Permit �A,tr CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
!.. t.
° COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00205
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/22/2006
PARCEL: 1S136DD-04100
SITE ADDRESS: 11740 SW 68TH PKWY ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT: 007 JURISDICTION: TIG
Project Description: Building 4, low voltage for fire alarm.
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:
PACIFIC NW PROPERTIES SALEM FIRE ALARM, INC.
ATTN: PAUL GRAM PO BOX 12789
P.O. BOX 2206 SALEM, OR 97309
BEAVERTON, OR 97075
Phone: 503- 626 -3500 Contact #: PR! 503- 364 -4566
FAX 503- 3640617
FEES Reg #: ELE 24- 133CLE
LIC 76884
Description Date Amount
[ELPRMT] ELR Permit 11/22/200€ $75.00
[TAX] 8% State Surcha 11/22/200€ $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. ,1
Issued By: '7 �� Permittee Signature: "[/j
AL TI N � 4
OWNER INSTALLATION'
NST LA ONLY
O O
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.
Elttctrical Permit Application FOR OFFICE USE ONLY
•, 'City tit Tigard I Re e d 1 �4� Permit N. �0b --00206 „ y
13125 SW Hall Blvd., Tigard, OR 97223 a , .....‘„t , ^ ' plan Revie r X05 51, Phone: 503.639.4171 Fax: 503.598.1960 ��� INI `''''' "' k+ a i ' ' Date/By: Other Permit
Inspection Line: 503.639.4175 �� -1 ~ ' ' _ Date ReadyBy: rte' El See Page 2 for
Internet: www.ci.tigard.or.us � 11 �( `U PP
r
9 �!1 N otified/Metlad: q 1 \ Su lemental Information
TYPE OF W Y '. ' . PLAN REVIEW
7 -
'
New construction ID Addition/alteration/ N Please check all that apply:
Demolition ID Other £STRUCTJON ❑Service over 225 amps, comm'I ❑Hazardous location
CATEGORY OF ■ ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling `R[ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Multi - family ❑Master builder ❑ Other ['Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: . 201 - 1Z2 ) I Job site address: //74/) D14J 6 a - '4, / ❑Health -care facility ❑Other
Submit 2 sets of plans with any of the above.
City/State/ZIP: ”' Q r, b� co as 3 The above are not applicable to temporary construction service.
—
Suite/bldg. /apt. no.: J I Project name: \ n�A '� `� FEE* SCHEDULE
J Desc iption I Qty. I Fee. I Total I"
Cross street/directions to job site: 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 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
CI I n k_ af m r �C / i J , V dwelling, service and/or feeder 90.90 2
Ti 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
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
Phone: ( ) I Fax: ( ) relocation
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
. ❑ APPLICANT 1 ❑ CONTACT PERSON 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,
first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
3&em ate Mossy - ) t \ ne....
extension. Describe: Paget 2
Business name: Al
Address: pp �x 1 � 1 V Each additional inspection over allowable In any of the above
1 Per inspection 62.50
City/ State/ZIP: 501 � q — Investigation per hour (1 hr min) 62.50
Pho • ( '5) 3 ( . (4 ( (,, I Fax: on ) 3to4 - 06217 Industrial plant per hour _ 73.75
ELECTRICAL PERMIT FEES
CCB Lic.: $14 Electrical Lic.:atf , Suprv. Lic.: ii (ALIA Subtotal 7)
Suprv. Electrician signature, required: dim Plan review (25% of permit fee) g l > s i ,
Print name: i � y Ho c Date: 46 - (1-6� State surcharge (8% of permit fee) (g. DD
f, ( 1 ! ' TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit Is not obt ained
days after It has been accepted as complete
Print name: Date: C o - _ V `Q • Fee methodology set by Tri -County Building Industry Service Board
V •• Number of inspections per permit allowed ��,
i:\ Buidiog \Permits\ELC- PermitApp.doc 12/03 440-4615T(10/02/COM/WEB 19-
CITY OF TIGARD
di
BUILDING DIVISION PERMIT #: El R2006-00205
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2/2006
Phone: (503) 639 -4171 Aaµj� +�
Inspection Requests (24 Hrs.): (503) 639 -4175 J- I I..
INSPECTION WORKSHEET FOR DATE: 2/23/2007 TIME: 7 :01AM PAGE: 22
SITE ADDRESS: 11740 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 4, low voltage for fire alarm.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626,3500
CONTRACTOR: SALEM FIRE ALARM, INC. C.,6-ci. PHONE #: 503-364-4566
Inspection Request Scheduled For: Date: 212312007 Pour Time:
Code # Inspection Description Confirm ' Contact # Message
13 5 Low voltage 043799 503 -932 -3780 `
Corrections /Comments /Instructions:
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FINAL E•INI of I‘ViqueA ` ai
1pp lov L e 6 ()Ws i 1, 6e-g, T a a
(cc N i'L_. C Z`; Nie 4 ,, - 3N - N1
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c4otfaci Fi A, P •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V 4 Ntla Vg Date: Phone #: (503) 718-2106
CITY OF TIGARD
ii ,
BUILDING DIVISION PERMIT #: ELR200&00205
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: V11/22/2006
Phone: (503) 639 -4171 i ,; M
Inspection Requests (24 Hrs.): (503) 639 -4175 "—
INSPECTION WORKSHEET FOR DATE: 2J22/2Q07 TIME: 7 :02AM PAGE: 45
SITE ADDRESS: 11740 SW 66TH PKWY CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 4, low voltage for fire alarm.
OWNER: PACIFIC NW PROPERTIES PHONE #: 503 6.2G3500
CONTRACTOR: SALEM FIRE ALARM, INC. c J PHONE #: 503
Inspection Request Scheduled For: Date: 2/72/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 043720 -01 603332 -3780 Y
Corrections /Comments /Instructions:
ii3 ,K •. ft.. 0 : 1.4 04 - e1,1 .
MARY. - Trio - 1W... -- 301 SLfiA .
V v Lota. Ito kr 14, �1� *) 1
�i
❑ PASS ► PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 1 �1 ty Date: 2.11' 0'1 Phone #: (503) 718- 1).0