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Permit `11. . ... ON BUILDING DMSI w C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT PERMIT #: ELR2005 -00290 �. �;� DEVELOPMENT SERVICES DATE ISSUED: 9/19/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD -01600 SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 ZONING: I -P SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG Project Description: 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 SERVICE COMMUNICATIONS INC 15350 SW SEQUOIA PKWY #300 -WMI 4120 SE INTERNATIONAL WY A -109 PORTLAND, OR 97224 MILWAUKIE, OR 97222 Phone: 503- 624 -6300 Phone: 503- 723 -6415 Reg #: LIC 90175 ELE 3- 365CLE FEES SUP 1127JLE Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 9/19/2005 $75.00 [TAX] 8% State Surcharl 9/19/2005 $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 follow rules adopted by the Oregon Utility Notification Center. Those rule are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct q €stions to OUNC at 50 - 246 -6699. Issued By: / j Permittee Signature: C OWNER INSTALLATION OtIJ 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. Electrical Permit Application Fo12 OFFICE LSE ONLY El, 1ty Of Tigard DDateB� 1 /' -5 ' Permit No.: . . 1 ^ Z4g..40 13125 SW Hall Blvd., Tigard, OR 9721 ECEIVE ti Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ' . - { , l Date/B , Other Permit: Inspection Line: 503.639.4175 9 J I Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us SEP 19 200 - Notified/Method Supplemental Information TY,REAg � Nf� PLAN REVIEW c kr New construction ❑ Addition/alteratio rep acement Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ['Hazardous location ❑Service over 320 amps —rating DBuildng over 10,000 sq. ft, CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling g' Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lightingplan RV park Job no.: Job site address: ❑Health-care facility ❑per: /.5995 rid - r�uoi.4 ..era1/ • Submit 2 sets of plans with any of the above. City/ State/ZIP: T oQ p'aaV The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: / y o Project name: FEE* SCHEDULE A/ ts 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'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential / 75.00 7,s"do 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.90 2 _ I_fTi¢ // f/o,c.E $t - 2.4) e"7- 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 2 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 • Reconnect only 66.85 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 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, 46.85 2 • each branch circuit Address: Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 • Business name:x , . ./cE t ratstovi e.s, RT.o..i r' _ .,V - Address: Each additional inspection over allowable in any of the above yiao — r2" _.T.V7 1477 Lj 9 C-- !, c./A4 J A7 — / 0 9 Per inspection 62.50 Ci State/ZIP: 4,i1 wAv4.14 / cwe 9�o7aa Investigation per hour (I hr min) 62.50 • Phone: f ) ,7....e.9... 46 Fax: ( 69/ ' Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: . .5-- Ele f1- ; _ ,j ' j/',,Z 1- Subtotal �JS'VU Suprv. Electrician signature, required �� / . Plan review (25% of permit fee) /'� i State surcharge (8% of permit fee) 6 • cm:, Print name: Z .) — f . ' ��, , a � — — TOTAL PERMIT FEE O �, ,,,,=. Authorized signature: This permit application expires if a permit is not obtained within I80 days after it has been accepted as complete Print name: ��/ ,0�. I Date: alt / • Fee methodology set by Tri- County Building Industry Service Board �)"� •• Number of inspections per permit allowed. i:\ Building \Pennin\ELC- PermitApp.doc 12/03 440- 4615T(10/02/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 ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: [ COMMERCIAL WORK ONLY: Fee for each commercial system. $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ta N i?ata 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 is Building \Pennits\ELC- PennitApp.doe 04/03 CITY OF TIGARD , A BUILDING DIVISION - PERMIT #: ELR2005 -00290 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 it Inspection Requests (24 Hrs.): (503) 639 -4175 �- INSPECTION ■ 4 RKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 63 SITE ADDRESS: - �'5 SW SEQUOIA PKWY 140 CLASS OF WORK: SUBDIVISION: PA , C CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: AIG DESCRIPTION: Voice/D- OWNER: PACIFIC REA 1, ASSOCIATES, PHONE #: 503 -624 -6300 CONTRACTOR: SERVICE COM '', NICATIONS INC PHONE #: 503 -723 -6415 Inspection Request Scheduled For: Date: 10/20/2005 Pour Time: Code # spe ' • • ' - • cription Confirm # Contact # Message 135 l volta..l. 018833 -01 503 - 723-6415 N Co rrectio s /Comm- ' - — • ions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4-f6 N081..- Date: 1 (4 Phone #: (503) 718 - CIT „.OF TIGARD BUILDING DIVISION ��` - PERMIT #: ELR2005 -00290 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 I I Inspection Requests (24 Hrs.): (503) 639 -4175 "'� i. INSPECTION WORKSHEET FOR DATE: 10/19/2005 TIME: 7:03AM PAGE: 71 SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: AIG DESCRIPTION: VoiceiData. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300 CONTRACTOR: SERVICE COMMUNICATIONS INC, jA SQt4 .BN s `- r PHONE #: 503-723-6415 IO LL s iN of -- F1 cal Inspection Request Scheduled For: Date: 10/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 018673 -01 503-849-0241 N 1 Corrections /Comments /Instructions: �� _ C9NQ LE 6'A cV.5 G-Ro v OLC)b Gfob - 1� Piktti ka App 6 V � C,ki3 1-_• ,-_____ _ , r�ov�L ` ■ i An A LL. S v tpYYN P INA u i T 6 U fl" • C) 'h("4 C-c$N N - pl 6 � R-O V AS A-NN g 6'k 1 k w B oN� �`� del___ t6Nb v W Pai IN G- -kovN� wicZ . 1.31' .IN R-Q,© eLP L, c6pE . ,_ >( Rb6 `r shim‹; s 6331 : ? Nt 160 • b'{4- 0191 - ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL 1 7. . CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /IL / ' Date: /0 ` Phone #: (503) 718- 2 OF TIGARD , B DING DIVISION PERMIT #: ELR2005 -00290 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1912005 Phone: (503) 639 -4171 io�� j' Inspection Requests (24 Hrs.): (503) 639 -4175 _..' F'I L. INSPECTION WORKSHEET FOR DATE: 10/17/2005 TIME: 7:04AM PAGE: 31 SITE ADDRESS: 15496 SW SEQUOIA PKWY 140 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: AIG DESCRIPTION: Voice/Data. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 -6300 CONTRACTOR: SERVICE COMMUNICATIONS INC PHONE #: 503-723 -6415 Inspection Request Scheduled For: Date: 10/17/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 018492 -03 503-888-0214 N Corrections /Comments /Instructions: — (k, ` 4 ALL t 1 4.c- .5 pa. cJab� . ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL -------- LL FOR INSPECT ON ❑ ADDITIONAL FEES ASSESSED e '/ Inspector: � I r / .4 //� Date: 10/1 Clr' Phone #: (503) 718- CJTY OF TIGARD , BUILDING DIVISION PERMIT #: ELR2005-00290 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 "'' I.. INSPECTION WORKSHEET FOR DATE: W28/2005 TIME: 7 :OBAM PAGE: 65 SITE ADDRESS: CLASS OF WORK: 15495 SW SEQUOIA PKWY 140 SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: AIG DESCRIPTION: Voice/Data. OWNER: PHONE #: CONTRACTOR: PACIFIC REALTY ASSOCIATES PHONE #: 503 -624 -6300 SERVICE COMMUNICATIONS INC 503-723-6415 Inspection Request Scheduled For: Date: 9/28 /2005 Pour Time: Codlnspection Description Confirm # Contact # Message N 135 Low voltage 016B18 -01 503 -B49 -3530 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v '` Y V V8 Le" Date: 9 (24 Q Phone #: (503) 718- V496