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Permit AA, C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2005 -00186 „LID DATE ISSUED: 7/12/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 25101 DA - 00102 SITE ADDRESS: 13221 SW 68TH PKWY 120 ZONING: MUE SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG Project Description: Voice /Data. 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 ESP TECHNOLOGIES 4650 SW MACADAM AVE STE 220 7929 SW BURNS WAY STE. F PORTLAND, OR 97201 WILSONVILLE, OR 97070 Phone: Phone: 503- 628 -4195 Reg #: LIC 73872 ELE 34- 269CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 7/12/2005 $75.00 [TAX] 8% State Surcha 7/12/2005 $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. Issued By: P.41 Permittee Signature: 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. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Date/B ? J / 5 PermitNo.: t�� ) A) /I6 13125 SW Hall Blvd., Tigard, 07223 Plan Review Phone: 503.639.4171 Fax: 50 59 • 1' • nn fe �d'q' ll I\ Date/B Other Permit: 503.598.1960 , Inspection Line: 503.639.4175 . ``__.. Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us - I - Notified/Method: Supplemental Information 1 1 , y'7 ... ' -1 - y A � '• ' OF W ORT( . y}v� z � pr' o •,- -. ", Y � , : ? 9. J� l r ,:' , -? _ e,- Te t . - � " - � El New construction QAddttion /alter4tiou/replacement Please check all that apply: ['Service over 225 amps, comm'l ['Hazardous location ❑ Demolition ❑ bthet; ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., •.' t -;•: . , ,r, • s CA1ZGO ' gam OF O N . $ ' IZTc TI O N _ -' ` `^ ++ Ir` Ff;,'S of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2 family dwelling OkCommercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ Multi family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or ;'' , ; ':, , JOB'.`;SE'I'E : Rl4TATION ANIJ LO ' - , •, ❑ E plan RV park ❑Health -care facility ['Other: no.: ®5�/1f `f Job site address: j3 f . '.i` RI. - /r Submit 2 sets of plans with any of the above. Cit State/ZIP: Pc9t.- f iCa.-cL . ke The above are not applicable to temporary construction service. • l � j M j / 1.... c II f lF s >a Fee Y Suite/bldg./apt. no.: Pro ect name: I C ' G Description Qa• 1 " Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non - residential 75.00 2 l 1.', 4IEk - .IO.N WORK''^ ° .. °" ::: , .,, r - Each manufactured or modular '/ I �p dwelling, service and /or feeder 90.90 2 V e 1 ` 1/tL.. C(.. `� G /'[ Services or feeders installation, alteration, and/or relocation 200 amps or Tess 80.30 2 ,. l: F • 201 as to 400 as 106.85 2 , i PROPERTY OWNER f , - o L , •I0 TENQ1VTT1 : 4 .... 401 amps to 600 amps 160.60 2 Name: e_ �' J, 601 amps to 1,000 a �(LS T ®(� mP amps 240.60 2 Address: .) 3 - z . ( .$2v G 7' park-404y Over 1,000 amps or volts 454.65 2 Reconnect only I 66.85 2 City/State /ZIP: to r F /4" J , � je Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ' f"!.•.:. I G❑ C©NTA ER$+ PON A. Fee for branch circuits with ©' All']?I+I AD1T i J r; r • service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: Each add'l branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle L 53.40 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- • , , ::,t, energy panel, alteration, or �� ";` COb RAGTOB - extension. Describe: J Page 2 C7 AU 2 Business name: P P �e�4 n0 (cy,s.e �ry q q �� / Each additional inspection over allowable in any of the above Address: 7 9 f .Ct iKtr �:5 '^' , fit F Per inspection 62.50 City/State/ZIP: 4 (S�� yy r 0- /(G I \ Q 70 -7(-) Investigation per hour (1 hr min) 62.50 JG 15644 /' / Industrial plant per hour 73 75 Phone: �',2— C( it�',C Fax: ( ) A la _ aZ . 76f �.-. itiell07 L?.PEIO *l CCB Lic.: 7 Electrical Lic.: -- nSu rv. Lic. Subtotal - 4 Suprv. Electrician signature, required: i' 7 # ,� Plan review (25% of permit fee) State surcharge (8% of permit fee) C,; , 06 Print name: �_r f- 5 9 Date: G _ �9� o s• �r, A— TOTAL PERMIT FEE e 06 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. is Building \Permits \ELC- PemtitApp.doc 12/03 440.46151(10 /02/COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: • Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918 260 - 260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i: Building \PermitslELC- PermitApp.doc 04/03 , CITY OF TIGARD " . , BUILDING DIVISION PERMIT #: ELR2005 -00186 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/12/2005 Phone: (503) 639 -4171 ° " ; i l` o � Inspection Requests (24 Hrs.): (503) 639 -4175 „JAI INSPECTION WORKSHEET FOR DATE: 7/20/2005 TIME: 7:11AM PAGE: 45 SITE ADDRESS: 13221 SW 68TH PKWY 120 CLASS OF WORK: SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE: PROJECT NAME: ETHIC & POINT DESCRIPTION: Voice/Data. OWNER: TIGARD TRIANGLE I LLC, PHONE #: CONTRACTOR: ESP TECHNOLOGIES PHONE #: 503- 628.4195 Inspection Request Scheduled For: Date: 7/20/2005 Pour Time: Code # Inspection ! : _cri•tion Confirm # Contact # Message 19a `' m-�= • =coon 011780 -01 t 42 503-454-7 0 313 j Y o ,., = ructions: • CEILIM If/ ,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cr N Date: 441)_ Phone #: (503) 718-14 LP.6