Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00443
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/10/2007
PARCEL: 2 S 112 DA -014 00
SITE ADDRESS: 15350 SW SEQUOIA PKWY 200 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: MANAGEMENT GROUP
Project Description: Low voltage: voice and data.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE 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 AMERICA'S PHONE GUYS
15350 SW SEQUOIA PKWY #300 -WMI 1503 SE 103RD. AVE
PORTLAND, OR 97224 VANACOUVER, WA 98664
Phone: Contact #: PRI 360- 904 -6782
FAX 360- 254 -1967
FEES Reg #: ELE CLE82
LIC 174014
Description Date Amount SUP 3541LEB
[ELPRMT] ELR Permit 12/10/2007 $75.00
[TAX] 8% State Surcha 12/10/2007 $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 • - • • • copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: _ / ' Permittee Signature: ,< \
C • /
\\
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 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.
Nit
Electrical Permit Applicati FOR OFFICE USE ONLY
City of Tigard Received
Received Permit N d •
Il q 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 1 2 /r cy6 -'I p o.: e�-IC ,, .r 3
g ,
L 1 ) 2001 Plan Review
C Phone: 503.639.4171 Fax: 503.598.196 t Date/By: Other Permit: .
T I G A R D Inspection Line: 503.639 ViTY OF tIGARD Date Ready/By: Suds: 10 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF Nyilk.DING DIVISION PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ® Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 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 ® Commercial /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 ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "l -3 ",
Job no.: Job site address: 15350 SW Sequoia Pkwy. 1oollPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: 200 Project name: The Management Group ❑ Service or feeder 600 amps or more.
FEE SCREDULE
Cross street/directions to job site: 1 -5 to exit 291, Carman Dr. head west & Description I Qtv. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
turn right onto Sequoia, bldg on right just before Redwood lane. Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
voice & data wiring residential (with above sq. ft.)
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
Name: The Management Group 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 15350 SW Sequoia Pkwy., Ste. 200 Over 1,000 amps or volts 454.65 2
City/State /ZIP: Tigard, OR 97224 • Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)598 -0552 Fax: (un)known 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT ( ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: America's Phone Guys B. Fee for branch circuits
Contact name: Lois C. Cook without service or feeder fee 46.85 2
first branch circuit _
Address: 1503 SE 103 Ave. Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Vancouver, WA 98664 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (360) 904 -6782 Fax: : (360) 254 -1967 Reconnect only 66.85 2
E -mail: Lois @americasphoneguys.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: America's Phone Guys Signal circuit(s) or limited -
energy panel, alteration, or
Address: 1503 SE 103 Ave. extension. Describe: ( Page 2 2
City/State /ZIP: Vancouver, WA 98664 Each additional inspection over allowable in any of the above
Phone: (360) 904 -6782 Fax: (360) 254 -1967 Per inspection 62.50
l\ ID. f . pq Investigation per hour (1 hr min) 62.50
CCB Lic.: 174014 1 E lectrica • • CLE82 \ • • . Lic.: 3541 LEB Industrial plant per hour 73.75 _
-V— -. ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: / Subtotal: •5"
Print name: Bert Alvaro Date: 11/30/07 Plan review (25 % of permit fee):
State surcharge (8% of permit fee): . ,
Authorized signature: 0 �tJ /1 Ca� _ TOTAL PERMIT FEE: 7/
Print name: Lois C. Coo 4499��" Date: 11/30/07 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 4404615T( I I /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00443
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/ 10/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/28/2007 TIME: 7 :00AM PAGE: 41
SITE ADDRESS: 16350 SW SEQUOIA PKWY 200 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 402 TYPE OF USE:
PROJECT NAME: MANAGEMENT GROUP
DESCRIPTION: Low voltage: voice and data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: AMERICA PHONE GUYS PHONE #: 360 -904 -6782
Inspection Request Scheduled For: Date: 12/282007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
C 99 _ Electrical final 062269-01 364 921 -3384 N
Corrections /Comments /Instructions:
o�
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( I O8 LE Date: Phone #: (503) 718 - �-4•
r .l
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007..00443
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1012007
Phone: (503) 639 -4171 dgi;91I{i"
Inspection Requests (24 Hrs.): (503) 639 -4175
•
INSPECTION WORKSHEET FOR DATE: 12/13/200 TIME: 7:00AM PAGE: 27
SITE ADDRESS: 15350 SW SEQUOIA PKWY 200 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: MANAGEMENT GROUP
DESCRIPTION: Low voltage: voice and data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: AMERICA'S PHONE GUYS PHONE #: 360 -904 -6782
Inspection Request Scheduled For: Date: 12/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 061453.01 360.9814 -6702 N
E
Corrections /Comments /Instructions:
•
Ii, PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • ti 1 .-‘ Date: 2• 1 3 , Q'' Phone #: (503) 718- 244/