Permit \t< CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00095
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/10/2007
PARCEL: 25101 DC -03703
SITE ADDRESS: 13500 SW 72ND AVE 250 ZONING: C -P
SUBDIVISION: BECK BUILDING LOT: JURISDICTION: TIG
PROJECT: BECK GROUP
Project Description: Data cabling.
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:
BECK, TOM L TRITON COMMUNICTATIONS, LLC
13500 SW 72ND AVE PO BOX 1091
PORTLAND, OR 97223 HILLSBORO, OR 97123
Phone: Contact #: PRI 503 -615 -5800
FAX 503- 628 -5689
FEES Reg #: ELE 34- 648CLE
LIC 154665
Description Date Amount
[ELPRMT] ELR Permit 4/10/2007 $75.00
[TAX] 8% State Surcha 4/10/2007 $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: ;� i�- atJt�/�, Permittee Signature: �� Ccc, --
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:
CaII 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 Ap it oa►tion ' ,.= < - r
'•r g FOR oI I Ici� USE oNi v
CI of Ti Srd Received 1
Dateiv 0 D Permit N. / _ / �p� ,
111 lIl ° 13125 SW HaII Blvd., Tigard, OR 972A pp 7 Plan Revie
Phone: 503.639.4171 Fax: 503.598 ipi 2007 Date/B : Other Permit:
TI RD A '�i Inspection Line: 503.639.4175 Date Ready/By: Juris/ ® See Page 2 for
GA
Internet: www.tigard- or.gov ` Q 6 t c t t . iAu.Lt t . Notified/Method: % Supplemental Information
rr d k Tir r' T' TTCT('1 PLAN REVIEW
❑ New construction ,[ i]rAddition/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
❑ I- and 2- family dwelling .2 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 ", "1 -2 ", "1 -3 ",
Job no.: D L R Job site address: \,5 -, r 5 7 1- "b cCf, 5 k - 2 D 1001 - 1P or more. ur o
l 0 or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ' fi %p ( �
C - -D a ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: D50 I Project name: '-k,-20,e___ G'7 (CS') ❑ Service or feeder 600 amps or more.
job site: Description FEE SCHEDULE
Cross street/directions to
J 1 Qty. 1 Fee. I 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'I 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
'IX–) cam},\ pkt9 Cp0.p1 C,? residential (with above sq. ft.)
75.00 2
�} Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ 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 1 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 ex tension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
�j first branch circuit
Address: t ,\`�I ' Each add'1 branch circuit 6.65 2
I Miscellaneous (service or feeder not included)
City/State /ZIP: 10' V Each manufactured or modular 90.90 2
dwelling, service and /or feeder •
Phone: ( ) �3 Fax:: ( ) Reconnect only 66.85 2
E -mail: `' Pump or irrigation circle 53.40 2
Tom, rd 1J CONTRACTOR Sign or outline lighting 53.40 2
c_ _ Signal circuit(s) or limited -
Business name: ��, , ( r \ OA l.A A co, 4,---4 cry 1 L LC_-- energy panel, alteration, or
Address: 2c,- V...6-5-)c.,.. �� l extension. Describe: 1 Page 2 � 2
iDiii City/ State/ZIP: \ Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (.o9( xl (5_ 5 cL00 Fax: (Spy (r2 - 3 (a -g9 Investigation per hour (1 hr min) 62.50
L CCB Lic.: v ((3 Electrical Lic.: _ c y ( t s cL Suprv. Lic.: aSX LEA Industrial plant per hour _ 73.75
77,4 ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: (2 ,4„„ ° t n Subtotal:
Print name: > A–C�1 ..)a...„(..\ cA Q�� Date. c-1 0.1/0-4_
Plan review (25% of permit fee):
State surcharge (8% of permit fee): (
Authorized signature: �� TOTAL PERMIT FEE: g.\ —
This permit application expires if a permit is not obtained within 180
Print name: CNI 10. � �I ` Date: y' 0‘ /0 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:i Building \Permits\ELC- PennitApp.doc 05/23 /06 440- 4615T(11 /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00095
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/10/2007
Phone: (503) 639 -4171 A I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/11/2007 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 13600 SW 72ND AVE 260 CLASS OF WORK:
SUBDIVISION: BECK BUILDING LOT #: TYPE OF USE:
PROJECT NAME: BECK GROUP
DESCRIPTION: Data cabling.
OWNER: BECK, TOM L, PHONE #:
CONTRACTOR: TRITON COMMUNICTATIONS, LLC PHONE #: 503 - 615.5000
Inspection Request Scheduled For: Date: 4/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046323 -01 503. 7148119 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ F I ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-- L Date: I A ! ( (VI Phone #: (503) 718- 21A4A)