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Permit ili '- a. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00170 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008 PARCEL: 25101 AD -03200 SITE ADDRESS: 12909 SW 68TH PKWY 410 ZONING: MUE SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG PROJECT: TOMPKINS BENEFIT GROUP INC Project Description: Installing (1) low voltage data system. 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: PACIFIC REALTY ASSOCIATES HECKTEC TECHNICAL LLC 15350 SW SEQUOIA PKWY #300 -WMI 3483 HILLSIDE CT PORTLAND, OR 97224 HUBBARD, OR 97032 Phone: Contact #: PRI 503 -572 -1938 FAX 503- 981 -0478 FEES Reg #: ELE CLE14 LIC 162394 Description Date Amount SUP 1496LEA [ELPRMT] ELR Permit 6/26/2008 $75.00 [TAX] 12% State Surch 6/26/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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: q Permittee Signature: am / /X _!,,,__,, 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. Jun 25 08 11:31a Hecktec Techna1 5039810478 p.1 piect ltl:ilal 1 GI 11111 ttV SUta1t1UU )� , � `, Received ' 1 ( 3 Tigard , Tigard, OR 9 13125 w\ ` 3 �00� 1125 SW Hall Blvd eIBY : No. :7e Ll�7f/tft�`�if')1 7 c ' R Phone: 503.639.4171 Fax: 503.598.1960 �\ ` GP $\ Review Other Permit i I L : `. 1; U Inspection Line: 503.639.4175 0 rt.S �� Date Ready/By kirir 110 See Page 2 for intemet: www.tigard-or.gov ��.�1 , �y ♦ Notified/Method: .-7/2"0 Supplemental Information TYPE OF WORK �`yv l PLAN REV1E V ❑ New construction ® Addition /alterationlplacement Please check all that apply (submit a sets of plans w/items checked below): El Demolition ❑Other ❑ Service or feeder 400 amps or more ❑ Build* over throe stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ❑ 1- and 2- family dwelling ®Commerciallindtrs[rial ❑ A building less to ground. or exceeds 14.000 ❑ Commercial -use agricultural Accessory g amps for all other installations. buildings. Multi family 0 Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE rNFORMATION AND LOCATION O Emergency system. Eger ��y derived system. ❑ Addition of um motor load of 0 Job no.: I Job site address: !2 L S" („ ; �rK ❑ Six or more residential ants. ❑ Recreational vehicle parks. 100HP or more. occupancy. City/State/ZIP: Tigard, Oregon 97223 ` J , v ❑ Health-eare facilities. ❑ Supply votiugo for morn than O Hazardous locations. 600 volts nominal. Suite/bldg./apt no.: Project name: ❑ Service or feeder 600 amps or more. 4 _ �c7mpK n5 +U�h� FEE SCHEDULE Cross street/directions to job site: oee,;adoa I Ori 1 Fee. 1 Toed i - New residential single- or mufti- family dwelling unit lndudes attached garage. Subdivision: I Lot no_: 1.000 sq. ft. or leas 145.15 4 Tax map /parcel no.: Ea midi 500 9q_ ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Voice and Data wiring Limited energy, multi - family 75 DD 2 residential (with above sq. It.) Services or feeders installation, alteration, and/or r'docation 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 arrtps or volts 454.65 2 City/State/ZIP: Temporary services or feeders insndlation, alteration, and/or relocation Phone: ( ) I 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 Owner signature: Date: Branch circuits— new, alteration, or extension, pe panel A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: 13. Fee for branch circuits Contact name wirhoru service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactiued 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: HECKTEC TECHNICAL panel, dryings) or limited - energy or 1 Address: 3483 HILLSIDE CT extension. Describe: Page 2 75 2 City/State/ZIP: HUBBARD OR, 97032 Each additional inspection over allowable in aayof the above Phone: (503) 572 -1938 Fax: (503) 981-0478 Per inspection 62.50 Investigation per hour (1 br min) 62.50 CCB Lic.: 162394 Electrical Lic.: cle14 Suprv. Lic.: Industrial plant per hour 73.75 _ Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES Subtotal: 75 Print name: RACHEL HECK per Plan review (25% of permit fee): Authorized signature: S State surcharge (12% of permit fee): q `( ) p TOTAL PERMIT FEE: 00 V( Date: / I This permit application expires If a is not obtained 1g0 Print name: ( ( �� 1 r � • Number of inspections allowed per permit drys after it has been accepted as complete. 1:lauildimpermaa\EL -PcmltApp .doer OS/23/06 I 440.46157(1 1/03lCOM/►YE9 CITY OF TIGARD BUILDING DIVISION PERMIT #: EL.R2008.00170 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2&!2008 Phone: (503) 639- 4171ue' I r� Inspection Requests (24 Hrs.): (503) 639 -4175 :! `'I I� INSPECTION WORKSHEET FOR DATE: 7/14/2008 TIME: 7:OOAM PAGE: 34 SITE ADDRESS: 12909 SW 68TH PKWY 410 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: TOMPKINS BENEFIT GROUP INC DESCRIPTION: Installing (1) low voltage data system. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: HECKTEC TECHNICAL LLC PHONE #: 503. 572 -1938 Inspection Request Scheduled For: Date: 7/14/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 072561 -01 503 -572 -1938 N Corrections /Comments /Instructions: • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C7 ��+VL' Date: �� Phone #: (503) 718 - wigt, CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008•00170 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/26/2008 Phone: (503) 639 -4171 ' �II�� Inspection Requests (24 Hrs.): (503) 639 -4175 , °__.. INSPECTION WORKSHEET FOR DATE: 6/30 /2008 TIME: 7:OOAM PAGE: 28 SITE ADDRESS: 12909 SW 68TH PKWY 410 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: TOMPKINS BENEFIT GROUP INC DESCRIPTION: Installing (1) low voltage data system. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: I IECKTEC TECHNICAL LLC PHONE #: 503 -572 -1938 Inspection Request Scheduled For: Date: 6/30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 071986 -01 503.572 -1938 N Corrections /Comments /Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date. r �-3 0 - Phone #: (503) 718-