Permit 111 v 11 OF F TIGARD I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00071
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/28/2008
PARCEL: 2S112DA -00800
SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: CAMBRIDGE INTEGRATED SERVICES
Project Description: Low voltage for data.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES PROGRESSIVE TELEPHONE SYSTEMS
15350 SW SEQUOIA PKWY #300 -WMI 710 NE CLEVELAND # 120
PORTLAND, OR 97224 GRESHAM, OR 97030
Phone: Contact #: PRI 503- 665 -4900
FAX 503- 655 -4830
FEES Reg #: ELE 26 - 1117CLE
LIC 150175
Description Date Amount
[ELPRMT] ELR Permit 3/28/2008 $75.00
[TAX] 12% State Surch 3/28/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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. Tho e rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 - 0100. You may obtain copies of these
rules or • c ques s to • C at 03.246.6699 or 1.800.332.2344. /
Issue By: ` � � / P ermittee Signature: � ��
OWNER INSTALLATION, , ''Y
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.
•
h.
Electrical Permit Application FOR OFFICE USE ONLY
Cit 'of 'ftgard Received or bib IV Permit No.: E1./2. g— Z 7/
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I N 8 Phone: 503.639.4171 Fax: 503.598.1960 Date/BY: Other Permit:
TI G A !t D Inspection Line: 503.639.4175 Date Ready/By: tuns: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: I ((j Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling SCommercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
CI Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
100HP or more. occupancy.
Job no.: Job site address:
5// S Std Se l p° f A leptt kfo 1 ' ❑ Six or more residential units. 0 Recreational vehicle parks.
City/State /ZIP: ' 1.1 w. J Q 12 t l 12-2 1 � ❑ Health -care facilities.
❑ Hazardous locations. ❑ Sup p l olts nomiy ao more than
600 bldg. /apt. no.: /CO Project name: C...ekt..10(.\- ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
1 Limited energy, multi - family 75.00 2
(T S Lo v.1 -o- a c.,,101 4,1 residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
`t PR ERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 P T✓�
Name: (— - 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 ORS 447, 449, 670, and 701. 401 amps to 599 amps _ 133.75 2
Owner signature: Date: Branch circuits – new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: ?ran ro iv* frr,,� s > $ + W
C6tt�- IN energy panel, alteration, or
f extension. rib T ( Page 2 7 5 2
Address: 7/0 foe cautc. A
City/State /ZIP: 6 � � C,. Per 7t ' Each additional inspection over allowable in any of the above
Phone: ( D3) (6S- LC goo Fax: (Sb3 ) t61T- y83o Per s ion 62.50
S. Investigation per hour (1 hr min) 62.50
CCB Lic.: 150/7. Ele Lic.: ./t f7& p 3 %7.4ZB I ndustrial plant per hour 73.75
Su rv. Lic.: P P
ELECTRICAL PERMIT FEES
Suprv. Electrician signat required: Subtotal: 7s-- 00
� Plan review (25% of permit fee):
Print name: KY� �Qw.N Date: 7 /..zirt/a.e.
State surcharge (12% of permit fee): 7o D
Authorized sipprature: TOTAL PERMIT FEE: g0 d
Print name: Kyle. r Date: 3 ( This permit application expires if a permit is not obtained w ' 180
' _ _ z g./ dy days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building'Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(Il /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 Supplemental Information •
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
( COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
gi Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling.
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: 1Building \Pertnits\ELC- PennitApp.doc 03/23/06
CITY OF TIGARD
re 0
BUILDING DIVISION PERMIT #: ELR2008- 00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2008
Phone: (503) 639 -4171 1n h `y�
Inspection Requests (24 Hrs.): (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE: 4/3/2008 TIME: 7:02AM PAGE: 43
SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: CAMBRIDGE INTEGRATED SERVICES
DESCRIPTION: Low voltage: for data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROGRESSIVE TELEPHONE SYSTEMS PHONE #: 503- G6&4900
Inspection Request Scheduled For: Date: 4/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 067820. 01 503- 969-4091 N
orrectior riments /Instructions:
$PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: 'Y' 66Iiir Date: i f I 04 k Phone #: (503) 718- 11 J/ LA
CITY OF TIGARD•.- ',
BUILDING DIVISION °' PERMIT #: ELR2008100071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2x/2008
Phone: (503) 639 -4171 :»uitµ it
Inspection Requests (24 Hrs.): (503) 639 -4175 I : _ ..
INSPECTION WORKSHEET FOR DATE: 4/29/2008 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: CAMBRIDGE INTEGRATED SERVICES
DESCRIPTION: Low voltage for data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROGRESSIVE TELEPHONE SYSTEMS PHONE #: 503. 66&4900
Inspection Request Scheduled For: Date: 4/29/2008 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 069026-01 ' 503-665 -4900 N
Corrections /Comments/ Instructions:
\`_
❑ PASS ❑ PARTIAL APPROVAL X CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-. N oe Date: 41 Z Q 01 Phone #: (503) 718- 144
•
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: .F;r i'•.a$-00/ S
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 'N2W200S
Phone: (503) 639 -4171 4 =' l
;, F il ��
Inspection Requests (24 Hrs.): (503) 639 -4175 J _ ..
INSPECTION WORKSHEET FOR DATE: 4/30I)008 TIME: 7:06AM PAGE: 35
SITE ADDRESS: 15115 SW SF.gt.UOi! PKVN 100 CLASS OF WORK:
SUBDIVISION: f'A(:IFlt: C C:, rte }Ol. :: CENTER LOT #: TYPE OF USE:
PROJECT NAME: t.;r",MEP4C 31iN;I=*,_FAlf i)`.ERVik;E`:
DESCRIPTION: I. av i'+'dt;=r fi'vr &la.
OWNER: F'A { ;II '1 ; r ?EA LP/ A.':. -:r0( Alt -17, PHONE #:
CONTRACTOR: PRA.: GF'i:: IVL:_ TEI.E- >FI ?NE `.3YSTEIVIS PHONE #: 50345654
Inspection Request Scheduled For: Date: 4/3012003 Pour Time:
Code # Inspection Description C• .: Contact # Message
! Llecb ,.al fin a;' 06131 Sfr01 503 4369 40r' 1 N
Corrections/Comments/Instructions:
Qk
i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� I V e be) Date: 1 3 , * f ■ Phone #: (503) 718- Ofilk