Permit .ae
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11 DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00258
°�� II 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 10/20/2006
PARCEL: 2S 113AB -01201
SITE ADDRESS: 16535 SW 72ND AVE BLDG F ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Low voltage. Data, telecommunication
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 MATRIX COMMUNICATIONS
15350 SW SEQUOIA PKWY #300 -WMI 4243 SE INTERNATIONAL WY
PORTLAND, OR 97224 STE C
PORTLAND, OR 97214
Phone: 503- 624 -6300 Contact #: PRI 503 -513 -9152
FAX 503 -513 -9352
FEES Reg #: ELE 26- 694CLE
LIC 74332
Description Date Amount
[ELPRMT] ELR Permit 10/20/200E $75.00
[TAX] 8% State Surcha 10/20/200E $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.
Issued By: Permittee Signature:
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.
licatioln
•
Electrical Perm A R �, ; ,,�t Permit Na: i� -.......-.:-..t — �
IN R : ro OA Off City of Tigard q t , � Other Pernik:
a 13125 SW hall Blvd., Tigard. OR . 7223 ' tbitc/e : ®3ee page 2 fe -� -
Inspection 5n Line: Fax: 503,598,1960 Date lt endy111y: Supplemental 2 lnfnrm�tion
Ins n l..ine: 503.639. Nt+( cdM ctbod:
Tl c, n I . t) intcn+cr. www,tigard-Cr•gov
1!Lill�l•
a m nets of plans wiiroms checked Y+u1ow
Of' WORK :. check all Mal apply (submit 2 •
F. ddit;on /alteration /rcplaccttttent -��� - �"
�> • ❑ Service or fee 4N0 amps or more O 13nitdh over three stories.
lNmrt+A9 raid,ary},fd4
1] New litiStruCtion mrrcnl 0 Floating In
Other: excxds 10,000 imps at. t 50 volts of 0 agriculture;
i] Demolition where rile available fault a •• less to t ionnd, or exceeds 14,0x0 0 Commerelakete • CAT CONSTRUCTION � � � nil o ther installations. buildings
Accessory building [] I uil d in . of 75 KVA or
�] t _surd 2- family dwelling Commercial/industrial ❑ ❑ Piro pomp, larger cgmrntely derived sy: :icm.
❑ Msntcr builder ❑Other: ❑ g,,,ergcney system ❑ Multi- family e" ,.i.- .�,1_z,•.,,t. ;,.
LOCATION ❑ Addition anew mntnr l oa d o ❑ "� , m 1 !.".
JOB • STI E TNFl7R11iA IOIV . A1V17 . / � I ix or or more.
0 Recreational vehicle n.ake.
� . N� ❑ Six or more residential ,mite. ❑ SupN� vnita rrn , rn c OW
,
toh n o.: Job Site addr - •
❑ Heahfi -tort facilities. on w,hA,lnminAl
❑ Harntdmss locations.
ity /5tate/7[P: • / psnrmore. — --
s �. [] griviCe of feeder 600 Am
Project 1 . " pEDEILE
Sil Re/bldg. /apt. no.: P ect name: 1 - Itll 3s rM.i
N ew residential singla or multi-family dw colt.
< 'mss street/directions to job site: Includes attached garage.
1,000 sq. R or leas - 145.15 4
Subdivision!
Lot no.: Nil E add'I 500 sq. ft. or portion 33.40 =MEN
fax map /payee ( no.:
Limited energy, ra5idcntial 75.00 .111
; with above • • .. It
DESCRIPTION • OF WORK Limited energy, multi - family 75.00 NMI
• residential with above ... ft.
Services or fredcrs installation alteration and /or relocation •
200 amps or less
11111 80.30 2
i . — ...
❑ PROPERTY OWNE1Ei
TENAN .. - I X0 201 amps to 400 amps 2
. --- 4 -
4 01 amps to 600 amps all 11+0.60 _—
Name! 601 amps to 1,000 amps In 240 240 .60 - 2 -
•
Over 1,000 amps or volts -
65
CddrSt 'lip: - Temporary services or feeders installation, alteration, and /or
relocation
I 66.85 t
one: ( ) • Fax: ( ) 200 amps or less
'hnne: 201 amps to 4—
Owner installation: This installation is being made on property that town which is not 2 01 amps to 400 amps �� 2
intended for wale, Icase. rent, or exchange, according to ORS 447, X149, G70, 599 amps �� and 701. Branch circuits— new alteration or extension, , er stncl w — 2
. - A. Fee for branch circuits with l )wrier signature; above service or feeder fee, 6.65
❑ APPLICANT '
CONTACT' PERSON ' • each branch circuit
B. Fee for branch circuits
I;asin s name: without service nr feeder fee. 1 46.85 2
first branch circuit ---- 2
t_:vntact name: Each add'1 branch circuit 0.65
Addrats: Each a Ia I bra service t ftedcr not cind
c
Each manufactured or modular 90.90 2
ity /State /7_.iP: dwellin service and/or feeder 66.85 —
Reconnect only =
E-mail: Phone: ( ) F ax, ( ) Pump or irrigation Circle
� 2
�, mai . . Sign or outline lighting 53.40 .
l Signal circuit(s) or limited-
energy panel, alteration, or
! Business name : . hop v� �.ifitii� i .L - 0 �' J
extension, Paget
y •
Address: r� tl l � f�� - ~ �� Each additional ins etion river allowable in an of r_ hc strove
� � 0 4 , • ii 62.50 •
0. ity /Statc/lIP:
J� / in Pct insp per hour (t hr loin) -
62.50
PMonc ) Fax:11
./ Electrical Li . Ltc.: N Eiil e Industrial plant per hoar rn. ooti.... [ jn.:1F'
Suprv. Electrician sigttanire required: (/ ,- Plan review (25%ofpermit flx):
S: ..
V �� , I¢ t , i
Date: State surcharge (8% of permit fee): ' , I ar
Print name: V °
_ �� T (8 / PSRMIT F �� JO
Authorised siErlahrrC:. � � ��„ 'MLR permit npptieartun expires if a permit to not obtained ithin la
U � C �O 79� 0 d after It eat been accented as pnmpLete•
Print name:. —(�/] ( • Number of in<pectioa' allowed per permit.
■ wadicA \Pr:mi,n, \E,I:r:- Pe„m,App.der. 05n3m6
a,nsFlsrtt Irt+Srcn+nnvee
CITY OF TIGARD _ .. BUILDING DIVISION PERMIT #: ELR2006 -00258 " "
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006
Phone: (503) 639 -4171 Awif
Inspection Requests (24 Hrs.): (503) 639-4175 .-1.-,.41- A L
INSPECTION WORKSHEET FOR DATE: 11/1/2006 TIME: 7:03AM PAGE: 1
SITE ADDRESS: 16536 SW 72ND AVE BLDG F CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OCE
DESCRIPTION: Low voltage. Data, telecommunication
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624.6300
CONTRACTOR: MATRIX COMMUNICATIONS PHONE #: 503 - 513 -9152
Inspection Request Scheduled For: Date: 11/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 039172 -02 503- 956.6290 N
Corrections /Comments/ Instructions:
FINAL w`PA No s j'ick c6 sqc
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c"� 06B Date: f ti f 6G Phone #: (503) 718- iii i t e b
G