Permit q. 'CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00344
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/13/2007
PARCEL: 2 S 112 D D -002 00
SITE ADDRESS: 15862 SW 72ND AVE 100 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: ROCKWELL COLLINS
Project Description: Installation of low voltage for data telecommunications.
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 PROGRESSIVE TELEPHONE SYSTEMS
15350 SW SEQUOIA PKWY #300 -WMI 710 NE CLEVELAND # 120
PORTLAND, OR 97224 GRESHAM, OR 97030
Phone: Contact #: PRI 503 665 - 4900
FAX 503- 655 -4830
FEES Reg #: ELE 26- 1117CLE
LIC 150175
Description Date Amount
[ELPRMT] ELR Permit 9/13/2007 $75.00
[TAX] 8% State Surcha 9/13/2007 $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 NotificatianCenter. Those rules are set forth in OAR 952 - 001 -0010 through OA' 952 - 001 -0100. You may obtain copies of these
rules o direct ques ., s t• al7N.0 at 503.246.6699 or 1.800.332.2344. 1
I
Issued By: ._ i A �; ;1 Permittee Signature: -
--
OWNER INSTALLATION ON
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.
•
L,- ctrical Permit Application
FOR OFFICE USE ONLY
City of i' igar c l Received 9 is b
13125 SW Hall Blvd., Tigard, OR 97223 DateB
Phone: 503.639.4171 Fax: 503.598.1960 L - Plan Review
� Date/8 : OtherPennit:
Inspection Line: 503.639.4175 . n 1,1 4 i Date Ready/By: ®g Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental ee Information
❑ New construction ❑ Addition/alteration/replacement Please check all that apply: •
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'1 ['Hazardous location
�t •• �- -., ,��•. t :. .� > ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
-� � t� '�-- -= � Vi i <
:... , -,.. :g °- ��„_ -: , I
� of 1 -and 2-family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ❑ Commercial/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:
rj;r - - �_;,�s s t .. �- T . , „ .',,, ['Occupant load over 99 persons ['Manufactured structures or
1. . Iii' ; it 3 e : �� 1, �a x ° s `i: . :t ['Egress/lighting plan RV park
Job no.: Job site address: GG // tti'J ❑Health - care facility ❑Other:
t O k.� '_ Ave Submit 2 sets of plans with any of the above.
City/State/ZIP: p64'o-MA 6, 2 94.94W / The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: MO FProject name: n Q I `1 t t e -1 . k#; Y
Description I Qty. I Fee. 1 Total I ..
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'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2 •
ter- i- - Limited energy, non - residential 75.00 2
' ; x� zi ty t - r I- 7,F,f`5, ' t-. 4,.i . Each manufactured or modular
1 ...01J.1 11 11 11 r dwelling, service and/or feeder 90.90
U `) wir (h� Services or feeders installation, alteration, and/or relocation 2
200 amps or less 80.30 2
w r s ' =r=' `1 01 a s to 400 amps ' ;RQ' - �n��� � T � Tie' V : '` 2 mP rte 106.85 2
Name:
' '- ?' ';S' ' - `""` 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
Reconnect only 66.85 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or .
Phone: ( ) 1 Fax: ( ) relocation
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 s to 600
amp amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
°�` '`� ` °-`'" A.
ryf' .��,' . a ✓5 t . ;•� tb`; t` aw...'�Y' ., L'� 3'�. ^� e �
.` Lei t''.E 1 Fee for branch circuits with service or feeder fee, each
Business name: P i g i ve, },, j St S) 5 f / ourvi 1Cct S branch circuit 6.65 2
Contact name: ( ' "'�1 �1�1 B. Fee for branch circuits
I �Jf E f� w N without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail' Signal circuit(s) or limited -
1k• sir' s' t. % `i l`! T (A_A ; '. '�v"` "'i " energy panel, alteration. or no
7 extension. Describe: ( Page 2 2
Business name: pre °e,,,,,, Q _ 1 _ �e�Z. s r� 1 S fi cork►. -vo fGa{iOy s i7( - ?
Address: '�I� Gtr 1l�La S>� Z� Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: rash d Q�0 Investigation per hour (t hr min) 62.50
Phone: ($33) 665- L/c(OO Fax: (5 )665 4/$315 Industrial plant per hour 73.75 J
CCB Lic.: 15'a - 11 C Electrical Lic., - 1)3s Suprv. Li 3 i467 .t do
Subtotal '7
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: KY 4C- UQDiv N Date: q /12)07 State surcharge (8% of permit fee) b • (°
","• TOTAL PERMIT FEE -D I i
Authorized signature: 1 j This permit application expires if a permit is not obtained within 180
days after it bas been accepted as complete
- Print name: D /
Date: / f0
'p/ � Fee methodology set by Tri- County Building Indtutry Service Board
'• Number of inspections per permit allowed.
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CITY OF TIGARD
BUILDING DIVISION v PERMIT #: ELR2007 -00344
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2007
Phone: (503) 639 -4171 fl t Inspection Requests (24 Hrs.): (503) 639 -4175 `- _
INSPECTION WORKSHEET FOR DATE: 10/26 07 TIME: 7 :00AM PAGE: 63
SITE ADDRESS: 16862 SW 72ND AVE 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: ROCKWELL COLLINS
DESCRIPTION: Installation of low voltage for data telecommunications.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROGRESSIVE TELEPHONE SYSTEMS PHONE #: 503.665.4900
Inspection Request Scheduled For: Date: 10/262007 Pour Time:
Code # Inspection Description j.onfirm # Contact # Message
199 Electrical final 058425 -01 503 - 6654900 N
Corrections /Comments /Instructions: `�� 57Z " �3`��
raPNL ELc,2 }Z-- 00591
4 1 - 3 - A - 9 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v r Nisei Date: 12,6101 Phone #: (503) 718- -/ * tb
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Ft_R007 004
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2007
Phone: (503) 639 -4171 �� 1
Inspection Requests (24 Hrs.): (503) 639- 4175jll..
INSPECTION WORKSHEET FOR DATE: 10/1&2007 TIME: 7:01AM PAGE: 34
SITE ADDRESS: 15002 S/ 72Nt) AVE 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: ROCKWELL COLLINS
DESCRIPTION: Installation of low voltage for data telecommunications.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROGRESSIVE TELEPHONE SYSTEMS PHONE #: 503- 6554D00
Inspection Request Scheduled For: Date: 10/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 057591 -01 503-665-4900 N
Corrections/Comments/Instructions:
S \kA Sber eF- istsZrtk■ pal o b ,(■
t . P
ON RN s k fie. Ott
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
is FAIL ,CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 49 dv Lac Date: 1 01 0 Phone #: (503) 718 - r v
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