Permit ELECTRICAL PERMIT -
C ITY ®F TI GIRD RESTRICTED ENERGY
I� DEVELOPMENT SERVICES PERMIT #: ELR2004 -00286
13125 SW Hall Blvd., Tigard, OR 97223 (5031 639 -4171 DATE ISSUED: 9/8/2004
SITE ADDRESS: 07358 SW DURHAM RD BLDG G PARCEL: 2S113AB 01400
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage voice & data cable.
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 TELEDIGIT INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 22287
PORTLAND, OR 97224 PORTLAND, OR 97269
Phone: Phone: 736 - 3316
Reg #: ELE 3- 414CLE
LIC 116188
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/8/2004 $75.00 Elect'l Final
[TAX] 8% State Surchari 9/8/2004 $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 may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by > f'p 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Sep7 07 -04 11:48A nn P_O2
' Plectricail Permit Appli ata on uEl V L •
City of Tigard SEP Received ��B v y / n a � (/ • -au
g 0 7 2004 Retry' / , f) Permit No.: 7
13125 S W Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 '''n 1.l' Date/By: Other Permit:
TIGAR Inspection Line: 503.639.4175 CITY OF Ti • � -� Date Ready/By: tuns ® See Page 2 for
Internet: www.ci.tigard.or.us ' � " a �� Notified/Method: - fI f Supplemental information
BUILDING rminQrnht
'• �4;%���0."r4iltl4:. ,r .W ,r<u, , <• if , c:a •' i� 'lisi. . ..,.. I<� .. " � i °�1i1'Y�
❑ New construction „la Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other ❑Service over 225 amps, comm'I ['Hazardous location
. ;, ul t s[ L ' a , ❑Service over 320 as — rating DBuildng over 10,000 sq. ft.,
- „< .
^ r , � k t ,, • , , t ) 't L „ C`�' �, i t ' .:',.:11. It tt) - < >t swr , 'S tr • _ - .
� . i��`s� ,- ,, in gi ,� „i �j�, � •�,� �.� I t'�'` _ � of I- and 2- family dwellings 4 or more new residential
❑ I - and 2 family dwelling jii Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family 0 Master builder ❑ Other: ['Building over three stones Feeders, 400 amps or more
Occupant load over 99 persons ❑Manufactured structures or
t t ' i k. i r i9x it n . ,. :'� ❑Egressllightingplan RV park
Job no.: Ii S Job site address: 7 • SW b tAr 6 m R 6 DHealth-care facility ❑Other:
` Submit 2 sets of plans with arty of the above.
City /State/ZIP: P G1/1�tl 01Z, 9'Z2.-vt / The above are not applicable to temporary construction service.
g p Project ,CA: �R".�� Pa m?. „�; z b � it3 •���'+ :” 6`'ri �r j 9 J irl'r: :,1',- ./a t. no.: P ect name: ttr2cutf •� •' :
Suite/bldg./apt.
Description Qty. Fee. Total
Cross street/directions to job site: �' . ik o � \1 ,,
Cross. a c New residential single - or multi - family dwelling unit.
t � \
Includes attached garage.
'SW 1/� �QOt'�QS Fur gr10\ .1\A) v4-‘,k0,4,% 1,000 sq. ft. orless 145.15 4
Subdivision: t f Lot no,: Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no Limited energy, residential 75.00 2
y x �- ry r Limited energy, non - residential 75.00 2
• - • wt !ti. { ,< 3 :a �rlitr.•• �� , .s i }D? N<r @ fa�k.,l� w �?r
. i r «x ' 1.t<�ts.�„.., e. _ : i l >a �.? xl t titrl , ` ...,w ita it i«t» ,,� a �+' iea,al . Each manufactured or modular
r \ c dwelling, service and/or feeder 90.90 2
- - I ow V O C O i CR_ AA •1 _ gx Got e t Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
M• T • ' r ri ::i; 7 tom'. 201 amps to 400 amps 106.85 2
..•r t
' • - ' ' `”` • • `• 401 amps o 600 amps 1 60.60 2
Name: G? rg,1iA P.61i �1 C 601 amps to 1,000 amps 240.60 2
Address: 1 1 55 - ti SW 1 'i\r" r`"^^'+ 1-2-- . Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
Cit /State /ZIP: Pbs ''\,� 7ZZ,1 Temporary services or feeders installation, alteration, and/or
Phone: (6 ) V(4 -- “:"1 Fax: ( ) relocation 00 m
200 amps ps 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. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
i ' + t'. , . : p .£ .* x . , i ?u .li 73, i e , , ti k l # (�q ' , p' k ' ' A- Fee for branch circuits with
` service or feeder fee, each 6.65 2
Business name: 't" e , 7 rct, ` n (. branch circuit •
B. Fee for branch circuits
Contact name:
?.Q A y G d without service or feeder fee, 46.85 2
R each branch circuit
Address: l d go), Each add'l branch circuit 6.65 2
City /State /ZIP: C t � OIL c l TZ C9 Miscellaneous (service or feeder not included)
Phone: ( )-72-2.- &b$q 1 Fax:: (5 722.- q °I IH Sump irrigation
tlin lighting L 53.40 2
Sign or outline lighting 53.40 2
E -mail: , e 4 Mc_ C CO 4” Signal circuit(s) or limited-
. , : ,•. - �z q v r.: « $ ,,1t d u pra c �I
y< Ti °wtf t «'"` , , GEC
s...' . ?t ,<<<t i k? < - .d'.<<1;ALL...s. .t.li raAr.f.[ � AMVI <524« ill energy alteration or
.p /
` extension. Describe: Page 2 75 2
Business name: --Ce1P� e It+ kik, -
Address: P d h -2,--2,2-7 Each additional Inspection over allowable in any of the abov
V 1 Qty z ` 1 Per inspection 62.50
•� City /State /ZIP: Investigation per hour (I hr min) 62.50
c,- phone: (541S) 7 ( y 15 tit Fax: ( 563) 72Z -1/ Iii Industrial plant per hour 73.75
r ':'�""- ''k"4; "T " . ,ir- r x :d dV N i l :
CCs Lie.: (I (p` tf, 1 Electrical Lic.: 6912,3 8 Suprv. Lie.: 3 ici Z ` Subtotal --75 co
Suprv. Electrician signature, required: ( f ? -_l: ` �iI4 j Plan review (25% of permit fee)
T �' !�- State surcharge (8% of permit fee) b
Print name: ) c..- A Vc4t%. o S Date: q - -fi _ott
TOTAL PERMIT FEE S ` /
Authorized hb permit application explret If a permit Is not obtained within 180
days after It has been accepted as comple
Print name: Si ;; gLA 9._1 Gk-ArA..„ Date: g / U • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
i ',Buiidina\PermivtELC- PennitApp doe 12/03 440- 4615T(10/0 COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection.lskine: 1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / ( AM PM BUP
Location 7 D L-a- J Suite ( MEC
Contact Person 9/4flf t- " Ph ( ) PLM
Contractor Ph ( -) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELRahZ) / L `-°°cRe j
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: Cr"
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 Q1- 7// L - ',49
Fire Alarm
('C er\ PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Ei Please call for rein pection RE: • Unable to inspect - no access
Fire Supply Line
ADA / / '
Approach/Sidewalk Date Inspector -l� ` ` Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL