Permit „It
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00106
- Ail 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/23/2006
PARCEL: 2S101 BB -01400
SITE ADDRESS: 12178 SW GARDEN PL BLD3 ZONING: C -G
SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG
Project Description: Limited energy for voice and data. Job No. 22794
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 TELEDIGIT INC
4380 SW MACADAM AVE STE 100 PO BOX 22287
PORTLAND, OR 97201 PORTLAND, OR 97269
Phone: Contact #: PRI 503 722 - 8084
FAX 503- 722 -9914
FEES Reg #: ELE 3- 414CLE
LIC 116188
Description Date Amount
[ELPRMT] ELR Permit 5/23/2006 $75.00
[TAX] 8% State Surchart 5/23/2006 $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 do d by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
th gh OAR 952 -0 -010. You may obtain copies of these rules or dir questions to OUNC at 503 - 246 -6699.
Is ued By: 1. eLtft.4 __A Permittee Sign t i 0_0 --4, ,
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.
,
May -23 -1 •5 1O : 17A P - 03
ISlectrical ermit A 3 3 ' c tiOn � 1 Fir.,
��`l Of Tigard 1- - / 1 "ter � Received 13 4, ‘, •
g J J,e,7„„ Peut No. ezi. .06 ...1..t16 ...1..t16 i
13125 SW Hall Blvd -, Tigard, OR 97223 p l a n R e iew ,✓ 45 /`
Phone: 503.639.4171 Fax: 503.598.1960 ' • o. other Permit.. MAY 2 3 2006 J . Date /By: • Inspection Line: 503.639.4175 Ai. ,. t � ' _ Date Ready/By. �t n^ H See Page 2 for
Internet' www.Ci.ugard,Or.ue NonlScd/Mcthod: I 'l P� Supplemental information
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PI New construction PL a . i rrt i2repla t ',... Please check all that apply:
❑ Demolition ❑ Other: ['Service ['Hazardous over 225 amps, cornm'l Hazardous location
amps rating over 10,000 sq ft ,
❑Service over 320 mps r in ❑Bwldng ove t
v;; .), ;,l• l; f: d , "i fa?:,. of 1- and 2-family dwellings 4 or more new residential
❑ I - and 2 - family dwelling In Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stones ['Feeders, 400 amps or more
❑ Multi family 0 Master builder ❑Other
` x, , ['Occupant load over 99 persons ['Manufactured structures or
i ;AO; '+; 4 ' : t • .,> h, =a ar of 6 t6i'). rt� c n � � ❑Egress/li htin plan RV park
�, ..1,. _rr's +i l,z.. 1. g B P
['Health-care facility ['Other
no.: a;la7C Job site address: 12/ 7s ) gQ/d 10/ Submit 2 sets of plans with any of the above
City/ State/ZlP: I t 1 LI_-ci O 87 .223_ The above are not applicable to temporary construction service
Suite%bldg. /apt no.: ( _Project name : j p.6Ly_4- -i 0 - - De ier tpt i°n - Qry — Fec es — Tool — - " -
Cross street/directions to job site: I New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145 15 4
Subdivision: I Lot no.: Ea. add'l 500 sq ft or portion 33 40 I
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75 00 2
4:''' ' • i)`r.t ..G) `:i(t' .:Jj ,.d )`;I. ' . . ' • ' : Each manufactured or modular
Lou) b l e- Vol ef- 4 b6.--6- ea b1 t. , service and /or feeder 980.9030 2 I
�1 Services dwelling or feeders Installation alteration, nd/or relocation
J , ri 201 amps t 400 amps 106 85 2
+" +'d�.�. .....: : : ; ;... _ .._ ,.,. 401 amps to 600 amps 160.60 2
Name: p 4-a 0 - IL{ or 601 amps to 1,000 amps 240.60 2
J / Over 1 amps or volts 454 65 2
Reconnect only
Address: 121 7 g e q &ti e :A- �(, mp
/ 66 85 2
City/ State/ZIP: '' ,r ei7
p�.
(C{(,4 44,6t_ � , t/ i_ /23 Temporar services or feeders installation, alteration, and/or
Phone: ( ) i I F ax: ( ) relocation
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. 401 amps to 600 amps 1 33.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
M i .':_; a t y•,I 4-(u)` - A. Fee for branch circuits with
`' service or feeder fee, each 6.65 2
Business name: /�' a • 1 1 1- Inc_ branch circuit
Contact name:�0 Cw H. Fee for service circuits
1� without service or feeder fee, 46 85 2
Address: Pa 1 ' o' 2x 4
each branch branch it
Each add'( brch circuit 6.65 2
city/ State/ZIP: Torf 16 4 Miscellaneous (service or feeder not Included) 1
G 1 +✓ .21.91 T Pump or irrigation circle 53 40 2
Phone: ( 7 it' CI - Obi Fax:: (503) 7.22 - 'I e i / Sign or outline lighting 53.40 2
E -mail: f.�e.YV I CZ e., edt i f 1 /1G, e QYYI Signal circuit(s) or limited -
energy panel, alteration, or
extension. Describe: i Page 2 2
Business name:
AA/A rS r 6DA- i
Address: Each additional Inspection over allowable in any of the above -
Per inspection 62 50
City/State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) I Fax: ( ) Industrial plant per hour 73 75
. .... U'x 1.lif(t YL + ,i :t . f o..i' t. . 'r 't.,
CCB Lic.: ( i y I Electrical Lic.: 3 -4-/ /Lie c Suprv. Lic ' .� - j- p
Subtotal "7 5-, p
Suprv. Electrician signature, required: r _ Plan review (25% of permit fee)
' t1 State surcharge (8% of permit fee) 6 00
Print name: I
1 I r Da te: 5 ( .c• p TOTAL PERMIT FEE '/ , Do
Authorized signature: , t �l��� This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: M- u e ( VA ti e_ / PC, D: e JC 3 f of • Fee methodology set by Tri -County Building Industry Service Board
J •• Number of inspections per permit allowed.
I \Bwldmy?etntslELC-PamitAppdoe 12/03 440 o/02/COM/WBB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: n. ;�i ;{i'.:�� -Oti 10;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: p 237^,( C
Phone: (503) 639 -4171 / /�mUidrypi10Cllll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: Ri lmiy' TIME: '7:O3AM4 PAGE: 57
SITE ADDRESS: 12178 SW GAf).►; }a{ CLASS OF WORK:
SUBDIVISION: PAW 217 LOT #: OCR TYPE OF USE:
PROJECT NAME: `,110 R7l'�/'St
DESCRIPTION: t ifl it 4d t: 'l �i a'r„' :;) F:kfld vita` & ; ,!.:w'� No 727b'1
OWNER: S1 Fr PROPl:•R"I lE i.P, PHONE #:
CONTRACTOR: TEl E0"`::3i f PHONE #: 50;: -. r:?-8C•
Inspection Request Scheduled For: Date: 6/1/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
�( 1,x4N Yi11tCa{ G 011.08913 i 50 S 22.2301.34. J
Cdre%ns /Gomm n Instruc io s:
•
N
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I " "Q Date: ' 1 — 6 -1 0 Phone #: (503) 718- 144,6