Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00078
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/16/2007
PARCEL: 2 S 112 D D - 00200
SITE ADDRESS: 15862 SW 72ND AVE 200 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: NATIONAL MORTGAGE
Project Description: Installation of low voltage system for 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:
PACIFIC REALTY ASSOCIATES TECHNOCOM
15350 SW SEQUOIA PKWY #300 -WMI 7929 SW BURNS WAY STE. F
PORTLAND, OR 97224 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503- 682 -4195
FAX 503- 682 -2781
FEES Reg #: ELE 34- 269CLE
LIC 73872
Description Date Amount
[ELPRMT] ELR Permit 3/16/2007 $60.00
[ ELPRMT] ELR Permit 3/16/2007 $15.00 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 3/16/2007 $4.80
[TAX] 8% State Surcha 3/16/2007 $1.20
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 ules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or •• -ct ques i• - to 0 - C -t 503.246.6699 or 1.800.332.2344.
Issue. By: , 22 0141 Permittee Signature:
War
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.
Electric. . .. Perm Applicatio FOR OFFICI USE ONLY
Cl of Ti and Received L —„
`J g DateB /f�M�n Permit No.: & / r ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 b4mmfrl � , :'�ykts,i`I Date/B : Other Permit:
Inspection Line: 503.639.4175 ` - Date Ready/By: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: EMI Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition /alteration /replacement Please check all that apply:
El Demolition Other: ❑Service over 225 amps, comm'l DHazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION 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 0 Master builder
❑ Other: ['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION J ❑Egress /lighting plan RV park
Job no.7Ll0L Job sit address: 2so -77G[ � DHealth-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: 1 4 6z ,e-- , or / 72.24 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 260 Project name:A /cif JL '
/ /J FEE* SCHEDULE
V Az. - ea FEE*
I Qty. 1 Fee. I 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 I
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/ nn ct dwelling, service and/or feeder 90.90 2
�/ l.� 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
401 amps to 600 amps 160.60 2
Name: 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
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 • Owner installation: 1 .'s - - .. te • j . a.: o. . : P - •• • t . : t' s : 't 201 amps to 400 amps 100.30 2
i , de• • . :I: & • . r • - .Ei , • : • • ' ' • ' i, • : - i . 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 1 stNTACT PERSON A. Fee for branch circuits with
15 service or feeder fee, each 6.65 2
Business name: (] branch circuit en �
1 B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: 7 I r7C / 4Qo•
'(/
Address: .7c- ZC' S 0) 6j this WWag S f- Each additional inspection over allowable in any of the above
�n ' Per inspection 62.50
City /State /ZIP: w (soh v 1 1 Je- 0 h C/ 7C) 7( rr� • Investigation per hour (1 hr min) 62.50
Phone: ( (: o� , (.1 (cis" Fax: ('Z3) (liIJ" a 78 ( Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 7 3 SS 73 Electrical Lic.: 2j - - 2 ( Suprv. Lic.: Subtotal , 0,
Suprv. Electrician signature, required: W4 Z$( Plan review (25% of permit fee)
S eorrr E at / State surcharge (8% of permit fee) 4, 8
Print name: �/ Date: �� /�
TOTAL PERMIT FEE (P 4 • go
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.
i:\ Building \Permits\ELC- PermitApp.doc 12)03 440- 4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00078
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2007
Phone: (503) 639- 4171m' p lb'
Inspection Requests (24 Hrs.): (503) 639 -4175 '1J!.
INSPECTION WORKSHEET FOR DATE: 4/2/2007 • TIME: 7:02AM PAGE: 7
SITE ADDRESS: 15862 SW 72ND AVE 200 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL MORTGAGE
DESCRIPTION: Installation of low voltage system for data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: TECHNOCOM INC. i PHONE #: 503.6024195
Inspection Request Scheduled For: Date: 4/2/2007 Pour Time:
Code # Inspection Description Con # Contact # Message
199 Electrical final 045847 -01 503 -956 -6290 Y
pc i OIL
Corrections /Comments /Instructions: 41
v -N (V R- \ F6LLo w t/ v W ItAm:111
•
\PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r 1V tb Date: 4("2 Phone #: (503) 718- I
iI
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00078
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2007
Phone: (503) 639 -4171 ,
Inspection Requests (24 Hrs.): (503) 639 - 4175 112. I
INSPECTION WORKSHEET FOR DATE: 3/21/2007 TIME: 7:02AM PAGE: 51
SITE ADDRESS: 15862 SW 72ND AVE 200 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL MORTGAGE
1• DESCRIPTION: Installation of low voltage syqern for data.
- OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: TECHNOCOM INC. PHONE #: 503 - 682 - 4195
. Inspection Request Scheduled For: Date: 3/21/2007 Pour Time:
Code # Inspection Description C.. ' •• : Contact # Message
135 Low voltage 045130-01 503 - 750.0659 N
Corrections /Comments /Instructions:
•
•
/ //PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (3- K68 L' Date: '5 -'7-1' 67 Phone #: (503) 718- 1.4
.