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Permit
C 1TYOFTIGARD ELECTRICALPERMIT - RESTRICTED ENERGY , 4 , DEVELOPMENT SERVICES PERMIT #: ELR2001 -00041 „� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/16/01 SITE ADDRESS: 13221 SW 68TH PKWY 510 PARCEL: 2S101 DA -00102 SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE BLOCK: LOT: 002 JURISDICTION: TIG Project Description: Tenant Improvement - Job #20900 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: TIGARD TRIANGLE I LLC ALLEN/FALK INC 4650 SW MACADAM AVE STE 220 9020 SW GEMINI PORTLAND, OR 97201 BEAVERTON, OR 97008 Phone: Phone: 646 -0533 Reg #: LAC 47238 ELE 34- 258CLE FEES Required Inspections Type By Date • Amount Receipt Ceiling Cover PRMT CTR 2/16/01 $75.00 2720010000 Wall Cover Elect'I Final 5PCT CTR 2/16/01 $6.00 2720010000 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 -0080. You may obtain copies of these rules r direct questions to 0 . NC at (503) 246 -1987. ( /1. � Issued by Q OD Permittee Signature !� ().1,j/(0 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application • y Date received: Permit no.: A _ Ilo O l H4 dzio('000 y1 . ,J j, ;.j i 1 City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receiptno.: • Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERM 1T ❑ 1 & 2 family dwelling or accessory %Commercial/industrial 0 Multi - family 0 Tenant improvement ❑ New construction ❑ Addition/alteration /replacement ❑ Other: 0 Partial .1011 SITE INFORMATION Job address: /3a a / ,yl,l/ Z17 m At UI// , Bldg. no.: Suite no.:. /D Tax map /tax lot/account no.: Lot: I Block: (Subdivision: _ Project nameTr 1/ (7p / I Description and location of work on premises: //p/ e y/ ir_ t, e f _A /, 1 . Estimated date of completion/inspection: CON774AC1'OR APPLICA'T'ION FEE SCHEDULE Job no: 4 0 %p—r Fee Max Business name: / / / /�/ ` / Zfr J • e . Description Qty. (ea.) Total no. insp New residential - single or multi-family per Address: 9G,to S l emon .D /• dwelling uait . Includes attached garage. City: j51 6 vo, f,, I State:/}/2 I ZIP: 97 r P f Service incIuded: Phone: 6.94 -pry," I Fax :( 9/ lo o /4 E -mail: lOt� ?`SP�i> ✓� p i95 9 # o ess 4 J Each additional 500 sq. ft. or portion thereof CCB no.: 'y7jJf I Elec. bus. lic. no: 3i_g3 - M'L'LE Limited energy, residential 2 etro lic. no.: M,9,s',J5 Limited energy, non- residential 2 Each manufactured home or modular dwelling Signature of su rvising electrician (required) Datt )j(3-0/ / Service and/or feeder 2 _ Si C - / . ___,r License _: [ 6 Services or feeders — installation Sup. elect. name (print): alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to htstallatlon , alteration, orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: - I State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax E-mail: of service or feeder fee, first branch circuit: _ 2 Each additional branch circuit: PLAN RLVI ENV (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps - commercial O Health -care facility Each pump or irrigation circle 2 0 Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* - _ 2 O Building over three stories 0 Feeders, 400 amps or more *Description: O Occupant Toad over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: 0 Egress/iightingplan 0 Other: Per inspection 1 1 1 1 Submit _ sets of plans with any of the above.. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 7s• F O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ / Credit card number: / / within 180 days after it has been State surcharge (8 %) $ 4 - !/D Expires accepted as complete. TOTAL $ �/ Nara of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6i00/COM) Electrical Permit Fees: Limited Energy Fees: r, TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular • ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less • $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 -260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. n Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 IA Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 ❑ HVAC Each additional branch circuit $6.65 Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension / $75.00 75: r"D ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over n Medical the allowable in any of the above n Nurse Calls Per inspection $62.50 Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ 71 n Other 8% State Surcharge $ / Number of Systems 25% Plan Review Fee See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ 7f <Z Enter total of above fees $ 74= !V ❑ Trust Account # 8% State Surcharge $ 6- ry Total Balance Due $ ' L 0 i :\fists \forms \elc- fees.doc 10/09/00 . CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 171 = = BUP Date Requested - ' ' 5 ' AM PM BLD --- Location /3 ZiZ/ 5(..) � le Suite 5 U MEC T Contact Person Jv4 "— Ph yY - Z 4 '/ 7 /y7 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 0• 0O4 Retaining Wall ELR . Z& - D % -- CDC �/ Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing C- 2.-4`G 0 6- Firewall Fire Sprinkler Fire Alarm CL� _ t9-O J 09 q7 Susp'd Ceiling ! ©n �J 7 Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out r^ Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In • Gas Line Smoke Dampers Final PASS PART FAIL L-FL E T CA Service Rough In UG /Slab Low Voltage e Alarm Fi PART FAIL E Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date - / �c - ° ( Ins Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.