Permit ,''
CITY OF TIGARD
!�
`q ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00325
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/27/2007
PARCEL: 25101 DC - 00200
SITE ADDRESS: 13535 SW 72ND AVE ZONING: C -P
SUBDIVISION: 72ND AVE OFFICE BUILDING LOT: JURISDICTION: TIG
PROJECT: LOBBY
Project Description: First and second floor lobby doors, (4) total, added to access control system.
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:
INSTRUMENTATION: OTHER: ACCESS X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC NW PROPERTIES LTD PTNSHP SELECTRON INC
9665 SW ALLEN BLVD STE 115 7225 SW BONITA RD
BEAVERTON, OR 97005 TIGARD, OR 97224
Phone: Contact #: PRI 503- 639 -9988
FAX 503- 684 -4357
FEES Reg #: ELE 26- 497CLE
LIC 64341
Description Date Amount SUP 3645LEA
[ELPRMT] ELR Permit 8/27/2007 $75.00
[TAX] 8% State Surcha 8/27/2007 $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 • uestions to OUNC at 503.246.6699 or 1.800.332.2344. •
Issued : i/ / � / / Permittee Signature: IJ2k.. L (Q, /efil)
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.
•
•
e lectrical Permit Applicatio i p
City of Tigard =' � C. ,j V FOR OFFICE USE ONLY
� �'' /�
111 `� g D 2� V J 5 I PermitNo.: .20,07 -0032,5
• 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
C ' Phone: 503.639.4171 Fax: 503.598.1960 AUG 2 Z Date/13 2007 y Other Permit:
fiV J ' �.
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: Ei See Page 2 for
Internet: www.tigard - or.gov CI'L r (�.r,� t '1 t' j i)ed/Method: 77 Supplemental Information
TYPE q)� c 1 nv " ; y , o r r\ PLAN REVIEW
❑ New construction j Addition / 8 alterat placement r L).1' j 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.
❑ I - and 2 dwelling C /industrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
y g ❑ 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.
N ll ❑ Addition of new motor load of ❑ "A "E ", "I - ", "1 - ",
Job no.: ( Job site address: 13535 5 `77) ) - — I00HP or more. occupancy.
-❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: " ,'� d 0� �1 ❑ Health -care facilities. ❑ Supply voltage for more than
�O y ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: ri. ( Project name: _ 0 Service or feeder 600 amps or mere.
O gpyy i • FEE SCHEDULE
Cross street/directiors to job site, ^ � 4' � � ' Description 1 Qt I Fee. i Total 1
N)0 t4,..... GL y — New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: U U I 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
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family
add Li doom mss 4/lCl residential (with above sq. ft.)
75.00 2
�j`"' 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 1 ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: 13. Fee for branch circuits
without service or feeder fee,
Contact name: 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: SELECTRON, INC Signal circuit(s) or limited -
energy panel, alteration, or
Address: 7225 SW BONITA RD 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) 639 -9988 Fax: (503) 684 -4357
Investigation per hour (1 hr min) 62.50
CCB Lic.: 64341 Electrical Lic.: 26497CLE Suprv. Lic.: Industrial plant per hour 73.75
+ ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 75.00
Plan review (25% of permit fee):
Print name: JIM LEPPER Date: 8)200'7
State surcharge (8% of perrnit fee): 6.00
Authorized signature: TOTAL PERMIT FEE: 81.00
This permit application expires if a permit is not obtained within 180
Print name: 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- 4615T(1I /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION = PERMIT #: ELR 1007 -00325
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: 8/27/2007
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/24/2008 TIME: 7:02AM PAGE: 69
SITE ADDRESS: 13635 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: 72ND AVE OFFICE BUILDING LOT #: TYPE OF USE:
PROJECT NAME: t..OI3BY
DESCRIPTION: First and second floor lobby doors, (4) total, added to access control system.
OWNER: PACIFIC NW PROPERTIES LTD PTNSI-HP, PHONE #:
CONTRACTOR: SELECTRON INC PHONE #: 603-639-9988
Inspection Request Scheduled For: Date: 1/24/2008 Pour Time:
Code # Inspection Description Co• • # Contact # Message
135 Low voltage '63787 -02 503 - 519-9273 N
1 a1 °I Corrections/Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: '. N 64 t- T Date: — a- " 0' Phone #: (503) 718- MY" 1