Permit Cr CITY OF TIGARD' ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00310
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/7/2007
PARCEL: 1S136DD-00900
SITE ADDRESS: 06830 SW ATLANTA ST 100 ZONING: MUE
SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG
PROJECT: JERMEY T. VERMILYEA ATTORNEY
Project Description: Low voltage data cabling.
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:
MALCOLM ESLINGER MATRIX COMMUNICATIONS
11575 SW PACIFIC HWY 4243 SE INTERNATIONAL WAY
PMB 160 PORTLAND, OR 97222
TIGARD, OR 97223
Phone: 503- 997 -8478 Contact #: PRI 503 -513 -9152
FAX 503 -513 -9352
FEES Reg #: ELE 26- 694CLE
LIC 74332
Description Date Amount SUP 1202LEA
[ELPRMT] ELR Permit 8/7/2007 $75.00
[TAX] 8% State Surcha 8/7/2007 $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 dire .. - 'ens to OUNC at 503. 6.6699 or 1.800.332.2344.
Issued B • � // �- f / Permittee Signature: 44/2//7
�
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 hoR OFFICE USE ONLY
r City of Tigard tl y * '' �/ Received U PermitNo.: i / 0 _ • —
II 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C • Phone: 503.639,4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 R`k 01 2001 Date Ready /By'. ruris: Ea Sec Page 2 for
T I G A K ll Notified/Method: �� Supplemental Information
Internet: www.tigard or.gov r ITV r a ,,,,,, x , ,r, ti I • '.t1 3 s r., } .w. l { :'t'E1't; i { `li l ii i '1 i : ,!€
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i4s Please check all that apply (submit 2 sets of plans wlitems checked below):
❑New c onstruction [[[t ddition /alteration replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: • where the available fault current ❑ Marinas and boatyards.
": { 'i[ # ' gsr ?tata ;pi t t'. tili ` ` " ' • s, } , t , . t r: .s s; ;,; Fz,° £� :,u,; as , t< 1sN =a � t3�,Iit';Illli` #` ;' 'ii�� 1 }z u i{� , y� (� �j}' j = # � }rp +�(itI exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
14iiiltilsl >i igi rI .l ii °,i ! r { : s { a1 :,1,r I . { ,,l At{ , , 01i '' • ; I t ,!' ; i 1il t ! , p, 13 (^ r l. l: #: i ll i I1 i [i
w �i °a#;isli.ji 4ps +i #ailItg tl. = =tjt'•.,44 ,_4,414,414 i,414f , {r,s +? , t,t,.l4.ft(tfll,l:: , :11 • tt a ,. L ail f , f •E.,. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' #I {l ,,,,, i n + , , , ._ sr,•{ • i >_i: , " £ .,, t•:, sirs .r a, t s:; -: { 6 .Y' '' +, <s£. r�;{., a :, a t .�., +,+'.' 1 111111,411141,90i' '{?l''1 {4i8fiil'jI �;l;j[1111.1 1'I Emergency system. Y em.
p ❑ E larger separately derived system.
1 ,ilc :.,`yf;j° {: 1 14 , . t ll .tJ , f it ' # 7+0 !# 1 gi j I . ❑ separately deriv
,, ;g i, K „ tr' : <`..t., 111111 =:• s i `, . � i'! t �' 1 { I•Iii ::a £ ! t Addition of new motor load of ❑ • >:ie��,earF�*eti , ylheF !{aa. e .,t}a.E la r..„�e ,:, 1_: u,tFl.n 3 ii; % - =s�° . v i • Yr, =,, lh$ns + § £ I ��t {i :'J 1 s �., u , z,n. ,tf� # a�t €>, ie.
Job no.: I Job site address: 6 1001-1P or more.
❑ Six or m occupancy.
ore residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 7 ' (96 9 0 Health-care facilities. ❑ Supply voltage for more than
a ❑ Hazardous locations. 600 volts nominal.
f i
Suite/bldg. /apt. no.: /00 Project name: Vl, F Zdi.e.) �• ❑ Service or feeder 600 amps or more.
t :i�� =' { 'ul'll; ,l. rt "n` :RihjSr a, yyy��t ,�?�}g� y{}, r l''11'r^j iiii t;Ir:I;jrjtii {'sr;` .
r I:j1i1 { j�'I � �i`41,�,.� •„,�, rt 33 { 'lr' � s {. B! j j t ,'. l ('. 1:11'11:
, 113 =. i!!?it 143, ;1.'fh�� ,,1,3 ,•',xliSi£ 1 #.v nxvg. t: l.' €fi�3. E �.;i ,` i #' I+, t,:,;l {lit, 1” I
Cross street /directions to job site: Description I Ott Fee. I Total 1 "
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: 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
it . ... ,, u'i?;i'# WH :°'1 IIII't;`#i=i1 * 113 +ii'i .iy t:} • ,F t, z r * ra { yt^ 11 ' d(iII} "t r f: t r°
11 ' j'{ j1 _ ` l inf # :£ tl,f,t t (withabovesq.0.) 75.00 2
dil:ij w -,i4 sdS ?`Si = "',ti # dial,' - 4.1101 i01e Vitt! tli ikim aTii,,, r�#+m - -4. {" ,,,,, it ,, tm , f , ' I { ;Fr {. { Ittl,til11 , ,, i'sr „,,, „d., i. „ # 0,
• Limited energy, multi- family 75.00 2
o a r , "I ,:h :1 .. AU' r residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
.ji;:.l :lr #;' d 3';t f� : +, ",> r43kt ,tliir t zt {uu(r, ,,,+ •`! 1> I i
^iti'i1( £ 'i'i `1111 �1 ; {,#t !Mgr �, +i9 +£; , I I{ , a • +^,} -'t q {'9
P ' 1 1 j rn
;, qt iiiiilli f i a t p! 0 6, , , El ii It r ilji , I ! '� r ,aI , E . I ° I i'1 {j' (' l i 201 amps to 400 amps 106.85 2
a eg,i eii££aetl t,i?�„ #+, <¢ 'n,- {V� sru. ,a. 4), ,.q,a, itril, 4 ;1 •, I, 't1 ,,, . . . 4 ;,. :.,. 4 Ii ?Slt'll F+ „1d .fk' ir':_II«; ,.Lid ; i,
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
t3 relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on prope
rt 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
,r? RI i +: £t.'i:p 1 ` il i T�'jr � ° ni { F, £ ,r sa , s. #'t £E t µ . 1 1f}1 S' iill t1 k - n { • �f ., , >u eyit , r ;rear , £ .4 ..,£ =i i I1 :'''+4 i; " ts'
,l,r: I #; i h t .,,,, {: € { i i M -• +C ail , t£ i -,i igl .l 11 1 � t1:; gl iiii . , ?I i,1i`';. : ltr f t� s � , ((� $ ty+3ryj' £y lit i,i { }t�, 1 [ s $ ; � jif< above service or feeder fee,
;, au,µ!, }I ti ia-`£r:£?F,1,£t,m a'11 ,<S;xil)7 re4S{".-,!!li4{ £ ?E,i..ssts l° 1,1• `f: ',,,, •f i's�.`.l.,t, : ., µ1m ,. �'R} e , l ;ali#1 p1,14 MI a:,ll; 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or Contact name: first branch circuitfeeder fee, 46.85 2
Address: Each add'I 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: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
i s { i {!• ";Rp:v e t' i rs t y.. 3 , „ + + t't d t •11 n , 4 , •1' s
l.,,e ; i } { ;II::E;. , xj ., 1 . £# ..t 4. , o "O ' ; { ' l' , a . ,'j ' 1 i tit }. , , ,;I ( `j { , 1 9 , - j l ; j , t l ij, .l ..; ; ; 4 53.40 Sign or outline lighting 2
icsf±r l ;11111h1i{,£h: 1x= £r�tlna ii { tf tl 3e ed1,£t{ €'jr + C* 1 ji tt� .34€ i ` I 1t J ` i e �li.li3tll ,�fa� t.(t ii .t „I , t
Business name: ' �/ /'1j / ( ;_ Signal panel, or limited- j
+ ! l � energy panel, alteration, or
Address: Apo I / ( / L al/ / extension. Describe: Page 2 2 Al
City/State /ZIP: * 0
• 0 )-1Z Each additional inspection over allowable iii any of the above •
Phone 5 /52, I Fax: CO3 .) 3 ..965 - Per inspection 62.50
Investigation per hour (1 hr min) 62.50
,f I n er hour
73.75
CCB Lic.: � `electrical ��•�prv. Lic.: /.2Q�L,�fr" Industrial p a t p ,
° ° F P i l " t , ; I 1 3 , 1 £:t:i£tt }.t x;:.,
/ � a / I , Vttlitl "dfl tlljii t , i , ifs 43 +,:3,:;a'7i'' { ".,t,
1 D 8 . arJi allli r i��jr �r�' �! s�� 1? ',� =k,�'4�. t
Suprv. Electrician signature, required: A Subtotal:
Print name: 4) J ()Ede_ I Date: �% O " Plan review (25% of permit fee): .
State surcharge (8% of permit fee): , -
Authorized signature 1 rj i ' TOTAL PERMIT FEE: /
0,',0 This permit application expires if a permit is not obtained within 180
Print name: Date: 8/7/0 This after it has been accepted as complete.
° Number of inspections allowed per permit.
1:\ Building \Permits \ELC- PerrnitApp.doc 05/23/06 440-4615TH I /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00310
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/7/2007
Phone: (503) 639 -4171 IIHQ>
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8//312007 TIME: 7:01AM PAGE: 26
SITE ADDRESS: 06830 SW ATLANTA ST 100 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: JERMEY T. VERMIL.YEA ATTORNEY
DESCRIPTION: Low voltage data cabling.
OWNER: ESLINGER, MALCOLM PHONE #: 503.997 -8478
CONTRACTOR: MATRIX COMMUNICATIONS PHONE #: 503 -513 -9152
Inspection Request Scheduled For: Date: 8/13/2007 Pour Time:
•
Code # Inspection Description # Contact # Message
135 Low voltage 053864 -01 503-513-9152 N
‘q1
Corrections /Comments /Instructions:
PASS I I PARTIAL APPROVAL CANCEL fI NO ACCESS
I I FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: N tiQ Date: t.13' d1 Phone #: (503) 718- 241Pf