Permit i► . .
C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00263
:# 1 DEVELOPMENT
125 HO B I d Tigard, SERVICES -639 -4171 DATE ISSUED: 9/6/2005
PARCEL: 2S112DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
Project Description: Fire alarm low voltage.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES T & L COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 87387
PORTLAND, OR 97224 VANCOUVER, WA 98687 -7387
Phone: 503- 624 -6300 Phone: 360 - 737 -9725
Reg #: LIC 67787
ELE 37- 428CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/6/2005 $75.00
[TAX] 8% State Surchar€ 9/6/2005 $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 rules are set forth in OAR 952 - 001 -0010
through OAR 952- -01 . You may obtain copies of these rules or direct que • to OU C at 503 - 246 -6699.
Issued By: Permittee Signature:
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 EgGM C
Ci}� Tigard of Ti an n Received
City g J QED ��Y / / , .5 .- ZJ J Permit No — 0,,,k.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 it , 14
., _, I I , Date/By. Other Permit:EU
Inspection Line: 503.639.4175 CITY OF TIGARD �_ 6.;i ' I ■ I Date Ready/By. a 0 See age2 for
Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ['Building over three stories ['Feeders, 400 amps or more
❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: S--Li / �S� SEfu Of ❑Health -care facility ❑�
Submit 2 sets of plans with any of the above.
City/ State/ZIP: fa1/ $) ,"2-- f A C— ? ? ZZ Gf The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg./apt. no.: Project name:
Description I Qty. I Pee. 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
c r , - dwelling, service and/or feeder 90.90 2
i rt` t J c Ch &_�� 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: ' ( L. � 1,��ru, f c — branch circuit
B. Fee for branch circuits
Contact name: g 56 `-t f ( „ J without service or feeder fee, 46.85 2
• • Address: I O 6 ,)c.._ $---2..3 eh a d'I bra branch it
Each add'I branch circuit 6.65 2
City/ State/ZIP: /„ Cza ) Miscellaneous (service or feeder not included)
3 (4 ),) 3 7 X7 > 3 79 g Pump or irrigation circle 53.40 2
Phone: 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: �/-,
- t C0.--,(12 �
trim-- � G��^E
Address: fl� g� Each additional inspection over allowable in any of the above
U r- ` Per inspection 62.50
City /State/ZIP: L . Gffj,4 9 %F7 Investigation per hour (1 hr min) 62.50
• Phone: g 0 7379'72 Fax:Bed) 7'29 f' Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: ( Electrical Lic. }��L Suprv. Lic.: G kfLy' Subtotal 1 S
n st
Suprv. Electricia e, re quired: " 1 GV 37� y� Plan review (25% of permit fee)
Print name: L Y ' f `� Date& OS
State surcharge (8% of permit fee)
/ `� TOTAL PERMIT FEE S I
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
is\ Building \Penn its \ELC- PermitApp.doc 12/03 • 410.4615T(10/02/COM/WEB
. . .�,
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information -
LIMITED ENERGY, PERMIT FEES:
PRESIDENTIAL 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
❑ Data Telecommunication Installation •
. Fire Alarm Installation
HVAC - V
❑ 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.doc O4/O3
DITIt OF TIGARD
BUILDING DIVISION PERMIT #: ELR200 &00263 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6/2005 I
Phone: (503) 639 - 4171 4t
Inspection Requ - is (24 Hrs.): (503) 639 -4175 ,I
INSPECTION WORK ET FOR DATE: 10/17/2005 TIME: 7:04AM PAGE: 42
SITE ADDRESS: 15495 `t SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC RPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: Fire alarm low bltage.
OWNER: PACIFIC REALTY ,SSOCIATES, PHONE #: 503-624-6300
CONTRACTOR: T & L COMMUNICA . ONS INC PHONE #: 360 - 737 -9725
Inspection Request Scheduled For: Date: 10/17/2005 Pour Time:
Code # nsp- • Description Confirm # Contact # Message
199 Electrical final 1 16463-01 360-737 -9725 Y
Corrections/Comments/Instructions:
■
IA 17.57
. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G WC LE Date: 100 `� 09 Phone #: (503) 718 3.44 f
CITY OF TIGARD ,
BI�IL DIVISION PERMIT #: ELR2005 -00263
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
9/612005
Phone: (503) 639 -4171 ,, 11 'V�g f i
Inspection Requests (24 Hrs.): (503) 639 -4175 ____ �'I I..
INSPECTION WORKSHEET FOR DATE: 9/28/2005 TIME 7:08AM PAGE: 46
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 15495 SW SEQUOIA PKWY 140 LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CORPORATE CENTER
DESCRIPTION: AIG
Fire alarm low voltage.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: .503-624-6300
CONTRACTOR: T & L COMMUNICATIONS INC PHONE #: 360 - 737 -9725
Inspection Request Scheduled For: Date: 9/29/2035 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 016840-05 503 -880 -0214. N
Corrections /Comments /Instructions:
------- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t" /66 LJ Date: 11 Phone #: (503) 718 -2)4 •