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Permit , * CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT #: ELR2004 -00294 13125 SW Hall Blvd.. Tigard. OR 97223 (5031639 -4171 DATE ISSUED: 9/15/2004 SITE ADDRESS: 15575 SW SEQUOIA PKWY 140 PARCEL: 2S112DD -01600 SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P BLOCK: LOT: JURISDICTION: TIG Project Description: T -stats 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: OUTDOOR LANDSC LITE: OTHER: : HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES PROTEMP ASSOCIATES INC 15350 SW SEQUOIA PKWY #300 -WMI 807 NE COUCH PORTLAND, OR 97224 PORTLAND, OR 97232 Phone: Phone: 233 - 6911 Reg #: ELE 26- 1063CRE LIC 38868 SUP 2613LEP FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 9/15/2004 $75.00 Elect'I Final [TAX] 8% State Surchart 9/15/2004 $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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. Issued by ) � L�- Permittee Signature A ,>94,ce 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 Electrical Permit FOR OFFICE USE ONLY � �p1/ E D Received /J City-of T Bard Dat I �.J `5 /Qif 70 Permit No. j y rr�yY 13125 SW Hall Blvd., Tigard, OR 9722 p 7 Phone: 503.639.4171 Fax: 503.598.1IbEr 1 5 LOO4 /0 ph� +�� Date/By Plan Review / Other Permit: Inspection Line: 503.639.41751 Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: '7 I G Supplemental Information Bu. l)X IQ . . • PLAN REVIEW - ' ' . • ❑ New construction ❑ Addition /alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location OService 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 OSystem 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 • DEgress/lighting plan RV park �t ❑Health -care facility DOther: Job no.: O Job sit address: LL 7 /�� 1� sLa/ �° f/O / I}�O 7 Subm 2 sets of plans w any of the above. City/State /ZIP: ;,p9i.e. CM-. C_. The above are not applicable to temporary construction service. Suite/bldg. /apt. no.:/e Project name: .5'J FEE* SCHEDULE . 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 2 DESCRIPTION OF WORK Each manufactured or modular I 57-19-7-> dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ,PROPERTY OWNER I , . • 201 amps to 400 amps 106.85 2 . ❑ ! TENANT 401 amps to 600 amps 160.60 2 Name: 4 'r' L' Qtl 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 . ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: 1 i c e branch circuit B. Fee for branch circuits Contact name: 6, Q a✓ t N-0.—/G.. without service or feeder fee, 46.85 2 Address: C� o, each branch circuit r ? o ' s £. / 7 77 i to - Each add'l branch circuit 6.65 2 City/State /ZIP: po,o 60..ark 8 t , Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (S ) 2.„3,3 -C ? ,, Fax: : (CO 23 ?9 )67 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- . CONTRACTOR energy panel, alteration, or Business name: extension. Describe: Page 2 2 .S _� ..e._ r •t4 o Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* — CCB Lic.:3 g Y4 8-- Electrical Lic.; /o JCp Suprv. Lic.., C$(€ Subtotal S� Suprv. Electrician signature, req 'red: Plan review (25% of permit fee) _ i /r State surcharge (8% of permit fee) 6 1 Print name: gh) ./ e....4 N�t� Date: tJ Q /y TOTAL PERMIT FEE c 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. i:\ Building 'Permits\ELC- PemiitApp.doc 11/03 440- 4615T(10 /02JCOM/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 11 \ \ 3 \ PM BUP BUP Location I 5 S j W 1� U 0 ' Suite )4v MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR �q Crawl Drain � Slab Inspection Notes: SIT Post & Beam • Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL \r)Y7 PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final P S PART FAIL ECTRI Service Rough -In Slab Fire arm arm sr Troui Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. • SS PART FAIL SITE Q Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA � Approach/Sidewalk Date /O Aj Q Inspector j Ext Other: Final DO NOT REMOVE this Inspection record from t h ob site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line:1503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST / BUP Received Date Requested ` v —/ / AM PM BUP Location l 7 S Suite / MEC Contact Person Ph ( ) 37 ( /R 9 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: ELR 02 vv %- ao a 9,4 Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm ' Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL SITE 0 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line Approach/Sidewalk Date /7/ Inspector I/ /�._� • i .reasab. Ext Other: Final DO NOT REMOVE this inspection record from t ' e job site. PASS PART FAIL