Permit ELECTRICAL PERMIT -
A CITY OF T RESTRICTED ENERGY
_141Ii4C DEVELOPMENT SERVICES PERMIT #: ELR2005 -00051
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/11/2005
SITE ADDRESS: 15495 SW SEQUOIA PKWY 100 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of restricted energy 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: 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 NETVERSANT CASCADES INC
15350 SW SEQUOIA PKWY #300 -WMI 9740 SW NIMBUS
PORTLAND, OR 97224 BEAVERTON, OR 97008
Phone: 503- 624 -6300 Phone: 503- 646 -0533
Reg #: ELE 34- 589CLE
LIC 150328
FEES SUP 2903LEA
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 3/11/2005 $75.00
[TAX] 8% State Surchart 3/11/2005 $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 f w ru - - dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
throw OAR 952-061-0106. Y•u may obtain copies of these rules or direct quesi. • OUNC at�) 503) 46-66' .
Issu d by , /' Permittee Signatu ' s' f%jj < ' • '
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.
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 Perm Application FOR OFFICE USE ONLY
r -
City of Tigard Received / // 0K NM M 'i5/
}y, / Permit No.: L / GV��
`� g DateB .�i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /0 :d 1� Other Permit:
�C
Inspection Line: 503.639.4175 ! e' ii Date/By: Date Ready/By: 1 • El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: /co Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction I' Addition/alteration /replacement Please check all that apply:
❑ Demolition Other: ['Service over 225 amps, comm'l 0 Hazardous location
OService over 320 amps — rating ❑ Buildng ovei 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Buildin over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: I S q 5W Sep u o i4 Milt ❑Health care facility ['Other:
2 sets of plans with any of the above.
City/State /ZIP: )Q (.j1 i 4 1922 4 The above are not applicable to temporary construction service.
bldglapt. no.: l 0 0 / Project name: wiheykit1 ` FEE* SCHEDULE
Description I Qty. I Fee. I Total I .*
Cross street/directions to job site: 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
Ito i Cz 4 o c -I-z Ca b t i VI &, dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER yr TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: �{k p I, .. P C.. 1�
pmt Ni)oor e 601 amps to 1,000 amps 240.60 2
Address: a 1 _ " CI s Sv✓ seek 0 i 4 P i f i Z c W y l y t SWte IQ O Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
l.4'G City/State /ZIP: /lh, o g " el 9 2,2 4 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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT I ❑ 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,
Address:
each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
• • CONTRACTOR ever anel, alteration, or
extension. Describe: ' Page 2 CIS 2
Business name: NO. eilSeadeS l AC.
Address: L1y 0 SW N i wtb N s men v e x Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: b or ,,„ E , On 1100 X Investigation per hour (1 hr min) 62.50
Phone: (513 ) byte_ 0533 Fax: (5•03) (Kt - if (p 1 3 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: Electrical Lic.: 3 �9a$ Suprv. Lic.: // Subtotal /5
Suprv. Electrician signature, required: C (/ td 1 1, Plan review (25% of permit fee) /4/01.
y State surcharge (8% of permit fee) 11.00
Print name: I A ' g l r j Date: 3/ l I / 0 TOTAL PERMIT FEE $' 00
Authorized signature: This permit application expires if 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.
i:t Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD ' "
•
BUILDING DIVISION PERMIT #: ELR200500051
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/11/2005
Phone: (503) 639 -4171 �� gl�aeIli I
Inspection Requests (24 Hrs.): (503) 639 -4175 -'!+- '__
INSPECTION WORKSHEET FOR DATE: 4!712005 TIME: 7 :14AM PAGE: 103
SITE ADDRESS: 15496 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: SECURITYCO,INC.
DESCRIPTION: Installation of restricted energy for voice & data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 -6300
CONTRACTOR: NETVERSANT CASCADES INC PHONE #: 503- 646 -0533
Inspection Request Scheduled For: Date: 4/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 003914 -02 503- 968 -3330 Y
Corrections /Comments /Instructions:
S° " 6-1
N
i
I
1
Vi PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
L ✓
Inspector: _ 1. Date :7 — 2 L Phone #: (503) 718 -