Permit CITY OF TIGARD ELECTRICAL ENERGY
-
RESTRICTED ENERGY
ly � DEVELOPMENT SERVICES PERMIT #: ELR2004 -00219
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/21/2004
SITE ADDRESS: 15575 SW SEQUOIA PKWY ).81:1 11,20 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Access control panel.
Job # 7240127093.
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: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES HONEYWELL INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA
PORTLAND, OR 97224 STE 100
PORTLAND, OR 97224
Phone: Phone: F - 968 - 3398
Reg #: S918- 330941LEA
LIC 150191
ELE 26- 207CLE APP. SAYS CI
FEES Required Inspections
Description Date Amount
[UELPMT] ELR Permit 7/21/2004 $75.00
[UTAX] 8% State Surcha 7/21/2004 $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 ' 7, 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
JUL -21 -2004 11:30 HELL 503 968 3398 P. 01i02
Electrical Permit . A lic • h'o12 OFFICE USE ONLY
City of Tigard � �Q�� Date/Byr, /' 0 y Permit No.: 6 1. ( Ott _ay. l 1
13125 SW Hall Blvd., Tigard, OR 9 • Plan Review
: .., ;
Phone: 503.639.4171 Fax 503x596 960 l' l' Other Permit
:i: -' Ii'' Daff
Inspection Line: 503.639.4175 ' 3" i' 4 + r'' L Date Rea dy/By: ri ni9: t23 See Page 2 for
Internet: wwwrci.tigard.or.us QF 0 -, Nobfied/lvtethod: 1 (T Supplemental information
'F:: - rtiv� 'l'u.�U711r- .6;'.� ter: ::� - - "• .Y ' _14: :::: 1' r I:,nGY .r �., l': �6
';w,.'T ':'-"�. "rr':.�'rr�,��� �� p�y
,.' .: •.' 1 v y ,n,.• :: ...'.::::/i'... ,. ',•��'. .I'lli I'.1.� ' r
�. . Ir L'AN '' 1Ri Viit;tr. . • yam. ... '�
. ,,Y.. w,¢'•_! •y vl_ 4 i ..,, ; a t .i . ^' k ? ,., A ;:k,i•.+ %14.1 ,' : ,...-::t: l r:<,'� 'I. •
❑ New construction arAddi ■r.: 'alteration/replacement Please check all that apply:
OServiee over 225 amps, comm'l OHazardous location
❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑l3uildng over 10,000 sq. ft.,
= .•t ' - '� :srge �'.. ' 'i• ." . :, .g a y' 1' ; " s'¢ ' of 1 and 2-family dwellings 4 or more new res
1 �,, �r..._.
='•�. y �., } -»:z_ x. ; SSu ...r �+..+ -r `.tGf•' :� »v.,��r • M1 •: �:�.�. .. _4:.1- ni�:.: t_aln` y g
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manuf red snvctures or
,} �...,,. k . , •a, ,x , '�r�j ..: r• 'fe,a: 'i:,..l, e•w,' k
'r.`'' c � O ` •,`' ' %';'�'. :!„ f" t '.2'.....:.: 4 :19 F.I.': ,,, � ,7R,'cti';,.. .., ;, ��; /r'':,317-i7 :.' 4 r DE$ress/lighting plan RV park
Job no. : 1M Job site address:
3 ( 551r, S V I I &€-Of 1A1)12# ka v [IHealth -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: j x/1,1, U eri VA `loo The S above are not applicable to temporary construction service.
Suite/bldg. /apt no.: i Project name: h a s Du¢rtpuoo Qtr. Pee. ':: Total -
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' 1 500 sq. ft. or portion 33.40 1
limited energy, residential 75.00 2
Tax map/parcel no.: ' ,..., ,. . ,, , , ... . Limited energy, non - residential 75.00 2
`'` ,>!;:,,� �'4 y���y.r `�'��' t EtCh1300- � W 1 '." ttr ' , "' �%.:` ,•:
:.£h \l:e; er 7 '. v' ��. �/ �: T( �. JL? ertl Ci�...-' �Iru- '..T.'�::::��,r: + Q'��'.�'�. I.li. }i� - : 5.. •�:S.ik'...
.t.9� "J. S��G..1 Each manufactured or modular
- : dwelling, service and/or feeder 90.90 2 •
_ �t a7 IAA 1 �� Services or feeders installation, alteration, and/or relocation
200 amps or less 50.30 2
r t, 1_ - �, »,... -;,,; ., •� : , :.t ,:;;�.: ., } , • 201 amps tO 400 amps 106.85 2
: 'RR !� '. : .: '...,. : . , I i .4 1 r . i�1Y r`.;: ., °:. : -- 401 amps to 600 amps 16
:r :lt! Y : u=1 vr ;:s.•. e: : lt'� ....:.a. O.fiO 2
Name: 601 amps to 1,000 amps 240.60 2
Address:
Over 1 amps or volts 454,65 2
- Recommect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 �; o r less I 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
A; , f. , . 'a ,. p. ` • '� ` ' t ' ., . - . -. " "' . " ^'" i 7 A. Fcc for branch circuits with
�L 61t' j 1.4 k�;: rr � .��•I' '�'�' *• �� lY °�ws. service or feeder fee, each
6.65 2
Business name: • branch circuit
- - B. Fec for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: '
Each add'l branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 _ 2 • Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 _ - 2
E-mail: Signal cimcuit(s) or limited -
,\.' ,., .y..5 . , try... ''.;? :} �•
'a °sr ,,,, : M 7 fi t: S', air : ` ; '; : '_ ; .. 'alkt ;'` g,, • energy panel, alteration or
rs%i•:;•:�ci.�p €iiT7: ..1'• •,''i��iva: +r� :��J s:. I- ,�'. :.. i Page 1� 2
-" extension. Describe:
Business name: 1 ,}'t"�'
Address: � 6 s S IN 61 � f �,o A p�(/(lu * to D Each additional inspection over allowable in any of the ab
Per inspection 62.50
City/ State/ZIP: p r' t OR 01 17.2 -� bivestigadon per hour p br tmun) 62.50
Phone: 05)5) q to g. 36 C) I Fax! ( ) 6 1 IS g - 831 g Industrial ptantperhour _ 73.75 • CCB Lic.; 150 II 1 I Electrical Lie.; "j4 04 Suprv. Lie.; q1.�� - Subtotal _ �S _
Suprv, Electrician signature, required: j Plan review (25% of permit fee)
�� ffrat 117/1114 State surcharge (8% of permit fee) 0
Print name: Date: t I
TOTAL )PERMIT FEE
Authorized signature: • ', .• Thi permit application eapirea if a permit is cot obtained within 180
days after it has been accepted as complete
�
Print name: , ei I) 74 U • Fee methodology get by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
440.46151110102/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
Q BUP
$
Received Date Requested 17 . AM PM BUP
Location X15 s et t - t) Dl /" Suite Ma MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR Zoo"-' AO 2/ 7
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear =E
Int Sheath/Shear
Framing
Insulation fTiY C— f MP f 7 T FW4i
Drywall Nailing
Firewall V
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
Fiylarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA /1-0 /'n 9Q Date j� l '-" , j " r D Approach/Sidewalk `� � Insp ector /� Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL