Permit •
U' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00458
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/13/2007
PARCEL: 2S113BA -00400
SITE ADDRESS: 07632 SW DURHAM RD 130 ZONING: I -P
SUBDIVISION: SW CENTER SDR1999 -00020 LOT: JURISDICTION: TIG
PROJECT: UNITED HEALTHCARE
Project Description: Low voltage for access control. Job No. 107076 -10593
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: ACCESS CON X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OPUS REAL ESTATE OREGON IV LLC DYNALECTRIC
1000 SW BROADWAY 5805 SW HOOD AVE
1130 PORTLAND, OR 97239
PORTLAND, OR 97205
Phone: Contact #: PRI 503- 226 -6771
FAX 503- 226 -7720
Reg #: ELE 26 -59C
FEES LIC 66793
Description Date Amount SUP 4653S
[ELPRMT] ELR Permit 12/13/2007 $75.00
[TAX] 8% State Surchar 12/13/2007 $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 direct questions to OUNC at
503.246.6699 . :00. 332.2 344.
Issued ::y: 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.
'" " Dec 12 20 10: 02e �CE'V p 2 ED
Electrical Permit Application 2 2007 FOR OFFICE USE ONLY / -
City of Tigard DE p Received /* / er7 .. pem\itNo.: �jjxi��f'1�y5�
x Daten3 �r
1 : 1 11 1 111 .
" 13125 SW Hall Blvd., Tigard, OR UM O� j ' n61 O Plan Review
� 9 � q Other Permit:
' „_ Phone: 503.639.4171 Fax: 50 IIl f �J% NGDI'VISION D
Inspection Line: 503.639.4175 ju 6d Date Ready /By: 2w El See Page 2 for
'TIGARD p
tntemet: www.tigard of "gov Notified Method: Supplemental Information
TYPE OF WORK : PLAN REVIEW
❑ New construction R"Addition /alteration /replacement -
Please check all that apply (submit 2 sets of plans w /items checked below):
0 Service or feeder 400 amps or mote ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts of ❑ Floating buildings.
less to ground. or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1 - and 2 family dwellutg L✓ Cornmcrcial /industrial ❑ Accessory building amps for all othet installations. buildings.
❑ Fi pump. ❑ Installation of 75 KVA of
El Multi ❑Master builder ❑ Other: [] Emergency system. larger separately derived system,.
. _
'JOB SITE INFORMAI'TON AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E "I - 2 ", "I - 3 ",
11 Da 10011P or more occupancy.
Job no.: ID7O7tn -109 3 Job site address: "7(o3 z SW buirilaIYI 2. ❑ Six or more residential units. ❑ RexrevUoual vehicle parks
��� ^� El Health -care facilities- El Supply voltage for mote Qlan
City /State /ZIP: �l X (* f ,O L ❑ Hazardous locations. G00 volts numiva1
/ ' ❑ Service or feeder 600 amps of more.
Suite /bldg. /apt. no.: .... Project name: 14.1.1-& C,e h � G FEE SCHEDULE
Cross street /directions to job site: #t R C 4'��i u �syry " °" IIKIMINILIMI Total ---
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
- Ea. add'l 500 sq. ft. or put lion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRU°T1UN `.O .. . ... ...... .
.... • . • . _ OF )YQIiK' ::';'. (wit v
h a above
Limited energy, multi - family 75 00 2
/ 1 • residential (with above sq. ft.)
Al i.! �l ��� - Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
' '
PROPERTY OWNEE2', .:: .'',.::t .' : : :-7"IENANT' " :.. :' . i. 201 amps to 400 amps 106.85 2
J/Jl 401 amps to 600 amps 160.60 2
Name: Q I � � 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and /or
City /State /ZiP: relocation
Phony ( ) Fax: ( ) 200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits- new, alteration, or extension, per panel
Owner signature: Date: A. Fee fur branch circuits with
.... feeder fee, 6 65
2
. AlfPhrG�#N. .,:::!.1:-:::-.-..'::-'1::-_:-,:-..:.:: :< OT?1TACr Y , .: ,' ` -,, . , : :
...:: :• . . :, above service or ee
.-, eac branch circuit _
Business name: B. Fee for branch circuits
tvidlout service or feeder fee,
46.85 2
Contact name: first branch circuit
Each add'I branch circuit I 6.65 2
Address:
_... - 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 21
E -mail: Pump or in•igation circle 53.40 2 .
CONTRACTOR' - Sign or outline lighting 53.40 2
' Signal circuit(s) or limited -
Business name: ,..I PL - ( I Et energy panel, alteration, or ..
Address: 59 S u. d extension. Describe Page 2 Z�' 2
N n Each additional inspection over allowable in any of the above 4
City /State /Z1P: M ( 1 (�� ! O v6 Z� 9
�7� 3) 1'er inspection 62.50
Phone: (5p3 ))2,2,1 - t 7 � Fax: ( i-($ - D2,33 Investigation per hour (I hr min) 62.50 1
CC13 Lie.: GAT/ 9 3 Electrical Lie.: 2/ 59‘c Suprv. Lie.: Industrial plant per hour 73 75
• L. CL CTR'ICAL a:LES l
Suprv. Electrician signature, required: �, Subtotal: 75 (--) 2.-:: ) - ;'
. Plan review (25% of permit fee).
Print name: D ate: ( `, O f:
ti i State surcharge (R% of permit fee): Go- CO
Authorized signature: r' TOTAL PERMIT FEE: , ,,,
Pit if I { This permit application expires if a permit is not obtained within 180
Print name: c Mel Date: lZl t 2I days after it has been accepted as complete.
YYYY (111 11 ' Number of inspections allowed per permit.
l :,B,ild leg \Ecrmit.stELC -fct n 05 /23/06 440- 4615T( I 1 /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION . _ .„ PERMIT #: ELR2007-00468
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211312007
Phone: (503) 639-4171 A41110110i it
Inspection Requests (24 Hrs.): (503) 639-4175 A. - en..
INSPECTION WORKSHEET FOR DATE: 1/2/2000 TIME: 7:01AM PAGE: 2
SITE ADDRESS: 07632 SW DURHAM RD 130 CLASS OF WORK:
SUBDIVISION: SW CENTER 5DR1999 LOT #: TYPE OF USE:
PROJECT NAME: UNITED HEALTHCARE
DESCRIPTION: Low voltage for access control. Job No. 10707610593
OWNER: OPUS REAL ESTATE OREGON IV LLC, PHONE #:
CONTRACTOR: DYNALECTRIC PHONE #: f
Inspection Request Scheduled For: Date: 1/2/2008 Pour Time:
Code # Inspection Description __Corgi rn Contact # Message
199 Elotirical final 062425-01 503-849-4436 N
Corrections/Comments/Instructions:
N
(\ ,
A PASS n PARTIAL APPROVAL ri CANCEL n NO ACCESS
El FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G N 6e LE" Date: t - 2.- - (A Phone #: (503) 718- 2
._ ._. .. .. . .. .. ..
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E1R2007•00458
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2007
Phone: (503) 639-4171
„i Inspection Requests (24 Hrs.): (503) 639-4175 v
INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7:03AM PAGE: 68
SITE ADDRESS: 07632 SW DURHAM RD 130 CLASS OF WORK:
SUBDIVISION: SW CENTER SDR1999 LOT #: TYPE OF USE:
PROJECT NAME: UNITED HEALTHCARE
DESCRIPTION: Loy voltage for access control. Job No. 107076-10693
OWNER: OPUS REAL ESTATE OREGON IV LLC, PHONE #:
CONTRACTOR: DYNALECTRIC PHONE #: 603
Inspection Request Scheduled For: Date: 12) Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 062008-01 603.889-4617
Corrections/Comments/Instructions:
•
PAS PARTIAL APPROVAL n CANCEL I NO ACCESS
n AIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: N Date:11 141 tr Phone #: (503) 718- 7446-