Permit ,1 C I'TY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00446
TIGARD DATE ISSUED: 12/28/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 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: Fire alarm low voltage.
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: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OPUS REAL ESTATE OREGON IV LLC CAPITOL ELECTRIC CO INC
1000 SW BROADWAY 11401 NE MARX ST
1130 PORTLAND, OR 97220 -1041
PORTLAND, OR 97205
Phone: Contact #: PRI 503- 255 -9488
FAX 503- 257 -7121
FEES Reg #: ELE 26 -496C
LIC 48748
Description Date Amount SUP 3132S
[TAX] 8% State Surcharf 12/28/2007 $6.00
[ELPRMT] ELR Permit 12/28/2007 $75.00 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 t - r5 - nr h in 952 - 001 - 0010 through OAR 952 - 001 -0100. You m ay obtain copies of these rules or direct questions to OUNC at
503.(699 6 or 1.800.33: .44.
Issu By: / I / Permittee Signat ,i e , ,A� /� w
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 ApplicatioiN FOR OFFICE USE ONLY
City of Tl and Date /By: Other Permit:
y y Received P ermit No d' ,',,/� ' L /
4 ° 13125 SW Hall Blvd., Ti ar d, OR 97223 OEC 1 1 200 Date /By: I I i 1 / u7 i c. /,�]� .0/ / .. 00 7 .(O
g E TU3P.B Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 :
TIGARD Inspection Line: 503.639 01�Y o ,g ate Ready /By: Juns: 10 See Page 2 for
Internet: www.tigard - or.gov BUILDING li J S� N otified/Me[ hod: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION 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 E 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 INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", °I -2 ", "I -3 ",
Job no.: 280076 Job site address: 7632 SW Durham Road IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: 130 Project name: UHC T.I. ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I *
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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
- Install fire alarm circuit. Limited energy, multi -family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
® PROPERTY OWNER ❑ TENANT 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: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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 ® CONTACT P ERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Capitol Electric Co., Inc. B. Fee for branch circuits
Contact name: Dan Wilson wit /tout service or feeder fee, 46.85 2
first branch circuit
Address: 11401 NE Marx Street Each add'! branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /Slate /ZIP: Portland, OR 97220 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 262 -0411 Fax: : (503) 255 -1966 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Capitol Electric Co., Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 11401 NE Marx Street extension. Describe: 1 Page 2 75.00 2
Fire Alarm
City/State /ZIP: Portland, OR 97220 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 255 -9488 Fax: (503) 255 -1966
Investigation per hour (1 hr min) 62.50
CCB Lie.: 48748 Electrical Lie.: 26 -496C Suprv. Lie.: 313 Sl Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: / Subtotal: 75.00
Print name: Dan McNeel i Date: 12/6/07 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 6.00
Authorized signature: TOTAL PERMIT FEE: 81.00
This permit application expires if a permit is not obtained within 180
Print name: Date: 12/6/07 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \ Permits \ELC- PemmitApp.doc 05/23/06 440-46 15T( I I /05 /COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00446
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/2812007
Phone: (503) 639-4171
N/111041,1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/31/2007 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 07632 SW DURHAM RD 130 CLASS OF WORK:
SUBDIVISION: SW CENTER SDR1999 LOT #: TYPE OF USE:
PROJECT NAME: UNITED HEALTHCARE
DESCRIPTION: Fire alarm low voltage.
OWNER: OPUS REAL ESTATE OREGON IV LLC, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503-255-W8
Inspection Request Scheduled For: Date: 12/31/2007 Pour Time:
Code # Inspection Description -Confirm Contact # Message
199
Electiical final 062348-03 971-506-2982
Corrections/Comments/Instructions:
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0 PASS 0 PARTIAL APPROVAL fl CANCEL NO ACCESS
0 FAIL 0 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: G .-- 0(?) \-t Date:It-11' 09 Phone #: (503) 718- 1.-q4/40
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BUILDING DIVISION PERMIT #: �R�Q�O�46
13125SVVHa||Bhd,Tlgand.ORQ7223 DATE ISSUED: 12/28/2007
Phone: (503) 639-4171
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INSPECTION WORKSHEET FOR DATE: 12y91/2007 TIME: 7'OO�hA PAGE: 25
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SITE ADDRESS: O7f32SW DURHAM RQ130 CLASS OF WORK:
SUBDIVISION: SW CENTER SDR1999-DD02O LOT #: TYPE OF USE:
PROJECT NAME: UNITED HEALTHCARE
DESCRIPTION: Fi a la r m lo voltage.
OWNER: OPUS REAL ESTATE OREGON IV LLC, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503-255-9408 1
Inspection Request Scheduled For: Date: 12y91/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 L0wvoltagi; 371-50&2982 Y
Corrections/Comments/Instructions:
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FAIL | } CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
�� � �� m � J,z\ 01 Inspector: - . »� -� �� ��^ Date: � m^ � Phone#: (503) 718-40