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Permit • e a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' ° ' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00340 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/11/2007 PARCEL: 2 S 112 DA -01400 SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 ZONING: I - SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG PROJECT: COMMON SENSE Project Description: Installation of low voltage for voice & data. 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: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: : TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES TELEDIGIT INC 15350 SW SEQUOIA PKWY #300 -WMI PO BOX 22287 PORTLAND, OR 97224 PORTLAND, OR 97269 Phone: Contact #: PRI 503- 722 -8084 FAX 503- 722 -9914 FEES Reg #: ELE 3- 4I4CLE LIC 116188 Description Date Amount [ELPRMT] ELR Permit 9/11/2007 $75.00 [TAX] 8% State Surcha 9/11/2007 $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 may obtain copies of these rules ( Eirt" ' ect quests to OUNC at 503.246.6699 or 1.800.332.2344. . Issu By: P ermittee Signature dam' 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. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Date/By: // 07 �I 7'1 � Permit No.: III ga 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: TI G \ It D Inspection Line: 503.639.4175 Date Ready/By: Jul is: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: •1/C: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction / �ddition/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 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 ", "I -3 ", Job no.: Job site address: /.S3 5 c 3 4/ --S ' ryry ef p lq. /9/r Six or or more residential Recreational T.� /� ❑ Six or more residential units. ❑Rr vehicle parks. City/State /ZIP: 77'9 ,,.,- ✓ Q4 9 7 ZZ Y ❑ Health-care dour facilities. ❑ Supply voltage for more than / ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Z 5 Project name: C Oyr „ yo• A' se_ 1, v C+ br ❑ 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'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIP'T'ION OF WORK (with above sq. ft.) /� 0,-4 Limited energy, multi - family 75.00 2 VO i C e, / residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 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: ( ) I 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: '7'e /e �[ 15 , 7z 7., c energy panel, alteration, or 75— Address: ,° Bo)( 2 2 Z b' 7 extension. Describe: Page 2 2 City/State /ZIP: /C1",„ 7'" / 0/ ,7 R 9 7 L r%' Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (663) 7 ZZ- 9;0 452 I Fax: (S ?az -77V1/ Investigation per hour (I hr min) 62.50 CCB Lic.: /16 /$$ I Electrical Lic.: 3- %iyciE} Suprv. Lic.: g- /s-Loy Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: �f Subtotal: 7 S o0 Print name: 04,/, �OS� tY o Date: 9 // i /p 7 Plan review (25% of permit fee): State surcharge (8% of permit fee): 6 • 6 7O Authorized signature: TOTAL PERMIT FEE: 'r( . OB p Date: n1 This permit application expires if a permit is not obtained within 180 Print name: r f '4 �O /// / O 7 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(II /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* E l Burglar Alarm E l Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* El Other: TCOMMERCIAL WORK ONLY: 1 Fee. for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation El Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical ❑ Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations . I:' Building \Pennits\ELC- PamitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007- 00340 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2007 Phone: (503) 639 -4171 7qp Inspection Requests (24 Hrs.): (503) 639 -4175 F 'I �.. INSPECTION WORKSHEET FOR DATE: 11/30/2007 TIME: 7:00AM PAGE: 46 SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE: PROJECT NAME: COMMON SENSE DESCRIPTION: Installation of low voltage for voice & data. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: TELEDIGIT INC PHONE #: 503.722 -B0t 1 Inspection Request Scheduled For: Date: 11/30/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 1 F 060505-01 503 -830 -6745 Y 'IC t • ectio s /Com e s Instr tions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v '1` (w) L.> Date: 11 0 Phone #: (503) 718 - It • CITY OF TIGARD BUILDING DIVISION • PERMIT #: ELR2007 -00340 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2007 Phone: (503) 639 -4171 "it Inspection Requests (24 Hrs.): (503) 639 -4175 ° INSPECTION WORKSHEET FOR DATE: 9/21/2007 TIME: 7:00AM PAGE: 3 SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE: PROJECT NAME: COMMON SENSE DESCRIPTION: Installation of low voltage for voice & data. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: TELEDIGIT INC PHONE #: 503.722 -8084 Inspection Request Scheduled For: Date: 9/21 /2007 Pour Time: Code # Inspection Description C. • ..n # Contact # Message 135 Low voltage 166095 - 01 503 - 784 - 3869 N Y Corrections /Comments /Instructions: GRikQ 1 00L .!.v t CINM 1 NiVi tZ,+ft0 _ (VOI APIA V R4\11g V 11/414'D KepftVt4-> F m_aa, cg8l -T ( c-o100 &.Easic - cm kitICIAO c L . i-). L PASS X PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G 1 Date: 9114 \(11 Phone #: (503) 718- v1'1'b