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Permit CITY OF T I G A R D ELECTRICAL PERMIT - • RESTRICTED ENERGY ��� DEVELOPMENT H B (503) 639 -4171 DATE ISSUED: 7/3 0 001 -00185 SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -00800 SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P BLOCK: LOT: JURISDICTION: TIG Project Description: Tenant Improvement - Telecommunication Room / seven access doors & one panel A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES PINKERTON SYSTEMS INTEGRATION 15350 SW SEQUOIA PKWY #300 -WMI 15405 53RD AVE SOUTH PORTLAND, OR 97224 SEATTLE, WA 98188 Phone: Phone: 206 - 213 -0911 Reg #: LAC 146638 ELE 37- 924CLE SUP 3536JLE FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT CTR 7/3/01 $75.00 2720010000 Wall Cover Elect'I Final 5PCT CTR 7/3/01 $6.00 2720010000 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 suited 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. - Issued by �/ Permittee Signatur 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 1 0 Electrical Permit Application A Date received: '7— 5 -D l Permitnoid4 RDO/ - 00 /gS r .4 : cTI! City of Tigard Project/appl. no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd; Tigard, OR 97223 Date issued: By: I Receiptno.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory 'Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: tj d p fd 1tlq Bldg. no.: Suite no.: JO D Tax map /tax lot/account no.: Lot: 15'1/5 Block: Subdivision: .it*_ e-QIP EZ, Project name: g am/ L �4 alb I Description and location of work on premises:-it ew 1 M - .,4 taws etdrto Estimated date of completion/inspection: - 6- 0/ t I —' mil' al Job no: ! 10 Do 13 Fee Max Business name: (AJ E A : T o tJ % S T E l4. /'fR-E a ft oA/ Description Qty. (en.) Total no. Insp Address: /54106 53 AVE c) . New residential - single or multi - family per dwelling unit Includes attadredgarage. City: ((-'- ch- I State: t 4 I ZIP: 961 ' > Service included: Phone i) 2 e_d3 l I I Fa> 6)2t3.694g -mail: 1000 sq. ft. or less 4 CCB no.:. (40b3 I Elec. bus. lic. no: 3 922 CLE Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /1 tro lic. n0.: Limited energy, non- residential 2 2 7 -g -0) Each manufactured home or modular dwelling Signature of s i lectrician (required) Date Service and/or feeder 2 Services Sup. elect. name (print): License no: or feeders installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): i / ' / - 201 amps to 400 amps 2 Mailing address: 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only i Owner installation: The installation is being made on property I own Temporary services or feeders - , which is not intended for sale, lease, rent, or exchange according to Installation, alteration, orrelocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: • I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail' of service or feeder fee, first branch circuit: 2 Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc .(Service or feeder not included): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 1&2 O Hazardous location Each sign or outline lighting 2 family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension' 2 O Building over three stories O Feeders, 400 amps or more - *Description: O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: ❑ Egress/lighting plan 0 Other. Per inspection Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other - Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number. / / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6/00/COM) ELECTRICAL PERMIT FEES LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total si, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders El Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation • 200 amps or less $80.30 2 ❑ 201 amps to 400 amps $106.85 2 Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918-260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts. see "b" above. ❑ Audio and Stereo Systems Branch Circuits ❑ New, alteration or extension per panel Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation _ -or feeder fee. First branch circuit $46.85 ❑ Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional Inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ A� ESS L a+t17Q0 L 9yE�1 8% State Surcharge $ / Number of Systems 25% Plan Review Fee See - Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ ' Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ CD ' O Total Balance Due $ ' I , • i:\dsts\forms\elc- fees.doc 06/07/01 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24,Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP _ Date Requested / AM PM BLD Location / I, -0/ Suite /01 MEC Contact Person l/ Ph PLM Contractor AiV i Ph'?/3 op/ SWR BUILDING Tenant/Owner We_i �e c-k ELC Retaining Wall ELR ga Footing Access: Foundation ? «� te Gk FPS Ftg Drain SGN Crawl Drain Inspection Notes: /,. r �, l Slab !s �� G/'11 SIT Post & Beam 7 /G v / ( L�9 Ext Sheath /Shear Z =�"!" � Int Sheath /Shear Framing Insulation J Drywall Nailing /vl ie) �C c _ J - 4 ( 4 1, �Q C UY L Firewall S Fire Sprinkler P Fire Alarm Susp'd Ceiling Roof Misc: / Final _ g' L PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL 4 1141" Post & Beam Rough In Gas Line Smoke Dampers Final PAS 7 �t�tLttiJ KICAL PART FAIL Service Rough In UG /Slab Fir- : arm PASS :ART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk F,__ Other Date Inspector c�� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.