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Permit 10 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2009 - 00033 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/9/2009 PARCEL: 1 S 135AB -01003 SITE ADDRESS: 10300 SW GREENBURG RD 540 ZONING: C - P SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG PROJECT: HERR & DIMONE Project Description: Installation of voice & data. 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: Owner: Contractor: SHORENSTEIN REALTY SERVICES PROCOMM COMMUNICATIONS ONE SW COLUMBIA ST #300 2316 SE CLATSOP PORTLAND, OR 97258 PORTLAND, OR 97202 Phone: 503- 412 -4800 Contact #: PRI 503 -233 -8037 FAX 503 -233 -8052 Reg #: ELE 3397CLE FEES Description Date Amount [ELPRMT] ELR Permit 1/9/2009 $75.00 [TAX] 12% State Surch 1/9/2009 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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 or 1.800.332.2344. g ocity„ Issued By: Permittee Signature: 2 ' 9 \I o ricTu f �� A� � 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 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. ; W. 1/9/2009 7:43 AM FROM: procom Frocom TO: 503 -598 -1960 PAGE: 002 OF 003 0, . Electrical Permit Application . " FOR OFFICE USE ONLY • . . • City of Tigard ECE VED,.r A Permit No. a �i • o U PI • 13125 SW Hal Blvd., Tigard, BE Plan Review ' ® 0 N 0 9 Phone: 503.639.4171 Fax: 503.598 I i ;l a UDate/F1 Other Permit: T161111) i ( A R 1� Ins line: 503.639 `" 7 Da te Ready /Bye ID See Page 2 for Internet: www.ugard -or goy pp� w� r Notified/Method: Supplemental Information TYPE OZ yVOfllO ��`^� PLAN. REVIEW ❑ New Construction ®Additi Ili TI� Plea a check ail 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 ❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. • ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pomp. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", I OOHP or more. occupancy Job no.: Job site address: 10300 SW Greenburg Rd. ❑ Recreational vehicle part ❑ Six or more residential units City /State/ZIP: Tigard /OR/97223 ❑ Health -care facilities ❑ Supply voltage for more than ❑ hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: 540 Project name: John Knox CPA ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: J Dnrription I Qri. I Fee. ) 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') 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy. residential 75.00 2 DESCRIPTION. OF WORK (with above sq. R.) Limited energy, multi- family 15.00 2 Voice anti Data residential (with above sq ft.) Services or feeders installation, alteration, and /or relocatio 200 amps or less 80.30_ ' 2 ® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: Shorenstien 401 amps to 600 amps 160,60 2 601 amps to 1.000 amps 240.60 2 Address: 5335 Meadows Road, Suite 275 Over 1,000 amps or volts 454.65 _ 2 City /State /ZIP: Lake Oswego /OR/97035 Temporary services or feeders installation, alteration, and /or relocation _ Phone: (503)412.4844 I Fax: (503)619.3210 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 599 amps 133.75 , 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with ® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: ProCom Communications, Inc. B. Fee for branch circuits Contact name: Shawn Giles without service or feeder fee, 46.85 2 first branch circuit Address: 2316 SE Clatsop Each add') branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Portland /OR/97202 Each manufactured or modular 90.90 2 Phone: (503) 233 -8037 Fax: : (503) 2338052 n service and/or feeder Rec onnnee ct t only 66.85 2 Reco E -mail: shawng @procomcommunications.com Pump or irrigation circle 53.40 2 . . . CONTRACTOR .. , , Sign or outline lighting 53.40 2 • Signal circuits) or limited - Business name: ProCom Communications, Inc. energy panel, alteration, or Address: 2316 SE Clatsop extension Describe' I Page 2 75.00 2 City /State/ZIP: Portland /OR/97202 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 233 -8037 Fax: (503) 233 -8052 Investigation per hour it hr mint 62.50 _ CCB Lic.: 109929 Electrical Lic.: 3- 397CLE Suprv. Lie.: 1172L EA Industrial plant per hour 73.75 I s a01 o • 1, •p I©- I - t I ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: p Subtotal: -be.. AL— r Print name: Shawn R. Giles f Date: 1/9/2009 Plan review (25% of permit fee): JJ ///���'''��� State surcharge (12% of permit feet 9.00 Authorized signature: . t --Y--- ///111 �/ TOTAL PERMIT FEE: 84 00 Print name: Shawn R. Giles Date: 1/9/2009 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Number of inspections allowed per permit HnuildmglPermi,GELC- Perm,App doe 05/33/06 .140- 4615T/ 11./05/M1/WEB W OF TIGARD BUILDING DIVISION PERMIT #: FLR2009-00033 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 119/2009 Phone: (503) 639-4171 .anull Iiii\ Inspection Requests (24 Hrs.): (503) 639-4175 ...,_._!+' ... INSPECTION WORKSHEET FOR DATE: inin0a9 TIME: 7 PAGE: 1 SITE ADDRESS: •0300 SW GREENI3URG RID 540 CLASS OF WORK: SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: HERR & DIMONE DESCRIPTION: insialiation of voice & data OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800 CONTRACTOR: PROCOIVIIVI COMMUNICATIONS PHONE #: 503-233-8037 Inspection Request Scheduled For: Date: •/21/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage C079001 503-519-M47 N , IC\ 0 1 Fill4NA,L..-- Corrections/Comments/Instructions: \\ k\A \\\\■'\\\ ‘:\!s \ VI/ \\\.\ 4 12 PASS) 0 PARTIAL APPROVAL 0 CANCEL I I NO ACCESS I I FAIL I I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: G ---- - N 690 1— "' " , Date: 1 " 2 4 ' 0 1 Phone #: (503) 718- 1.--- 4 „ . , . OF TIGARD BUILDING DIVISION A . PERMIT #: ELR2009 00033 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 1/9/2009 Phone: (503) 639-4171 1"IIVAlit Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1114/2009 TIME: 7 PAGE: 38 SITE ADDRESS: 10300 SW GREENBURG RD 540 CLASS OF WORK: SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: HERR & DIMONE DESCRIPTION: Installation of voice & data. OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503412-4800 CONTRACTOR: PROCOlv1M COMMUNICATIONS PHONE #: 503-233-8037 Inspection Request Scheduled For: Date: 1/14/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 136 Low voltage 079665-01 603-519-9447 N Corrections /Comments/ Instructions: .. , ) C. I L 1 C,6 Va. 0 01; PASS 0 PARTIAL APPROVAL 0 CANCEL fl NO ACCESS FAIL fl CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: CY N 0, l'el (...-6 Date: I 'I L { ' 1 Phone #: (503) 718- l ,