Permit A* CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
or DEVELOPMENT SERVICES PERMIT #: ELR2001 -00029
„� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/6/01
SITE ADDRESS: 15350 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Installation of data telecommunications for 2 cash registers.
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 DATATEC INDUSTRIES, INC.
15350 SW SEQUOIA PKWY #300 -WMI 37453 SOLSO DR
PORTLAND, OR 97224 SANDY, OR 97055
Phone: Phone: 503 - 826 -8745
Reg #: LAC 146022
ELE 3- 499CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 2/6/01 $75.00 2720010000 Elect'l Final
5PCT CTR 2/6/01 $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 are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct qu stions to OUNC at (503)
246 -1987.
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
Received: 05.Feb.01 01:55 PM From: 5035981960 To: 5093565495 Powered by ,_4Fax.com Page: 1 of 2
02/05/01 NON 12:44 FAX 503 598 1960 CITY OF TIGARD it 001
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ElectricalPermitA pplication
Tigard Date received: Permit no.: p ZpQ / -ad z.9 .
:, '`,_+�'_ City of Tigard Project/sppl.no.: Expire date: •
City of Address 13125 SW Hall Blvd. Ti OR 97223 Date issued: By: F Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval.
O 1 & 2 family dwelling or accessory Commercia1Cndustcial 0 Multi-family q Tenant improvement
0 New construction O Additios/aiteration/neplacelneat 0 Other. O Partial
lob address: /s'3SQ, "v4 ) Ua, ,Q B1d& no.: - Suite no.: Tax mapftax lot/account no.:
Lot: I Block: ISubdivisI •
Project name: �iS�'1�c.Clt S'1_3 I Deacrip don and location of work on prises: 7 ea Y /I !2 cS CASt1/2p_4- 5
Estimated date of •, i !ledonI ,. - .'on: /,r.c--. m.(z. y 2 / a 5'
(II q . I o lz A I'P1.,I( )\ 1 t I. SCHEI)tLE
Jab UM 5�.9�a//LS ' /-3 Tie Mu
Business name: ,DA7.4T� l i Qt (e.) Total oa tum
Address: 71.523 ..Sc' /Sa DI's rosfdeatist- sta�eersa a�par ,
City: SA2OY • I Stare :Q,i� ZIP ' 7D '2 6ertiooiad�edi a
Phi: S 2.,6- 27 951 Fhx: ss &ma: 1000 sq. fl. a liar 4
Elec. bus. lic. no: 3 - 4,99 L.....-
. c e addpianl 500 sq. a. or ptnttcn daeof
0:13 no : / �� 2 Z r i nxidennal 2
Ci /metro lie. no.: ZJOaA .C� /S r imitedatergy.mo{es ia1 • 2
7 .1610'/ Each mennhetu ed ham or modular dwelling
ofsupavis'mg detlndan (requited) Date Service sodlerfeeder 2
Sup. elect. name (pint): licnueno: t9avieeaarlicdera— lasbdbstioq
dlaation or r eloeatiose
/
200 a porlass 2
Name (print): ,,,5 C,'7. C__ �F/1/Ty ..i s pc /l S 201 amps to 400 amps 2 r
401 ampsto600amps 2
Mailing address: J 3 7 i, 601 amps a 1000 amps 2
ainf i 4L1 State: �i 7 z z Over 1000 amps or volts • 2
Phone: — 1Fax: I &mail: Reconnemoaly I
Owner installation: The installation is being made on 3mperty I own Teaposaryrndts+or Deem - •
Which is not intended for sale, l ease, rent, or exchanges according to ' d ' ° j a1° 0a
ORS 447, 455, 479, 670. 701. 201 amps cans 2
201 amps m 400 satin 2
Owner's Dare: 401 to 600 amps 2
Wench draas- aew,rtteredoe,
or attendee perpemnb •
Name: A. Pee for branch deceits with pordeue of
Address: service or feeder fee, each brands secant 2
Sty: State: 23P: B. Fee for chants without purchase •
Phone: • Fax: &01811: Each of service orfeederfee,flmtbranch&mit 2
> ach additional branch chat
I'I.;1N in :vi1:11' (I'Ica.c chccl: all Oa apple) Misc. (Sada or feeder not ):
O Service over 225ampa•eoumardal 0 Hmhh sefaaliti Eachpampor irrigation circle 2
O Semis= over 32Oamps-rating of 1&2 0 Ra>anloas bead* i Each sign cr outline truing 2
family dwd lingo U Bwlding over 10.noo squaie feet kur Signal eitatit (p)ora braked energy panel.
0Syammover600 volts nominal more maids:Mid nits inwestmcmte altemtinn,orextension* 2
O Building over ductworks O Feeders. 400 amp; or wore .D ®:
O Ooeuparx toad over 99 pemoes O Mesufivamod atn cones or RV pad: Each Mains' speaks• over the adaoweble b any atthe above:
0 t130 0 Other: Per inspection I L 1 i
Submit _ seta alphas Bs with any of the abate- investigation tee
The above are net applicable to temporary waste yeti= senior- Other
Permit fee --------- $ 7 • -
Hat all jmia lebam accept emit cads, plasm edlIndefinite for mate %Rmuaim Notice: This permit application
O Visa Ct MasorlCard expires if a permit is not obtained' Plan =view (at — %) $ - ,
Coda card rumba / within 180 days after has been State surcharge (8%) .... $ 4
1 e° accepted as complete. TOTAL _... $ R / n a
Remo or eosdatder as shown on omdit card
cardholder dpnMe Macau , 440.4615 QAit101COap
Received: 05.Feb.01 01:55 PM From: 5035981960 To: 5093565495 Powered by elFax.com Page: 2 of 2
02/05/01 MON 12:45 FAX 503 598 1960 CITY OF TIGARD ej002
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Electrical Permit Fees: Limited Energy Fees:
COm Jets Fee Schedule Below: - TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted S
• . Number of Inspections (FOR per pent* allowed (F R ALL YSTEMS)
Service Included: . Items Cost Total 4, Check Type of Wads tthvolved:
R - per unit
1000 sq. 2 or less $145.15 — 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft or
portion thereof $33x0 1 ❑ Burglar Alarm •
Limited Energy $75.00 — •
Each Manurd Home or Modular Q Garage Door Opener'
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Atr Conditioning System'
Installation, alteration. or relocation
• 200argrswless $80.30 2 ❑ VacuumSysteme
201 amps to 400 amps $108.85 _ 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 _�_ 2 ❑ Other
Over 1000 amps or volts $454.65 2
Reconnect only $86.85 2
Tlmperary.Senrices or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Insfaltation, attsratlon. or neocation Fee for each sys tem,..._..»........... _�............_ ...... ...... .. -.. $75.00
200 amps or lass $68.85 2 (SEE OAR 918 -260 -260)
201' amps to 400 amps $100.30 2
401 amps to 600 amps _ $133.75 _- " 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see ft" above. Audio and Stereo Systems
Branch Circuits • . E:1 Boiler Controls
New, alteration or emersion per panel
a) The fee for branch a/ service ar ❑ Clodc Systems
feeder fee
Eadt.brattdt circuit $6.65 2 ` Data Telecommunication Installation •
b) The fee for branch d *wits � •
without purchase of service 0 Fire Alarm Installation
or feeder fee .
First branch clout • $46.85
Each additional branch cbcutt $8.65 ; ❑ HVAC
Miscellaneous ❑ instrumentation
(Service or feeder not included) .
Fs ch pump or Irrigation circle $53.40 ._._ ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal (ircuu(s) or a limited energy .
panel, alteration or won $75.00 _ ❑ Landscape Irrigation Control'
Moor labels (10) $125.00 _
Each r drool over ❑ Medea)
the allowable In any of the above . El • Nurse Calls •
Per Inspection $6250 _
Per hour $6290 i
In Plant $79.7 _ ❑ Outdoor landscape Lighting*
Fees: ❑ Protective Signaling
Enter total of above fees $ _ [J Other • . •
5% State Surdtargo $ _ • Number of Systems
25% Phut Review Fee
See 'Plan Review" section on $ ' No licenses tae requires Licenses are required for all other Installations
front at applcaim _
Fees:
Total Balance Due $ •
--- Enter total o above fees $ 7�-
❑ Trust Account 0 tic State Stmhar8e $ � �'
Total Balance Due • $
•
is dsts1formaklc-fees.doc 10/09/00 . .
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 dour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /5351) 5 .S..l;(cce, /A— Suite MEC
Contact Person S/L r goat U Ph 5) "Z-3 y /f — PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC L /
Retaining Wall ELR/ - 00022
Footing Access:
Foundation FPS
• Ftg Drain SGN
Crawl Drain • Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing LC� 2-012
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: G �
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
L
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
BackfilUGrading
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: nable to inspect - no access
ADA
Approach /Sidewalk
Other Date Z Z b Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.