Permit ELECTRICAL PERMIT -
C ITYOFTIGARD RESTRICTED ENERGY
iij DEVELOPMENT SERVICES PERMIT #: ELR2004 -00202
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/13/2004
SITE ADDRESS: 06650 SW REDWOOD LN 290 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Limited energy for fire alarm alteration.
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 REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224
Phone: Phone:
Reg #:
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/13/2004 $75.00 Elect! Final
[TAX] 8% State Surchar€ 7/13/2004 $6.00
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) 6-6699.
Issued by Permittee Signature
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
? Electrical Permit Application FOR OFFICE USE ONLY
City of Ti and Received r
City g Date/By: 7 1 3 0 �1 P No.: f►(,� / (�JQQaQ.2
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 /
A ttu, Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 !L P'I I , Date Ready/By: Juris El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: a , Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location
OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling g Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑Health -care facility ❑Other:
Job no.: Job site address: 6650 SW RedWood Lane Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard, Or The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: pet Project name: FAIRWAY MORTGAGE FEE* SCHEDULE
• Description I Qty. I Fee. I Total I ..
Cross street/directions to job site: SEQUOIA PARKWAY New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 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
MOVE 2 EXISTING HORN STROBES TO ACCOMIDATE COVERAGE dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
ADD PRE INSTALLED DOOR HOLDERS TO EXISTING DOOR HOLDER 200 amps or less 80.30 2
CIRCUT 201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2
Name: PACIFIC REALTY ASSOCIATES 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
ddress: 15350 SW SEQUOIA PARKWAY
Reconnect only 66.85 2
City/State/ZIP: TIGARD,OR,97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503 )624 -3445 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 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 ❑ 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, 46.85 2
each branch circuit
Address: Each add'l branch circuit 6.65 2
City/State /ZIP: 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- 7500
CONTRACTOR energy panel, alteration, or
extension. 4 ��{{ Descri¢ Page 2 2
Business name: Fire Protection Services Inc // `"' Each additional inspection over allowable in any of the above
Address: 18270 SW Mountain Home Rd Per inspection 62.50
City /State/ZIP: Sherwood Or,97140 Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: (503) 590 -3732 Fax: (503) 628 -6214 ELECTRICAL PERMIT FEES*
CCB Lic.: 154333 Electrical Lic.: 34 -• 88CE SSA ' - . Lic.: 4120LEA Subtotal 75:
Suprv. Electrician signature, required: /� //
G Plan review (25% of permit fee)
��� State surcharge (8% of permit fee) G .D 0
Print name: A , /j . Date: 31.00
/ � , .. �,- J ' 1 -0 9 TOTAL PERMIT FEE
Authorized signature: �� This permit application expires It a permit Is not obtained within 180
// / 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- PertnitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection. LKr*: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
//
Location le tp,S /1 eic.do-c-W Suite cA MEC
Contact Person Ph ( ) S5 o- 3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 7 cv a-y in, ELC
Footing /
Foundation ELC
Access:
Ftg Drain ELR D cab
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors .�
Ext Sheath/Shear
Int Sheath/Shear r• ''
Framing
Insulation RV_ w � V ,6 p n N UJ
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: r t
Final C/
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
Fi : larm
in Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / kM Approach/Sidewalk Date QJ Q ( Inspector [ ApptEg) Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL