Permit •
R
CITY OF T I G A R D ELECTRICAL E ENERGY
-
RESTRICTED ENERGY
i6 DEVELOPMENT SERVICES PERMIT #: ELR2004 -00058
" — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/8/04
SITE ADDRESS: 10350 SW LINCOLN ST PARCEL: 1S135AB -00100
SUBDIVISION: TOWN OF METZGER ZONING: R -4.5
BLOCK: LOT: 005 JURISDICTION: TIG
Project Description: Limited energy for (3) systems: clock, fire alarm & intercom /paging.
Job No. B12
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: X MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
WASHINGTON CLACKAMAS CO C3 COMMUNICATIONS INC
SCHOOL DIST 23J 10950 SW 5TH
6960 SW SANDBURG STREET SUITE 110
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: Phone: 503 643 - 1922
Reg #: MET 00004740
LIC 117658
ELE 24- 373CLE
FEES SUP Ftgigirit4d Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 3/8/04 $225.00 Elect'I Final
[TAX] 8% State Surchart 3/8/04 $18.00
Total $243.00
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 throuc
Issued by Permittee Signature 67 f y�
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Mar-05-04 02 : 17P C3 Cotrunun ica ions -1- 503 643 1203 P . 02
429/2003 10:39 FAX 5035981960 CITY OF TIGARD t002 ..
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'i...„1._ --rAectrical Permit don Received FOR OFFICE USE ON LY
Elecnical :.' :Ai
',: .. Dete/Dy: "6 PermitNo.: ELILAvo -000SS - .-
City of Tigard ilect Pluming • - •
Date/By: Sign
Pemit No.:
....?
•
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:'. " .13125 SW Hal Blvd. 5 "10' Plan Review Other
Tigard. Oregon 97223 Vita ° Date/By: . Permit N -66586'
..,.., -.-
Phone: 503-639-4171 Fax: 503-5W640 ,. , . ..
..,,,,,.... Post-Itaview
, Date/Elr Land Use
.. •. . lutemet wvAV.oi.dgattarari Of 10 1 4;i Contact .1t161.4- 1131 See Pap 2 for
24-hour Inspection Requetik011902Vjg -"' '' " Name/Method: .7. ■ 1 gut:Pigments! information.
• : : •' ...:.. .: •: giliallirMitig.ttatti14 J. 1 .-plit' r .1 1 !P.:J.
.--
..41 New construction PI Demolition Service over 225 amps- Reelth•cate reality
commercial Q Hazardous location
• Additiontalteration/r -.lace:anent I. Other: 17,1 Service over 320 amps of as Building over 10,000 square feet,
IggiiIMOSTEL 03 I C SIMUCIIIPON iz. rttal PO 1 & 2 funny dwelliap four or mom residential units in
• 1 & 2-Family dwelling I 'frn. Commercial/Industrial 0 System over 600 volts nominal ans alrucbne
0 Building over three dories 0 Poe4ers,400 snips or more
• AOCCSSOraUildilla p Multi-Family 0 occupant load ova 99 persons o Manufactured embalm or RV park
• MaSiet Builder III Other: 0 Egradlighting plan 0 0 cher:
v i; i " •;:r.;:, . : . -- 0 - 5. t A 113 .' •Wil e Al e a T. 1 e . , Submit Sal of plans with any of the above.
Tire above are not apeeable to temperer? construction service.
Job site address: /02.5 3 go /' i' r /c/2
-, AL'
. Er .-:, sql Y !V.i;ir li$E:',.i. :'4411PA. tottovaiilY)..i;: . 7
Suite #: 1 Bldg./Apt.#: Number of Inspections per permit allowed
Project Name: Me Ito, 6",,,I. Descriptive 1 Qry I Pas (sk) Total
New residential-do& er multi-Wally per
Cross strect/Directiod to job • site: dwelling oak. include. gnarled prago.
Servke Incladed: • .
1000 14. It or less 1 4
. • Each additional 500 so. tt. or ponion thereof 33,40 I
Lomond Perm residential 75.00 2
Subdivision: 1 Lot #: Limited sw., nonresidential 15.00 z
. Tax ma/parcel #: Each man •dam'r W. home or modular dwelling
?ritfitIORIF.V.-V....7i.AtigAlladituntittprowsVioraci.di;t:;...1:;..:,-..,:i,,;,',..ji ..." an"r fecdcr 90.90 2
Service, or faders - installation,
alteration or relocation:
200 *mot or las 80.30 2
201 urros to 400 amp 106.55 2
101 amps VI 600 amps 160.60 2
'• N.MO ° • ' 7 1:_ie SEMIENIIINECiffaintiZINEEE;ri : 6°1 ' il m s1° I" am' 24040 2
Over 1000 wpm or yobs 454.65 2 '
Name: ' ) ,a/iii4 f/1�/ a i- riri- Ruction= OnlY 66.115 2
Address: Temporary services sr feeder.' - installation,
alteration, or reloadlon:
City/State/Zip: 200 ram or less 66.85 1
Plaone: Fax 201 amps to 400 amvs 100.30 2
401 to 6 amps , 133.75
ZatildelerliaMfiZt.iNV - la CO4TAMBERSON c:•.ii:' ;al . Br 00 anch clrenits - new, alt . 2 tion, or •
Name: /vel l S/akei extension per panel
A. Fes for branch eimuita with purchase of
Address: /De? S0 5 t J - /14 .14 . /10 service or feeder fak esdt branch circuit 6.65 2
City/S / • ip
tateZ: 1104.e• ., 04 7 B. Fee for branch &min without purchase or
tervice or feeder fee, tint branch circuit 46.85 2
Phone: 60 3) V6,* . 7/62 I Fax: (5 g69- 7/6 9 E.adt addidonal brands cimuit 6.65 2
E-mail: rdisc.(Scrvice or feeder cot inciuded):
..-• , fAch pump or irrigation circle
.:1434/14140:;i1=Yih,.::!0§RiTitiavvOnt'..W.i*44,,.:;;.-::1.,...ij.,1;:....; si . . 53.40 2
an or outhre lighons "-----77-10 2
Job NO: deLL Signal einatit(1) or a limited energy panel.
alteration, or exteasion Page l , 2
Business Name: C3 Communications, Inc. Desaipdon:
Address:10950 SW 5th Street. Suite in in it". r. -facia Rise
Eaelt additional inspection over irte allowable In an of the. above:
Ci /State/Zi.: Beaverton OR 9700 Per inspection per hour (ntio. 1 bow) 62.50
Phone:503 • Fax: 1 _ , , _ • Amtiatuts: _
CCB tic. ti: 117658 I - An Lie. #: ' A T _ Odter:
v is * . ,.. ,.. ..:•-:. ... t- .... 1
Supervising electrician Subtotal S 2.25
signature required: A .t • ' Plan Review (25% of Permit Pee) $
Print Name: Jerry Koch 1 Lie. #994 LEA Stine Surcharge (8% of Permit Fee) S •/ el'
TOTAL PERMIT FEE S .2 4
Authorized Notices lisle permit apptleation expires If a permit Is not obtained with/a
SignStUre: Date: ISO days atter k has beets accepted as complete.
• -Fee methodology est by TrI.Couaty Building industry Service Board.
. .
it • (Please print name) ' . •
k .. . LADsIsTermIt Foard■ElcfermitApp.doe 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date. Requested - AM PM BUP
Location J D 3 ST) y Suite MEC
Contact Person e. Ph ( )8 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
g Access:
Ft Drain ELR c2 DO7 - 00 0 .Se
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
irsulation / � a � V tT ,Qi v � — � /
'Drywall Nailing 1 /t ' I
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SIT Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line j 4„, 4 ADA Approach/Sidewalk Date 7 ✓ / 2 ' v Y Inspector �� � Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
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