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Permit CI TY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT rl n DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00113 ..i DATE ISSUED: 6/2/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD - 01601 SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 ZONING: I - SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 001 JURISDICTION: TIG Project Description: Data /comm. low voltage 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 NEW TECH ELECTRIC 15350 SW SEQUOIA PKWY #300 -WMI 13970 SW 72ND AVE PORTLAND, OR 97224 PORTLAND, OR 97224 Phone: Contact #: PM 503- 648 -1900 FAX 503- 670 -9572 FEES Reg #: ELE 26 -418c LIC 41868 Description Date Amount SUP 3849S [ELPRMT] ELR Permit 6/2/2006 $75.00 [TAX] 8% State Surcha 6/2/2006 $6.00 REQUIRED ITEMS AND REPORTS 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: e. 6 t J�tc, Permittee Signature: )-‘ c OWNER INSTALLATION ONLY Y' 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. JE P Application /� FOR OFFICE USE ONLY • City of Tigard (i11\ A Received / f r g �� Date/By: ii /�10(p / Permit No.: ll o o po 13125 SW Hall Blvd., Tigard, OR 97223 �f d �� Phone: 503.639.4171 Fax: 503.598.1960 e G" 4;V y wi e1 D an Revie Inspection Line: 503.639.4175 • t 1� 1 .,� M � �� Date/ By: Other Permit: c�!� -,,� Date Ready/By: y,,)+ . dk S Page 2 Internet: www ct trgazd onus �4 . a ■ � Notified/Method: Supplemental See Info rntation tti ti 4, ',,, , `('�'" e i ti1 A . i ©'8 "�rSr 777 t t $h a 7i t . ' y . y � x i 1 , c ...,.. , tr ,_,.: ,� M. t „lSS t .,.. �, h:!Ma 1l .� Q - ?�'� =��u:� � n - � L t tiiG h. �.. ier a�i a t `',,,'L.., 1 ' �'3 fi '1 ' A4.m. F � 'i� , .�. fk� .j .: a,.ir , .�i �•iT� � +; 4l�` %br -a�_ « a ..s. ❑ New construction , a Addition /alter'h Please check all that apply: OService over 225 amps, comm'l OHazardous location ❑ Demolition ❑ Other n 4 . � r._, a� „� . - ,. . ` l a _ Fj ❑Service over 320 amps — rating ❑Buildn over 10,000 sq. ft., •- .''`''4 er ':-' ,1, �« .9„ t�. § „ KTAN ,p, i ` , - of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling 2 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more s, r f ; a „ builder �.,- , _. DOccupant load over 99 persons 0 Manufactured structures or i .0 -' x1.4. J�O.tm , 'T x .. ; ,...w.,, • :, : © '.. O C A D t ' , 1 r . ` 1':;:r ❑Egress /lighting plan RV park Job no.: e ,ra71 y Job site address: r 1c c !j ❑Health-care facility ❑Other: �� �' I Submit 2 sets of plans with any of the above. City/State/ZIP: ,, ?t T-1 - f t (f-- ( Ft i ) The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: IV- f7L, - 7C,j�� § rn a:r.. _ Z :'S:CfIDDI1LE ;: , Description Qty. Fee. Total i ** Cross street/directions to job site: It'-'iA;..i I.l., 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'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 a .: + ry , `, f..,w, Limited energy, non - residential 75.00 2 - ?k' q t rea :Pr `°.00, R'LP�a` 4 01 O r ?i �� _ , ' 7! Each manufactured or modular t t dwelling, service and/or feeder 90.90 2 'AP 1.--t. (.- ttc---t-4) IT rf;X 1�1 i l Services or feeders installation, alteration, and/or relocation Pf'6-0-4 t. a w. - A' • L_ L_ - 200 amps or less 80.30 2 ,W ,. / k ,.� 4- �r: t'3 :^i't r� 201 am 0 amps 2 a? t, it Cl .; _.,w_,,, a- -- � q tr t •,« tiV. -c' ? . 01,- .. ” ;;.:: ,?t P P 106.85 ' 401 amps to 600 amps 160.60 2 Name: �—^ ! t�I Gr -� 16 V I �� a ¢ 601 amps to 1,000 amps 240.60 2 Address: . it,.„ '� v ,� ���Z u Over 1,000 amps or volts 454.65 2 1 Reconnect only 66.85 2 City / State/ZIP: Temporary services or feeders installation, alteration, and/or Phone: ( ) Fax: ( ) relocation 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: D ate: Branch circuits — new ;�,,, , 1,,';',M.,,-?.,no.,,, „ r -., . ,� , 1 5 ,alteration, or extension, per panel i /A'15F_I a "s p; _ i 'i , branch circuits with s "�' .. � 1� _> � �`�,�P�'I , ..: t'$:��" ;x,_ � : �:���?krh�� oCO , �'. ,,P„EROI�i' ,,, ,, ,,,,,,,, v�'`; A. Fee for ran t ' 'fit service or feeder fee, each Business name: branch circuit 6.65 2 Contact name: B. Fee for branch circuits without service or feeder fee, Address: each branch circuit 46.85 2 Each add'I branch circuit 6.65 2 City / State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - ly 'i h a. _1.,,,:@ rl, h+' r�.. ��: Iteration -.. n aft r `ii7l .'4, !, s i � ii -,i� "tK' %(OONFRAC.;T9 +i,113..t •Zi, , .. : t `;j4 t- energy panel, a .r. �:.,:. ,a m .:lFr�f.ti�i`:„ _ �4 �+b.- 's..h;t:::L- k o P or extension. Describe: Page 2 1 rj 2 Business name: N Tech Electric Address: 13 9 7 0 SW 72nd Ave Each additional inspection over allowable in any of the above P ort land OR 97224 Per inspection 62.50 City/ State/ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( 0 3 648-1900 Fax : 5 0 3 )648-3131 Industrial plant per hour 73.75 CCB Lic.: 41868 ':i.` t ,a =�.. _,� ELECTRICAL, PERMIT: FEESt.;:•�a' lr , , Electrical Lic.: 26-4182 Suprv. Lic.: t,4 14_, Subtotal 1 Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: (0 IL - A fijU� Date: C--, 2 c State surcharge (8% of permit fee) I TOTAL PERMIT FEE cy, I 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:\ BuildingWermies \ELC- PermiiApp.doc 12/03 440- 4615T(10 /02 /COM/WEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR200Ci-00113 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/212006 Phone: (503) 639 -4171 10/4u Inspection Requests (24 Hrs.): (503) 639 -4175 _..' F'f �.. INSPECTION WORKSHEET FOR DATE: 8128/2006 TIME: 7:00AM PAGE: 49 SITE ADDRESS: 16765 SW SEQUOIA PKWY 100 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE: PROJECT NAME: BRIDGEPORT MRI DESCRIPTION: Datalconim. low voltage OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: NEW TECH ELECTRIC PHONE #: 503 - 648.1900 Inspection Request Scheduled For: Date: 8/28/2006 Pour Time: P q Code # Inspection Description Confirm # Contact # Message 135 a e 035631 -01 503 - 049 -0167 Y C *1__CX rections /Comments /Ins ns: 1 �r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G NO8 L Date: V O Phone #: (503) 718 -41