Permit ti CITY OF T I G R ELECTRICAL PERMIT -
RESTRICTED ENERGY
'11 , DEVELOPMENT SERVICES PERMIT #: ELR2004 -00295
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 9/15/2004
SITE ADDRESS: 07405 SW TECH CENTER DR 100 PARCEL: 2S101DC 04603
SUBDIVISION: SW COMMERCE CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Low voltage: relocate t- stats, (clean up)
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:
INSTRUMENTATION: OTHER: : X
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
WATUMULL PROPERTIES CORP PROTEMP ASSOCIATES INC
307 LEWERS ST #6FLR 807 NE COUCH
HONOLULU, HI 96815 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 $225.00 Elect'I Final
[TAX] 8% State Surchart 9/15/2004 $18.00
Total $243.00
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 J Z„774,_ Permittee Signature X -,.,,
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
/ -. .,.; '''.,Ki.. , '7 _. l''' ''''''' "'; l ' i _t i 4
EleXrical Permit Application , - A
.
Receiveda
it' 4Tigard RECE1VED4 Date/By: - r 1S70 5 ea-1(2) Permit No.:E __ Pq(3
13125 SW Hall Blvd., Tigard, OR 9 ,..2.., Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 20011 , 0 Date/By: Other Permit:
Inspection Line: 503.639.4175 sEP 1 5 ,10.-- i•,-,:, Date Ready/By: fill See Page 2 for
Internet: www.ci.tigard.or.us
TIGARD Notified/Method:
C-4 Supplemental Information
.rITr( OF , ,2,,,„„,,,,„,,,,,,„,,,.,,,,,,„...„:„TON.I.WgWw1,:,4::::0.:,
0 New construction A ion/alteration/replacement Please check all that apply:
Xn
EService over 225 amps, comm'l ['Hazardous location
0 Demolition 0 Other:
' OService over 320 amps - rating pBuildng over 10,000 sq. ft.,
l',:: et040iZ'OlF'CONStitliOtIOk,,; :it: ';- l - ';': ;,'::t'- of 1- and 2-family dwellings 4 or more new residential •
0 1 - and 2 dwelling lit Commercial/industrial 0 Accessory building OSystem over 600 volts nominal units in one structure
E Building over three stories nFeeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
DOccupant load over 99 persons DManufactured structures or
Joo., „:j, : '‘: ' 0 Egress/lighting plan RV park
Job no.:EVii 5 Job site address: 7225 SA , ( / 1...A. , EHealth-care facility DOther:
Submit 2 sets of plans with any of the above.
City/State/ZIP: 7' The o/ve The above are not applicable to temporary construction service.
'1' 01050.J., ,t;''T ''6','3
Suite/bldg./apt. no.:So / l
00 Project name: C E
Description I Qty. I Fee. I Total I **
Cross street/directions to job site: 7 (--.)", 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
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non-residential 75 00 2
,T ::: , i, ,,•',',,x„:::,i',,,,:',„;:l1:::',:::,, ];*6)4100lifirfi%k3i*::::;,:: ggiiiing,tatOri Each manufactured or modular
_.....---,4 ji t i "f ii ,e2„,-"-..— ,r.....— ,.../ 4 ..
......... dwelling, service and/or feeder 90.90
1 el le •
to Cie ' -e-- I e $ -r- ' I Ae
0410 5. /; 1 - 1" Services or feeders installation, alteration, and/or relocation 2
4 1 T 3— C3) 5ific--1- 200 amps or less
80.30 2
't:t ''"': l l' '- . =:•':' ED -,iikPERfY ,' : L::::'''''''''"''' OfiZi■li÷ '-'
...„;,„ .,. ;-:, },,,, ,..,:,,,t 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: C 6 T 601 amps to 1,000 amps 240.60 2
Address: 2 y-6$ — S A) - re c C.:6_ 0 ,1 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: 774f-4,v) 0/te.. Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
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
?ArifIfeAr l'''1: CONTACT 7 ':: -:: 111:: ii,Ek A. Fee for branch circuits viiith
.pea ,,,'- , i--', ---:. - -, - service or feeder fee, each
6.65 2
Business name: ee /11. 4.5:fc) C . ...7-7 e— branch circuit
B. Fee for branch circuits
Contact name: A „
„ t,) c - e-- /el v rAlest.• without service or feeder fee,
46.85 2
each branch circuit
Address: , 2,p-g- 5 E 1 7 ;4
Each add'I branch circuit 6.65 2
City/State/ZIP: f 7 0 4 C 7 1-9 4 - ' 4_ o A.-e . 7 ? 2- 2-t— Miscellaneous (service or feeder not included)
Pump or in circle 53.40 2
Phone: (Z3) 421._ c7 1 i Fax: : (a ) ,&? yt 7
Sigh or outline lighting 53.40 2
E Signal circuit(s) or limited-
al,1•21:' ;" ':'Elii e Panel alt or
— - ' extension. Describe: : Page 2 2
Business name:
Address ___ Each additional inspection over allowable in any of the above
: --C/4, e
Per inspection 62.50
City/State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
','-,...:,:'.' - e , '""-qrija'r'i■All*;RNILT , ,,,PEEs, in
CCB Lic.J Fig IS Electrical Lic.:‘704c Suprv. Lied? 8 irz Subtotal 4 239.S. ---
Suprv. Electrician signature, required: Plan review (25% of permit fee)
. State surcharge (8% of permit fee) /5- ...-
Print name: R ekr - CA vell . Date
TOTAL PERMIT FEE
Authorized signatur4 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 \13uilding \Permits \ELC-PcrmItApp doc 12/03 440-461 5T( I 0/02/COMAVEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection V e;„ 503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
(� BUP
Received Date Requested ?°` / AM PM BUP
Location Suite / 6 MEC
Contact Person Ph ( ) ./ —4 -j 1 1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner - f JL ELC
Footing
ELC
Foundation
Ft Drain Access: 235" // �� ELR �
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear Ui •
Int Sheath/Shear
Framing
Insulation ;,� � � � r! ��� /-
Drywall Nailing �'
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: /
Othe
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 Hail, 13125 SW Hall Blvd.
PART FAIL
E l Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line / y ADA 'f lX . ,3� �/
Approach /Sidewalk Date ! Inspector Ext
Other:
- Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL