Permit A: CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2001 -00162
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/13/01
SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -00800
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of data/telecommunication system.
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 PROCOM COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI P.O. BOX 22288
PORTLAND, OR 97224 PORTLAND, OR 97269
Phone: Phone: 233 -8037
Reg #: LAC 109929
SUP 2933JLE
ELE 3- 397CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 6/13/01 $75.00 2720010000
5PCT CTR 6/13/01 $6.00 2720010000
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 ar et forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct estions to OUNQ (503)
246 -
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/08/2001 15:43 FAX 5036847297 City of Tigard . IJ 002
:
ElectricalPermitApplication - .. ..
ale meeeived: - /S 0/ P e r m i t n o . : E L / • • — / L
•
t City of Tigard Expire date:
3,MTa� Address: 13125 SW Hall Blvd, Ti OR 97223 part issued:
r�le,
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
•
TYPE Or l'LR IIT _ • . . •
•
O 1 & 2 family dwelling or accessory - 1 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other. _ Uo 0 Partial
'
JOB SITE 1NFO1tMMATlON " ' '
Job address: 57/,1)— ii s' ueji.e., Bldg. no.: Suite no.: /d) Tax map/tax lot/account no.:
Lot Block: Subdivisiod
Project name: : ea. , A At - Description and location of work on premises: Law - /MJIIIIIIMIMIIIIIII
Estimated date of completion/inspection: 0
CONTRACTOR APPLICATION '''''.`.,,
FEE SCIIEDL:LE:
Job tta t -��
Business name: ,l /lpfam .(2 ,ii,u'r0,,%/zo /4U New rvsdmdd- m>ale ormuttihmByper Address:_ : _ sworn mit. ladodes attached garage.
City: fir i, a n State®/, ZIP: 7.)4 p.- Serrimiteladcd:
Phon / 33. ,u Fax :, _ .<I_:,2 E - mail: — MOO • . ft. or las 4
Limited _
CCB no.: 7(f
-3 Q ' .� Elect bus lie no: /Qt^jG� Each additional 500 sq. B. or Portion thereof OM __
!y mited energy, residential _� 2
City /metro tic- no.: ` -i 7, Limited energy. no - tesidcndJ 2
'� /f / Emit mtnufmural home or modular dwelling um
isin
Signature of �svuu / D"er 6 '`„g el 'inn (required) " - Date 6 16 Service and/or feeder 2
Sup. elect name (prior): LW ,. a U oatse no: � a Senlsaor feeders - imtallatioa,
alteradon or reloWitm:
PROPERTY OWNER . 200 emporia's
Name (print): 201 maps to 400 amps •
Mailing address: 401 amps to 600 amps
II 11
601 amps to 1000 amps
Qty. State: ZIP: Ova loco amps or volts
Phone: Fax: E -mail: 9smmeotaady I
Owner installation: The installation is being made on property I own Temporary Iereicesor
which is not intended for sale, lease, rent, or exchange according to d KrelOObO°
ORS 44'1.455.479, 670, 701. 200 amps or las 2
201 amps to 400 amps 2
ner m
°V MS'S signature: Date: 401 600 amps 2
. E\GL \ELR : BraaeAdrtaita- bew,attenian,
Nagle: or Wearies per panel:
A. Poe for branch circuits with purehare of
Address: aavioe or locales foe, each breads circuit 2
qty: [State: I ZIP B. Foe for branch eitruits without petchate
Phone: Fax: � ( of service or feeder foe brat bra ch circuit 2
ELAN REVIEW (Please check all that appl,) . ' Mice. (Sen1cear feeder not included):
O service ova 225 amps—commercial O Neatth.nma facility Each pump or irrii anon circle 2
O Swine aver 320 atnps- raring of 1 &2 0 lasaddus Iowiom Each sign or outline lighting 2
family dwelling% 0 Building over 10,000 square feet four Of Signal circuits) or a limited energy panel,
0 Systan over 600 volts nominal mars rtmdcnia1 outs in one unman alteration. or ettowon• 2
O Building ova dune stories 0 Reim, 400 amps or more •Description:
Cl Occupant load ova 99 persona O Manufactured stnacares or RV putt E eb addltloaal losweetian seer dal allowable in may of the above
0 Egradligliting plar O Ouse: Painspocdon 1 I I I
Submit lets of plans with say of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Na an iw<iab cam draw coora accept a & can judadlcaao tar awn idormrioo. Notice: This permit application
Permit fcc $ 7 , ,,.
0 Yua 0 MartaCaud expires if a permit is not obtained' Plan review (at — 96) $ 6 cro
Owen cad samba: / / - within 180 days alter it has been State surcharge (8%) $ -
Hann at tardboiser a these m credit card /lapis' accepted as complete. TOTAL $ 5/
i
choicer seesaws Ammo 4404613 (60%ICOM)
08/08/2001 15:44 FAX 5036847297 City of Tigard Q 003
E t e ctridal Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy fee..- ..•... — - ••• —•. •- » $76.
Number of Inspedfons per pemtit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Type of woric Involved:
Residential - pear unit
1000 sq. R or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft or
portion thereof $33. 1 1:3 Burglar Alarm
Lamed Energy $75.00
Each Manufd Hone or Modular ❑ Garage Door Opener'
Doering Service or Feeder 390.80 2
Services or Feeders 0 Heating. Ventilation and Air Conditioning System'
Installation. alteration. or relocation
200 amps or less $80.30 2 Systems'
201 amps to 400 amps 3106.85 2
401 amps to 600 amps $160.60 2
601 amps 101000 amps $240.60 __�� 2 ❑ 011w
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Instal/alien, alteration. or relocation • Fee for each system....__......_._ ....... $75.00
200 amps or less 566.85 2 (SEE OAR 918-260.260)
201 apps to 400 amps $100.30 2
401 amps to 600 amps 8133.75 —,--- 2 Check Type of Wort Involved:
Over 600 amps to 1000 volts.
see le above. ❑ Audio and Stereo Systems
Branch Circuits
New. alteration or extension per panel ❑ Boiler Controls
a) The fee for branch drc+itb
with purchase ofservvke or 0 Clock Systems
feeder foe.
Each branch cinWuit $6.65 2 Data Telecountcatlon Installalionr-
b) The fee for hearten circuits �c mm
without purchase of service
or feeder fee ❑ Fire Alarm Installation
First brand► mutt $46.85
Each additional Drench circuit $6.65 ❑ HVAC
Miscellaneous 0 Instrumentation
(Service or feeder not bnduded)
Each pump or irrigation curie $53.40 Intercom and Paging Systems
Each sign or outline raiding 553.40 ❑
Signal circuit(s) or a Sanded energy
panel, altnratlon or extension $75.00 ❑ landscape Irrigation Control'
Minor Labels (10) $125.00
Each additional Inspection over ❑ Medical
the e in any of the above $62.50 ❑ Nurse Calls
Per Inspection Per hour $82.50
In Plant $73.75 ❑ Outdoor Landscape lighting'
Fees: • ❑ Protective Signaling
Enter total of above fees $ [] Other
a% State Surcharge $ Number of Systems
25% Plan Review Fee
See 'Plan Revte*r section on $ ' No licenses ere requited. Licenses are required for all ether Installations
fiord of applaatio,. Fees:
Total Balance Due $
. Enter total of above tees f
❑ Trust Account S 8% State Surcharge $ c � � _ ;�
Total Balance Due $ a ! -
•
•
•
i:ldstittertnslelc- Iiees.doc 10d09i00
ITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUD
. nIK Date Requested Co/t4f AM PM BLD
Location '7.3:/e E5 //‘ Lft I Suite 1072 MEC
Contact Person Ph PLM
Contractor Ph a 7 6 13 ( l SWR
BUILDING Tenant/Owner ELC
nnd0 ' 7 ?i G 1
Retaining Wall ELR V/ C /(OZ
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: /� / / / SGN
Slab /. JG 1 �Cc a �J SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: e ! / )1 /) _/J d'!�
Final
/"Q
PASS PART FAIL
PLUMBING
Post & Beam /
Under Slab `f 4 / 4 L A —
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
•
Final
PASS T FAIL
40 -113r
Rough In
UG /Slab T1 4164-
Low Voltage
Fire Alarm
Final
•
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date h 1 /z-/ - D ( Inspector ,tom Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.