Permit ELECTRICAL PERMIT -
CITY ®F T I GARD
RESTRICTED ENERGY
Y
� ik DEVELOPMENT / Hall Tigard, SERVICES
�
ERV 2 (503) ISSUED: 01001
639 -4171 DATE SUED: 8 12/2004
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 PARCEL: 1S126BC -01506
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Data communications.
Tenent name also: Virogenomics
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:
PORTLAND OFFICE ASSOCIATES PRIDE LTD
BY TC PORTLAND, INC 6965 SW 184TH
8930 SW GEMINI DR ALOHA, OR 97007
BEAVERTON, OR 97008
Phone: Phone: 503 259 - 9338
Reg #: EBB 3561943
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 8/12/2004 $75.00 Elect'I Final
[TAX] 8% State Surchart 8/12/2004 $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 1' };l Permittee Signature _S.¢. -c R �n,p
OWNER INSTALLATION ONLY \ t
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 Application FOR OFFICE USE ONLY
Received ; �
Plan R evie � G C ,„ - D �� /
Ci ty of Tigard / Permit No.
13125 SW Hall Blvd., Tigard, OR 97223 : •
Plan
Phone: 503.639.4171 Fax 503 598.1960 "" teadl v i" Date/B Other Permit
Line: 503 639.4175 � ' ' Date Ready/By 63 See Page 2 for
Internet: www.ci.tigard.or.us Nohfied/Method t/[ - Supplemental Information
TYPE OF WORK- _ . "PLAN REVIEW
❑ New construction Addition/alteration /replacement Please check all that apply
❑ Demolition Other: ❑Service over 225 amps, comm'l ['Hazardous location
i ,
CATEGORY OF CONSTRUCTION _ ❑Servof 1 -and ce over 2- fami ly amps dwellings — rating ❑ Buildng 4 or more over new 10 residen sq tial ft
❑ 1 and 2 family dwelling gbommerciallindustrial ❑ 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
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
lit�aSliii C, T 7`� ❑Health -care facility ['Other:
Job no.: Job site address:
9 Oa0 5 W g [,30p2E R D Submit 2 sets of plans with any of the above.
City /State /ZIP: TicyA an The above are not applicable to temporary construction service
Suite/bldg. /apt. no. Su ad Project name: / ( I S - FEE* SCHEDULE `-,
v � � Description Qty. I Fee 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'l 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
(DATA corn 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 ❑ TENANT 201 amps to 400 amps 106.85 2
t 401 amps to 600 amps 160 60 2
LAD ( t L' D mod- ` 1 . A-L7 574-7 € eau t Ty 601 amps to 1,000 amps 240 60 2
Address: , j j 0 ,I FTH' 41 l t , T t . /14 d Over 1,000 amps or volts 454 65 2
Reconnect only 66.85 2
City/State /ZIP: pp LT L 4 .3 1 , 6 9 7 ii 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 I ' ❑ CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6 65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or imgatlon circle 53.40 2
Sign or outline lighting 53.40 2
E Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe / Page 2 2
Business name: pgizE LTD — 7:) 4''rR
Address: 6%5 Se-0 / g y * Each additional inspection over allowable in any of the above
J Per inspection 62.50
City/State /ZIP: A wl/4 0 IL q700-7 Investigation per hour (i hr min) 62 50
Phone: ( ) teas 9 9•‘? 3 g Fax: (S23) 33$ 70 11 Industrial plant per hour 73 75
CCB Lic. • / / 9 3 Electrical Lic.: 3 SQvi E Suprv. Lic.:e a teA ELECTRICAL PE FEES * 76
V Subtotal 4
\\ Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) & • o O
Print name: (g77' 4)6w Date: g _ 1 / 0 y
TOTAL PERMIT FEE l w< 00
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 6/267r NC 4.007" Date: ( _/s/—O (I' • Fee methodology set by Tn- County Building Industry Service Board
•. Number of Inspections per pemut allowed.
I\ Building \Pernuts\ELC- PernutAppdoc 12/03 440- 4615T(10 /02/C0M/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
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 system $75.00
(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 \Bwldrng'Permtts\ELC•PertrutApp doc 04/03
CITY OF TIGARD " 24 -Hou
BUILDING • • Inspection.LinG: 4503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
BUP
Received p Date Requested — ' 7 AM PM BUP.
Location / 0 7- 0 L,9)- /�}' . , Suite /S-' MEC
f Y
Contact Person fi t Ph ( ) 3 / 3 ° 2 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR U /o
Crawl Drain <
Slab • Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation •
Drywall Nailing q Q �-�,�J
Firewall " Fire Sprinkler
'• U !��
Fire Alarm / l •
Susp'd Ceiling l/
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
_
_ jr Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
� FAIL
S El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA 6 17 hppLEgetity Ext
Approach/Sidewalk Date Ins pector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL