Permit CITY OF TIGARD ELECTRICALPERMIT-
RESTRICTED ENERGY
- �,�•,�.�J�II. ` DEVE Hall O BMENT Tigard, R 9 OR 97223 639 -4171 DATE ISSUED: IT 13125 V
SITE ADDRESS: 06713 SW BONITA RD 270 PARCEL: 2S112AA -00600
SUBDIVISION: NELSON BUSINESS CENTER ZONING: I -L
BLOCK: LOT: C -D JURISDICTION: TIG
Proiect Description: Low voltage: voice and data wiring.
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:
SPIEKER PROPERTIES LP DENNIS LINDOFF TELEPHONE
4380 SW MACADAM AVE STE 100 4090 SE EL CAMINO DR.
PORTLAND, OR 97201 GRESHAM, OR 97080
Phone: Phone: 503 665 - 7645
Reg #: ELE 26- 1103CLE
SUP 1138LEA
LIC 92614
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/24/2004 $75.00 Elect'I Final
[TAX] 8% State Surchar€ 5/24/2004 $6.00
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 . y obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by _� .4. � ` Permittee Signature .0 a. #(if 1 / / v
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day .
D LINDOFF TELEPHbNE 5036181167 OS/21/04 09:19am P. 003
zz r.1 _ �,
0 200
.
. Electr P erm it �'I iT� � a l ►EE R I N� .:. Fc >, R OI•fIcE l.l ONLY
\ 4 �li `"" .
C2�Criy of x igBlard �i1 D ��a a 1 _ !x V� . J f �/ L/- �O/3 _
tip \ ► 3125 t: Kwll vd•, Tigard. Ok 97223 Plzn Kco
VV Phont 503.634.4171 Fax: 5 03 .578 .1960 '�'r ; 1 l '• �s1_� Oth rPerm
(
Inspection Line: 5O3.639,4 __.a...:: oars fteady/By: s, ,. Z S ec eago 2 stir
Internet: ; wwe'.ei.tigard.or.us Notified/Method: : /0 � Sup lnt
C' l.l: l ,,, l . L ; I( 'li I r �''" 'I ' PLAN; REViE�%' •
New construction 1"Y ; ..:.t OR 1'.i•i,.,. '•° ::,,,, ase check all that apply:
❑ ion Additiozi/alteration / replacement Pic
•, . er- , v over 320 amps, s -r ai r3u n over 10 000 s t
: ❑ Demolition .
:.' :, : :.•.. ,i` ; + fe" - :i I t o JC r h-and 2- family dwelling;: � 4 or new residential
•::. i° i..; : s .,. �'::
.. .; ". ���. . , tic!' '�'? : I •.':. '; . ., I. I � CR' iC51Ue �
0 1 - and 2- family dwelling W CornmerCiai /industrial ❑ Accessory building ❑System over 600 volts nominal unite in one structure
MuIH fatnii I EBuilding over three stories OF coders, 400 amps or more
Master builder Other: Occ ant load over persons structures or
❑ Y ❑ ❑ up d er 49 pe []iVianw` acturCd structu
��, I '�'i' t a5,'li htin plan ark
F . I q'(;.4 °d j.a,, ,�a{B I Q�q�' I.4 �Ck.7 � •��i ! ❑ g 6P RV p
-,^? ff I
rl :,�i�i:.'. ���:'.,�' r i.:�7H' ... , ... . � ' r' ❑Other:
Job no.: lob site address: ' 1 /� ❑Hea lth -cart facility
'� , 3 JGZ: �f bl i -L LuC Submit 7 sets of plans with any of the above.
City /State /ZIP: - f .-- 1 0 i Z The above are not applicable to temporary construction service.
Suitc/bldg-/ p , j L.,.i! ., .;RE*jSC)`i:EUEILE i;; , '
a t. no.: ' iv Project name;
Description Qty Fee. 1 Total ;
Cross street/directions to job site: New residential single- or mufti family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision, Lot no.: Ea, add') 500 sq. ft, or portion 33.40 1
Limited energy. residential 75.00 2
Tax map /parcel no„ 2
Limited energy, non-residential _ 75.00
, :1. 1 ''' CA �/, ihl ''l'. ';. : p c . " I, . 1 4' II:
.•,'.;'p j';i i:, .:I��'. {�':.; , .:.i: . " S4'.F'' . 1 �Y�C;L. .�:: :1� I i * � n ,l .:. . _ ...,.. ,. ' d Each manufactured or modular
�( / '' dwelling, service and/or feeder ( 90,90 I 2
t L; .� _ ^ C� r'c. _ L.,L' y'' L i. .-1 Services or feeders Installation, alteration, and/or relocation
200 amps or less ' 80.30 2
l r.� i 20) ampe to 400 amiss 106.85 2
I -- - 401 amps to 600 amps 160,60
Name: p 4 4,c 1o1,.t) lit 601 amps to 1,000 amps 240.60 2
AddrosS: Lt) Wiz. ,, I A.: e_r; it. .k. Over 1,000 amps or volts 454.65 ; 2
_ -
Reconnect only 66.85 I 2
City /State /ZIP: 1 - l jl . _ - - CI ' I. Z ''-f _ Temporary Services or feeders installation, alteration, and /or
r relocation
Phone: .6 /'.3 ) . -- 05-3/ Fax. ( 7 ) -Z. : y� ; - j 9 2 200 amps or less 66.85 i
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. aol amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension. per panel
, 11!$ li 1;;: l A. Fee for branch nth ci rcuits with
''''..:'''.."''''.='' ' ,: 1 �l x'' - °•., ' '� � . I:, ' -. •I'❑� EERSAM.i i; > ,! c' i''. •
� : - � - service or feeder fee, each
Business name: branch circuit 6.65 1
_.
C3, Fee for branch circuits
Contact name: without service or feeder fee, gG•85 2
cacti broach circuit
Address: _ Each WI branch circuit t _ 6, 65 2
City /State /ZIP: Miscellaneous (scrvlte or !cedar not Included)
- Pump or irrigation circle I 53.40 _ 2 ,
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E- mail: Signal circuit(s) or limited-
,,: .,: ,I. ,, IIAIL� • ii I encrgY panel, alteration. 0
;, , ., ,. i1 _ ...:. , • . i _.;; ; �: I .._ . extension. Describe: Page 2. 2
Business narne: �-� U'L't .i..11• >1. cif) ' t � 1 >_ t ,' :s g, i>. c) 11, ` l
l Each additional inspection over allowable in any of the above
Address: ` J( ) , I .--
_ t ( C e .t.Lt_L.A.A. &: ! ;. 1.
Per inspection 62.50
City /State /ZIP: I.. �_ s• ~ i 1?.l - C" '- , . 0 ® investigation per hour (I hr min) 62.50
�.- S L. i .v='
' 2 r y duseriat plant per hour 73.75
C I
Pho (5 7 ) 4'4 _7-1-- , / F ax: ) �'> f d d " t'' ".:,.
.., ?:,;'; j':1 ELEcilue'ACHP.ERNLIT: FE'6S ,
cost Lie.: al Electrical Lic.:/ � 3 t . 4 .- uprv. Lie,; 2b - j/� c I Subtotal
' `'`I -105,-, j `� / () Plan review (25% or pe Tr it fee)
Suprv. Electrician signature, requ b - ) ' I
> g _ Stair. surcharge (8 % of permit fee)
• Print name i Alj'i,i( i> A Lt. 0 b) fr Dte: • - 'Li .,GI J
TOTAL, P EILMIT FEE
Authorized signature: This permit application expires if a permit iT not obloineC within ISO
__ - - - -. -• Jaye after it hos Peen neceplett as complete
Print name.: Date: I - Ace methodology sec by Td.Couury Buitdin$ Industry Service Board
" Number of inapection5 per permit allowed.
;. wetldine \rumim\arc 1510 tawtOI57(IO/OE /COMIWBD
T ^^ Ira, /TVVrTT T _IA T T T ' 1 AtIOTOReefle vv.r r7 : CT 17 ,r 7 /AT /Oh
CITY OF TIGARD 24 -Hour ti*
BUILDING . Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Q BUP
Received Date Requested 6 ��v AM PM BUP
Location 7 13 Suite v MEC
Contact Person Ph ( 7Ca S- PLM
Contractor Ph ( ) SWR
Maw
BUILDING Tenant/Owner ELC
Footing
Foundation Access:
ELC , /
Ftg Drain ELR d 60 ` 1" U
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam -
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewali hiliteV5b.- P
Fire Sprinkler t
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
alarm •
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
( 40 PART FAIL
S • ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date " (� "d1 Inspector 1--11 �� 4ppLe I ( 1 2 4' Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL