Permit 1 CITY OF TIGARD " ELECTRICAL RESTRICTED ENERGY PERMIT
11 ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00286
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/6/2008
PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 180 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: SIRIUS COMPUTER
Project Description: Voice and data 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 CABLE RUNNERS
15350 SW SEQUOIA PKWY #300 -WMI 10500 SW BOONES FERRY RD
PORTLAND, OR 97224 PORTLAND, OR 97219
Phone: Contact #: PRI 503- 245 -3669
Reg #: ELE 26-951CLE
FEES LIC 122854
Description Date Amount
[ELPRMT] ELR Permit 10/6/2008 $75.00
[TAX] 12% State Surch 10/6/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 0.: 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct qu • s to OUNC at 503.246.669' •r 1.800.3'2.2344.
Issued B Permittee Signature:
_ Iii
• 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 Application FOR OFFICE USE ONLY
I/ r Received. / �.
City of Tigard �g Dateiv : C v�/� r ` Permit No.: �_ „ �..
1 111 a 13125 SW Hall Blvd., Tigard, O' ' ' Plan Review
C Phone: 503.639.4171 Fax: 5I ip, : : Date/By: Other Permit: ii -
TI G A It D Inspection Line: 503.639.4175 6'�p:`. Date Ready/By: kris: 1 See Page 2 for
Internet: www.tigard - or.gov O c'` . . Notified/Method: SapplemenlalInformation
TYPE OF WORK 1,._ ` ' 1 , PLAN REVIEW
❑ New construction • ., Addition/alter. (H1 • 9 Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family El Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: / SnS Sit) u0 /4 ReOVII I more. occupancy.
❑ Six x or or more more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: A r - i 1( � l 7 2 Zy ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: / e Project name: S / r, ,S 60.0/4 Seili, ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description
I ljly. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
P117 fre C /160 Limited energy, multi - family 75.00 2
, V residential (with above sq. ft.)
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
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: e Ct. ;/ =r— (ZyN•e rl s' energy panel, alteration, or
Address: /c) j Cp s g00 44 4
7GU Pt, r rti 12.a extension. Describe: / Page 2 7 r! 2
City/State /ZIP: Oa r./.4 a t.e. l . )sf 9 7' L/ S Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (SUS) LW"- 36 Fax: ( ) 2 y5" — S 7US— Investigation per hour (1 hr min) 62.50
CCB Lic.: / Zg 8 s' Electrical Lic.ZG ,5 S I C suprv. Lic.:927L/q Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ..,„_..7.6.C.-7.1".\ Subtotal: 75 a-'
�� �� V Plan review (25% permit fee):
Print name: /9/4 r� Date: /4/06/66 cec
State surcharge (12% of permit fee): 9,
Authorized signature: Q T) TOTAL PERMIT FEE: ''L�
�/ / L �— v Da Q
This permit application expires if a permit is not obtained within 180
Print name:
f x • •(ice lb /4/ /4 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I :\ Building \Permits\ELC- PermiiApp.doc 05/23/06 440-4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information ` I '
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 $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
Nis Clock Systems
Data 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: 1
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PennitApp.doc 03/23/06
CITY OF TIGARD r ;
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 101E42 0
0 /Ed2ta 13 - 002f36 0ti?
•
Phone: (503) 639-4171 , u.
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I � ..
INSPECTION WORKSHEET FOR DATE: 10/13/2008 TIME 7:00AM PAGE: 31
SITE ADDRESS: CLASS OF WORK:
15575 SW SEQUOIA PK
SUBDIVISION: PACIFIC CORPORATE CE LOT #: TYPE OF USE:
PROJECT NAME: SIRIUS COMPUTER
DESCRIPTION: Voice and data system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CABLE RUNNERS PHONE #• 503-245-3669
Inspection Request Scheduled For: Date: 10/13/7008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage e e ■ ) ,' L S 076594 -01 603- 245 -3669
Corrections/Comments/Instructions:
•
AS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ID S '71 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION #: ELR2008-00286
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1w6/20013
Phone: (503) 639 -4171
A ,h
Inspection Requests (24 Hrs.): (503) 639 -4175 F__—
INSPECTION WORKSHEET FOR DATE: 10/23/2008 TIME: 7:OOAM PAGE: 10
SITE ADDRESS: 15575 SW SEQUOIA PKWY 180 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: SIRIUS COMPUTER
DESCRIPTION: Voice and data system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CABLE RUNNERS PHONE #: 503-245-3669
Inspection Request Scheduled For: Date: 10/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
077105 -01 503- 245.3669 N
ei
ons /Comment uctions:
CS P(thx/ICD TIUN G KovNiD tetobuidl2
fl bNV - oN ∎NA.E. .4
6 rs60. A io W �i i?)t
KC ., 'boo- . iel e44L f§61. I-M,
Qi.
Il k ,
�� A PAS 111 PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
- • * CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C,'"\ Me Date: 10123) Phone #: (503) 718 - Oh