Permit CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00077
r I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/4/2008
PARCEL: 2S 113AB -01201
SITE ADDRESS: 16575 SW 72ND AVE BLDG F ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: CONVERGINT TECHNOLOGIES
Project Description: Installing low voltage fire alarm, data, burglar, and sound masking systems.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: : X
TOTAL # OF SYSTEMS: 4
Owner: Contractor:
PACIFIC REALTY ASSOCIATES CONVERGINT TECHNOLOGIES
15350 SW SEQUOIA PKWY #300 -WMI 2040 SE POWELL BLVD
PORTLAND, OR 97224 PORTLAND, OR 97202
Phone: Contact #: PRI 503- 228 -8522
FAX 503- 228 -8521
Reg #: ELE 26- 1173CLE
FEES LIC 148358
Description Date Amount
[ELPRMT] ELR Permit 4/4/2008 $300.00
[TAX] 12% State Surch 4/4/2008 $42.00 REQUIRED ITEMS AND REPORTS
Total $342.00
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: / Permittee Signature: �A
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.
Electrical Permit Application y FOR OFFICE USE ONLY
ell. Receiv
Cit of Tigard r - „�, DateB : ` Permit No.: _ ,,A 8 • n 13125 SW Ha ll Blvd., Tigard, 'ii . •a22 ) (�, Plan Review
Other Permit:
G ' P 503 Fa x: 5 i . 't :" 60� � Date/B : , W7 . r
T I G A R D Inspection Line: 503.639.4175 1XC 4 Q Date Ready /By: Jug: Ea See Page 2 for
Internet: www.tigard ®� �� ��� Notified/Method: Supplemental Informadon
• > TAE .a>F- s•:*; ,�L PLAN .REV W
ro - _ New construction ❑ Addition/alt ` :non/replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
'r ckitCottitbi CONST,ItUCUON ' i si', exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 1 Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
Emergency system. larger separately derived system.
' JOB SITE. ti4VORMATION" AND LOCATION . < ❑ Addition of new motor load of ❑ "A ", "E" "1 - ", "1 -3"
y d 100HP or more. occupancy.
Job no.: Job site address: /6 575' b/ 'a iiG, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: F0, a'el 97c2v2 ti ❑ Health - care facilities.
❑ Hazardous locations. ❑ Supply voltage for more than
600 volts nominal.
Suite/bldg. /apt. no.: Project name: , r r « � �/zr� ❑ Service or feeder 600 amps or more.
lour ✓t v �? r i scA,ktit :, f
Cross street/directions to job site: Descripdon 1 Qtv. 1 Fee 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
r . LIESCRI<RT1OLNop WORK ,. � a 1 r f - , j r v (with above sq. ft.) 75.00 2
' Limited energy, multi- family 75.00 - 2
(v//'e' 9' id1t I/ A-OW vil /iNfe w/m9 Fr f reAtIawr11 DG1T� residential (with above sq. R.)
Services or feeders installation,alteration, and/or relocation
feif y /e , �/J7?M 7 O/>7
� JJ. /�}iwo J lf�i ".7 Cyfre 200 amps or less 80.30 2
OfP LOPRRTY OWNER r E.) TENANT; x i 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: / State/ZIP: Temporary services or feeders installation, alteration, and/or
tY relocation
Phone: ( ) I 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 . K , ,_ , . > 0 above service or feeder fee, 6.65 2
,' CONT1CT YE(iSOI� a „
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included) _
City/State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONNi'> tACTQR .- ,.' Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
O,ive,y, T etA ,/ , f ! energy panel, alteration, or . C., Address: ,7,L9,4/,0, iL" , O� rrel/ giv / , extension. Describe: Page 2 2
City/State/ZIP: ,rr, , � 9`7 Each additional inspection over allowable in any of the above
( 3 O ��� Per inspection 62.50
Phone: � g ) � F ax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: `l/ 357 Electrical Lic.: / /'C6C Suprv. Lic. j /f f4 Industrial plant per hour 73.75
'. )', ELECTRICAL, PER1 UT..FEES ` .' .n.: , et
Suprv. Electrician signature, required: Subtotal: J `�
Da te: Plan review (25% of permit fee): �
Print name: � /1� CID
/` /i Gf t✓�/' �i D� State suroharge�cg� /o of permit fee): (- __..--
Authorized signature. TOTAL ERMIT FEE: LI �'
This permit application expires If a permit is not obtainnwrthin 180
Print name: . Date. days after it has been accepted as complete.
' Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.d°c 05/23/06 440-4615T(I I/05/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008.00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008
Phone: (503) 639 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 " ' I..
INSPECTION WORKSHEET FOR DATE: 6/12/2008 TIME: 7:02AM PAGE: 19
SITE ADDRESS: 1655 SW 72ND AVE BLDG F CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONVERGINT TECHNOI..OGIES
DESCRIPTION: Installing low voltage fire alarm, data, burglar, and sound masking systems.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CONVERGINT TECHNOLOGIES PHONE #: 503 - 228-8522
Inspection Request Scheduled For: Date: 6/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 071287 -01 503 - 8'19.0551 N
Corrections /Comments/ Instructions:
\\‘
vV
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' N6(3 L� Date: q 6 Phone #: (503) 718 -1 4 4'
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008 -00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008
Phone: (503) 639 -4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175 y- `'I -
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:01AM PAGE: 45
SITE ADDRESS: 16575 SW 72ND AVE BLDG F CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONVERGINT TECHNOLOGIES
DESCRIPTION: Installing low voltage fire alarm, data, burglar, and sound masking systems.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CONVERGINT TECHNOLOGIES I`o PHONE #: 503228 - 8522
Inspection Request Scheduled For: Date: 6/6/2008 Pour Time:
Code # Inspection Description " /COnfirm #., Contact # Message
199 Electrical final 070975-01 \ 50322t3 -8522 Y
Corrections /Comments /Instructions:
�____-- 11, 30. g 00 Af`�62-,
N0 %,virn En)� •NS`Pg,LLt
1 'f R-o6 nr., .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
4 K FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G v(6 L' Date: 64 01) Phone #: (503) 718- Till‘
CITY OF TIGARD , -.. 1
BUILDING DIVISION PERMIT #: ELR2008. 00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 I
Phone: (503) 639 -4171 lands 1
s" "
Inspection Requests (24 Hrs.): (503) 639 -4175 ! IL
INSPECTION WORKSHEET FOR DATE: 5/2 /2008 TIME: 7:OOAM PAGE: 27
SITE ADDRESS: 16576 SW 72ND AVE BLDG F CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONVERGINT TECHNOLOGIES I
DESCRIPTION: Installing Iow voltage fire alarm, data, burglar, and sound masking systems.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CONVERGINT TECHNOLOGIES PHONE #: 503228 -8522
Inspection Request Scheduled For: Date: 5/2/2008 Pour Time:
Code # Inspection Description a Confirm # Contact # Message
135 Low voltage 069257 -01 971 - 645-5413 N
Corrections /Comments /Instructions:
Qa Q - \ 0 & LA-, 6
161
M
1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� V Na Date: m Phone #: (503) 718- Y