - 3398 Investigation per hour (I hr min) 62.50 CCB Lic.: 161567 Electrical Lic.: 37 -1054 Suprv. Lic.: 941 LEA Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: $75.00 Print name: Steve Morehouse Date: ( 1 I /,�I 0.1.- Plan review (25% of permit fee): .90// ��/� /� + l State surcharge (8% of permit fee): $6.00 Authorized signature: `N/ A 0 TOTAL PERMIT FEE: $81.00 OA lqi This permit application expires if a permit is not obtained within 180 Print name: �L'r' U Pl ^• ` �M/ Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1: \ Building \Permits \ELC- PcrmitApp.doc 05/23/06 440- 46157111/05 /CON /WEB CITY OF TIGARD i -, BUILDING DIVISION PERMIT #: ELR2007 -00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/5/2007 Phone: (503) 639 - 4171 ICI Inspection Requests (24 Hrs.): (503) 639 -4175 :� `_.. INSPECTION WORKSHEET FOR DATE: 3/20/2007 TIME: 7:00AM PAGE: 50 SITE ADDRESS: 11740 SW 68TH PKWY 2F0 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: OHCA Low voltage (intrusion alarm). OWNER: PNWP LLC, PHONE #: CONTRACTOR: SECURITY CO INC PHONE #: 503 - 968 - 3300 Inspection Request Scheduled For: Date: 3/20/2007 Pour Time: Code # Inspection Description a` • . as # Contact # Message 195 Misc. inspection 045087 -01 503-572-7295 Y I'Vt C'►1JAL = Corrections /Comments /Instructions: C \ ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS A PASS FA ❑ , LL FOR I SPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date:/ 6 9 Phone #: (503) 718- *A? CITY OF TIGARD BUILDING DIVISION ' PERMIT #: ELR2007-00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/6/2007 Phone: (503) 639 -4171 Arp, � ' I 1 I & Inspection Requests (24 Hrs.): (503) 639-4175 I NSPECTION WORKSHEET FOR DATE: 3/16/2007 TIME: 7:01AM PAGE: 25 SITE ADDRESS: 11740 SW 68TH PKWY 250 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: OHCA Low voltage (intrusion alarm). OWNER: PNWP LLC, PHONE #: CONTRACTOR: SECURITY CO INC PHONE #: 50;x- 968.3300 Inspection Request Scheduled For: Date: 3/16/2007 Pour Time: Code # Inspection Description Co ' - • Contact # Message 199 Electrical final ' 0449513-02 503-968-3333 Y Corrections /Comments /Instructions: q oq �2l I 3ovc i ❑ PASS ❑ PARTIAL APPROVAL ��CANCEL [1] NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION � ❑ADDITIONAL FEES ASSESSED Inspector: " 1 L Date: 1 f 1(o 9 Phone #: (503) 718-14-lb CITY OF TIGARD _ _,. • BUILDING DIVISION PERMIT #: ELR2007 -00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/5/2007 Phone: (503) 639 -4171 � I � • Inspection Requests (24 Hrs.): (503) 639 -4175 �� INSPECTION WORKSHEET FOR DATE: 2/12/2007 TIME: 7:05AM PAGE: 56 SITE ADDRESS: 11740 SW 68TH PKWY 250 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: OHCA Low voltage (intrusion alarm). OWNER: PNWP LLC, PHONE #: CONTRACTOR: SECURITY CO INC PHONE #: 503 - 960.3300 Inspection Request Scheduled For: Date: 2/12/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 195 Misc. inspection 043231 -01 503- 793 -2470 N c>r, L► NI Corrections /Comments/ Instructions: P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Iv "V I-- Date: 2=12- d7 Phone #: (503) 718 -1J