Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00285
TIGARD 13125 SW Hall (e9:41‘,.. Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/12/2007
PARCEL: 25101 DA -01900
SITE ADDRESS: 0,7400 Sw VARNS ST ZONING: C -P
SUBDIVISION: NELSON VIAL OFFICE LOT: 003 JURISDICTION: TIG
PROJECT: NELSON VIAL OFFICE ADDITION
Project Description: Install low voltage voice and data.
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:
NELSON VIAL, LLC LIMITED ENERGY ELECTRICIANS
7000 SW VARNS ST 4020 SE 1ST PL.
TIGARD, OR 97223 GRESHAM, OR 97080
Phone: Contact #: PRI 503 -519 -4496
FAX 503- 492 -4912
FEES Reg #: ELE 26- 1114CLE
LIC 136677
Description Date Amount SUP 3307LEA
[ELPRMT] ELR Permit 7/12/2007 $75.00
[TAX] 8% State Surcha 7/12/2007 $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 - dopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 1100. You m_, obtain copies of these
rules or direc • estions to OUNC at 503 246.6699 or 1.800.332.2344.
Issued B �� � f/ , � i � Permittee Signature: .2L#
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
.- r .-. Received
City of Tigard t r { (f r�" Date/By 7 lZ J — S P erm it No � '7 > • o
' [1 c- c.c i T
n 13125 SW Hall Blvd , Tigard, OR 97.fi? tl Plan Review /
C Phone. 503 639 4171 Fax. 503 598 1' itt Date/By Other Permit. - / 1
T 1 G A it D Inspection Line. 503 4175 Date Ready /By hurls ID See Page 2 for
Internet www tigard gov JUL 1 2 "[Ui) Notified/Method T / Supplemental Information
TYPE -OF, WOITY 6k7 ii , 1tl�' iii PLAN , REVIEW
iAi)Pe
New construction ❑ Addition /alteratf 13L r1t 11NI Please check all that apply (submit 2 sets of plans whtems 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 Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ 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: 264-67) 5'f„a 615' 5',1 10014P or more occupancy
❑
❑ Six or more residential units Recreational vehicle parks
City/State /ZIP: ' ❑ Health -care facilities ❑ Supply voltage for more than
/ ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: / / o u j f// / ❑Service or feeder 600 amps or more
�Iliat ' FEE SCHEDULE
Cross street/directions to job site: 7; _.. A/A /' Description I Qty. 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
Ea add'I 500 sq. ft. or portion 33 40 1
Tax map /parcel no.: Limited energy, residential 75 00 2
DES RR��77ON OF WORK . (with above sq ft )
� / Limited energy, 75 00 2
. - /� a residential (with th above sq sq ft n )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ❑ 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 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 599 amps 133 75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: 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'I branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
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: 4/ �r , a_ . (_, o , y S' energy panel, alteration, or
Address: '7- SX- J /Z . extension Describe Page 2 (y) 2
City/State /ZIP: / 1 . 5-4 p,,q� ! 76rt Each additional inspection over allowable in any of the above
�` Per inspection 62 50
Phone: j) 5/ 9 / ' Fax: (12 54 -' 19/Z Investigation per hour (I hr min) 62 50
CCB Lie.: /56 6 77 / Electrical Lic.: /, / u t . Lie.: ��D I Industnal plant per hour 73.75
" l / - ', - / (0/i lay ELECTRICAL PERMIT FEES -
Suprv. Electrician signature, required: ' Subtotal 5. 8D
-7
Print name: Date:
Plan review (25% of permit fee) 4
./■ , - % GC-Y j Z i State surcharge (8% of permit fee) CO.00
Authorized signature: • '
Date: � TOTAL PERMIT FEE. .8 I • 00
C � �' ` �/ This permit application expires if a permit is not obtained within 180
Print name: V' /7 // S a• ��� � days after it has been accepted as complete.
/// • Number of inspections allowed per permit
1 \Budding\Permns\ELC- PermtAppdoc 05/23/06 440-4615T( I I /05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information f • •
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 -260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ 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: _
*No licenses are required. Licenses are required
for all other installations
I \Bwlding\Pertnits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD --
BUILDING DIVISION PERMIT #: EI..R2007- 00285
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12/2007
Phone: (503) 639-4171 , ■
Inspection Requests (24 Hrs.): (503) 639 -4175 I ''' LL
INSPECTION WORKSHEET FOR DATE: 10/2/2007 TIME: 7 :04AM PAGE: 96
SITE ADDRESS: 06996 SW VARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: UO3 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE ADDITION
DESCRIPTION: Install low voltage voice and data.
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: LIMITED ENERGY ELECTRICIANS PHONE #: 503 -519 -4496
Inspection Request Scheduled For: Date: 10!212007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• -: • -• -: _ = 056708 -01 503. 519.2345 N
• - ctions /Comments/ a actions:
N6 si;c_ ‘ ON 5 11 k 1
i t
-
.', PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
r=-. ��...
�_• to ,' L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 ' I
Inspector: G- . Date: P bi -1 ni Phone #: (503) 718 - 1-44
, ,;
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00285
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/17J2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7 :03AM PAGE: 24
SITE ADDRESS: YARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE ADDITION
DESCRIPTION: Install low voltage voice and data.
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: LIMITED ENERGY ELECTRICIANS PHONE #: 503-519-4496
Inspection Request Scheduled For: Date: 7/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage Co va,c 05214 =r 01 503 -381 -0840 Y
Corrections /Comments /Instructions:
� Iet6el 6u
40 s4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /44r `2 Date: 7-17-07 Phone #: (503) 718-