Permit V. 9
CITY OF 0 TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: ELR2007 -00316
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/17/2007
PARCEL: 2 S 101 A D - 03500
SITE ADDRESS: 06600 SW HAMPTON ST ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: 037 JURISDICTION: TIG
PROJECT: QUEST DIAGNOSTICS
Project Description: Upgrade access control system.
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
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES SELECTRON INC
15350 SW SEQUOIA PKWY #300 -WMI 7225 SW BONITA RD
PORTLAND, OR 97224 TIGARD, OR 97224
Phone: Contact #: PRI 503- 639 -9988
FAX 503- 684 -4357
FEES Reg #: ELE 26- 497CLE •
LIC 64341
Description Date Amount SUP 3645LEA
[ELPRMT] ELR Permit 8/17/2007 $75.00
[TAX] 8% State Surcha 8/17/2007 $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 or 1.800.332.2344.
Issued By: Permittee Signature: 691
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, 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 ,.:._� e :�1 ��°° -- 5 I ; 4FORIOFF7CEIUS E- IONLY� • a, ° 4 �
_' 64. ® v ,' 6 ',7. k t t # r*, + . it ;, � N ?? C G a" =; i ,, ;1 kr t s ' 7
City of Tigard Recei ► 1�
Date /By: • / 7 0 % �� Permit No. 3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.4 fi(fl1 7 00 7 7 °77 I jt" I :\ Date /By: Other Permit:
Utz C
Inspection Line: 503.639.4175 - `� ,: Date Ready/By: 12111 El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method. Supplemental Information
."' ,,i, .':'_ , z t QUIIE FING tiJYW-1 N, - y''r PLA <., x c F t§
❑ New construction Addition/alteration/replacement Please check all that apply:
0 ❑ Demolition El ther: over Hazardous Service o r 225 amps, comm'l Ha zard location
El Service over 320 amps - rating ❑ Buildn over 10,000 sq. ft.,
r r, CA CONSTRUCTI t .,., .1 >~ of I- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling Commerciai /industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
El Multi - family Master builder ❑ Other:
.. : - :.:•.,- .,:,... .s;: ",,.;4 <k persons ['Occupant load over 99 e Manufactu red structures or
''; is : JOB SITE:INFORMATIONtAND LOCATION
. _ . _ .. _- - _ __ • ""_
'� °. ,�.._= ,
_. a:� ❑ Egress /lighting plan RV park
Job no.: 54 25g Job site address: U400 4 1 C) ❑Health - care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: The above are not applicable to temporary construction service.
p 1 .�" = . F . SGHEOULE -r ; -. ` -`
Suite/bldg. /apt. no.: Project name:
U l.� I ✓ h� �✓ . Description Qty. Fee. Total
Cross street/directions to job site: . New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less I I 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2 -
Tax map /parcel no.:
• Limited energy, non - residential 75.00 2
3 = •*- " iDESCRIPTION OE; WORKq '
` 2 '- h
.. .. , _. =� i;'M-�' -'.: " - _ �:•- -_ :t „ � ' ,t.;,: Each manufactured or modular
(> p Yl/ d I ' „ s s /!, �.. , _ I sbs I -- dwelling, service and/or feeder 90.90 2
v'(�� Y1 T�Yy ) Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
§, ' / ~- „ ,, s 4-..,T,, , ,:1„ : ,;',;,...,.«,, 1 a T 201 amps to 400 amps 106.85 2
� ® PROPERTY OWNE R'��:� ; " �.
„ 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: - - - .. Over 1,000 amps or volts 454.65 2
Reconnect only .. • 66.85 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 ( 417,1/9, 670, an t 701
401 amps to 600 amps I 133.75 I 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
i:3 } ® AP PLICANT ”, t - x wire ®,tCONTACT, PERSON - , y'" »'fit- A, Fee for branch circuits with
"" "" service or feeder fee, each 6.65 2
Business name: . :branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City /State /ZLP: , Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
. .:VZ:.., ` •'. • h. ; CONTRACTOR .,_, .,;:=`;: ,:< " . '•" ,,. : '''..: ,. energy panel, alteration, or
extension. Describe: I Page 2 /-�,b� 2
Business name: S yI �NL
Address: Each additional inspection over allowable in any of the above
��S S1�1 l l�a CJ Per inspection 62.50
City /State /ZIP: ► �a U c;f7)0-4 Investigation per hour (1 hr mm) 62.50
Phone: b6-3 )t.e'3C:i - n �4 Fax: (5 II U3) `,,,i../ _4_.1 S 7 Industrial plant per hour 73.75_ _ ti >
^ :TiELECTIRICAL, PERMIT FEES* _ M _i
CCB Lic.: Lti3;i 1 - Electrical Lic.: ':;,',8,4s--I c / Suprv. Lic.: Sub total
Suprv. Electrician signature,- required' . _ „� ' Plan review (25% of permit fee)
Print name: i I Date: State surcharge (8% of permit fee) , (.)O
Print
TOTAL PERMIT FEE I co
Authorized signature: This permit application expires if a permit is not obtained within IRO
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
is \ Building \Permits \ELC- PermitApp doc 12/03 440- 4615T( I 0 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200•-00316
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/17/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 -
INSPECTION WORKSHEET FOR DATE: 11/6/2007 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 06600 SW HAMPTON ST CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: 037 TYPE OF USE:
PROJECT NAME: QUEST DIAGNOSTICS
DESCRIPTION: Upgrade access control system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: SELECTRON INC PHONE #: 503639-9900
Inspection Request Scheduled For: Date: 11/612007 Pour Time:
Code # Inspection Description Contact # Message
135 Low voltage 059096-01 503-670-5216
ck
Corrections/Comments/Instructions:
N O m.c1 cA4a, 13(\
cL)66 'a O448
n PARTIAL APPROVAL CANCEL n NO ACCESS
I FAIL I CALL FOR INSPECTION [7 ADDITIONAL FEES ASSESSED
Inspector: 1(31-e Date: II 6(01 Phone #: (503) 718- 1-q14(0