Permit C ITY O F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00428
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/19/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD V05 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: LUCY
Project Description: Low voltage for fire alarm
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
WASHINGTON SQ. LLC TREK ELECTRIC LLC
9585 SW WASHINGTON SQ. RD 2980 SE TUMBLESTONE DR
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: Contact #: PRI 503- 430 -8984
FAX 866 - 730 -5960
FEES Reg #: ELE 5 -60C
LIC 160427
Description Date Amount SUP 2468S
[ELPRMT] ELR Permit 11/19/2007 $75 00
[TAX] 8% State Surcha 11/19/2007 $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 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 or 1 800 332.2344.
Issued By: Permittee Signature: j" . �
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.
r — 1 +./16/2007 11:42 186E7305960 TREK ELECTRIC LLC PAGE 03/05
Electrical Permit Application P( ?1< u1-TR F_ l t: I:>.1..1 of Tigard I ('07 if , , i I ;' Permit No.:SZ. aro —BO :
13125 SW Hall Blvd., Tigard, OR 97223 ptan Review
' fv+: Phone: 503,639.4171 Fax: 503.598.1960 DEWS : OdrerPermrr
i C; :l i s i? Inspection Lille: 503.639.4115 tare Rratly/By. Iii= RI gee raga 2 Far
gg ,lk Internet www.tigerd-or.gov Notifi Simple :r nfat Information
itoz - ; „ a �•q •
: , : ?.a ., Jh" „ .,.., Vq ,�, Y :
, XY�.,YYiIr t, T'' : .1'': t� ,�l.''' Ir, ' ,:.�; iF• •'ii { ,,,+ .�4 Z '' 7� "l .�y, v •,a+� V :j ?':
, r ; �_ 1t• ae , x+ 'wf ' , -,; ; ;`i , , , ,∎ 1 7f: . 4 ; ;. , u,, .. ' , ”'∎ .., '' ' ..; . ,0..1; •• '4!11+ t 2�K {� • r v. i''1
,,.{ ;U; 7,�:1�%,• h ” „f,,,'.1 :lr' 6 , , t •,LiF .. .w „ �" ,.,��i': •1T ' �5 4 1� ... , ' , ."-,..P0= - .1%•.;.7,. ��1•t .�� ...;v, e •,'fi. as �Yi•'i �;c� �Yr�t ` ,rr'Tl;e� �s �: c,,,,,2 ❑ New construction ® Addition /aheratioix/replacement s � all { of plans w /hams checked below):
�te
❑ Demolition 0 ❑ Service or feeder 400 amps or mare ❑ Budding over three scrim.
7.7,37'1771,,C-4",::: whom the amiable halt current ❑ Marinas and boatyards.
. . , ^' �.�.. ,: , ;
� �f.,�, y : �:� ;� , ; �< �� I0000 amps a< 150 cute W 0 � buildings. l i 1 % 4 iG:'17t.' `V k , Wt� :6'A'` � r1
i ,,1 7.7. '� (µt, ''� 'a. `YI'' " "' -" ., .,a .••,'e • .....T., r•• a'„ i':' :S �, o-r P'J�iu�._
[l 1- and 2 - family dwelling (al Commercial/industrial El Accessory building lase to far ca or exceeds stall 74,000 ❑ Commercial-use agricultural
aa�s for all okhtr i�alialiam' buildings.
0 Multi ❑ Master builder ❑ Other_ °Fie pump O Installation of 75 KVA or
�iti ��t' p'u`: :! 4 W r' "t �{{ � .Y t,�" ,� X :'� � i �, p r, ` 4 ❑ F IICr nay systme. larger separately derived system,
A: '� ,42,:;; R :',,.`' -v �r,1:2; . �bG� + YI-:'.t R,r, f i N-, • � ' 7 ,7. " , ,-al . �, i % % � DAdditen of ❑"�1;'. .`".
' s $ 1 'rGtS 1':t .G • o ,- a t., sx •: lox% '' Sn oowmotetload °I -3 ",
Job no.: I Job site address: 9302 SW Washington Square Rd. 10011P or mom occupancy.
__ ❑ Sin or roots residential units ❑Rea eattotal vehicle parka,
City / State/ZIP: Tigard, OR 97223 C71ieulth-care (}cilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts Nominal.
S uite/bldg. /apt no.: V05 [Pro name; Lucy ❑ mice or feeder boo amps or mom.
Cross street/direction5 to job site: Washington Square EVIW '.+ ) ` , " %'' I` � ,i '- ���'� Vi`i i �;�N:`• a
i car.- I Re, r Tots I
New residential single- or multi- family dwelling unit.
Indades attached garage
Subdivision: • Lot no.: 1,000 sq. ft. or less 145,15 I 1 4
Tax filar /parcel no.: Ea. add') 500 sq. ft, or portion 33.40 1
p f :;;, � u .. M � t � „ . c . �'1v ,, - 4• "�w�� e �. , •, ,� .p ,� r Limited scans, r idi:anal
'; }Zap ; ° � , • 6 � sti t ' Y "r r '^� i r „
, �, 4';. ' v ,.; ', ,
" +,,• ;, %� • y I (+ ', x Mw : $' i o r. I. •. . I , ,t, j ' A, .! u.r 1 f 75,00 2
/ wlth above a
ai'l11 .,� .,, i1�7�9, • �U�, �• ,i.1�v1 "`' , fl) • u� <,, ' :s4.,, "!:R ��.�fiOMy J �•� l �1 ) „
Limited energy, multi#unily 75.00 2
Fire Alarm residential (with above sq ft.) _
- „ ~ ' Services or feeders lastallattoa, alteration, and/or relocation
‘. , ,' •a r ,,;.,I e. ,� a 200 saps or less 80 30 2
•ci ° :f' "' 4 '= i, 1, ii rFi2yc7:-lid q !A a ��, t „r;6, ;, • a
4 '3!„. i ,it , ,il iC,, ,t,L, ' °dy d..$0,. , ' , t', v; �.. �, Ti 201 amps DD 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 nista a
liation, alteration, nd /or . ._
_ relocation
Phone: ( ) I Fax: ( ) 200 amps or less 6685 I t
Owner installation: This installation is being made on property that I own which is trot 201 amps to 400 amps 10030 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 or ext loa.per panel _
A. Fee for branch circuits with
Ti ! ?I,l 'er;=;,',2; (,;- t{i %i:i a T L a w:uat."'•`'',' ° y� +y + q•' , ^." � - ,J'1--4j; a bove service or feeder fee,
,, a,: 3 � 6.65 2
each
Business name: Trek Electric LLC. H. Fee for att e circuit
Mm oh circuits
Crmtauctname: Dawn Arwren
without serviceor fee, 46.85 2
first branch circuit
Address: 2980 SE Tumblestone Dr. Each add') branch circuit L 6.65 vic r 2
Miscellaneous (sere or feeder not included) _. -.
City/State/ZIP: Hillsboro, OR 97123 Each Manufactured or modular 90.90 2
dwelling., service and/or feeder
Phone: (503) 4,30-8984 Fax: : (866) 730.5960 Reconnect only 66.85 2
E -mail: trekelectrie @comcast.net Pump or irrigation circle 53.40 2
7 •• f, + 'h ^`�Yi'x:•:1. ,: w�� °r�ltC'' >.j�laF �'k' l ,�;f y ..5,'.'t a cl',y p�" F.+ ��Td"1''��t�bY •t`
cup', Ap ;�1i . , , '',4' ,'F, r, �} i yV�4! f l f x' ;1,:9:'lh I r 4�'h1: ' Ci1� F ,�1 SIiIgnor"Hine lighting 53.40 2
�• r,:4' i la -, ( j'1'h'SEb % l +�1 k?i „ . -;��t. �,? r,', f^ "1 ", ,,•.w,:.1+� r „'e�d'i'.Y. N. l.l,ra.�•n^y'.r,
Business name: Trek Eketric LLC. signal circuit(s) or !united
energy panel, alteration, or
Address: 2980 SE Tumblestone D extension. Describe; 1 Page 2 75.00 2
-
City /State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above
Perinseection
Phone: (503) 430 -8984 I Fax: (866) 730 - 5960 imec 62,50
pgaoaon per hour (1 tm aria) 62.50
CCB Lic.: 160427 Electrical Lic.: 5-60C Supra. Lic.: 24685 lodustrial plant per hour 73.75
Supt,. Electrician signature, ..y7 ' ` �i ' h,: : 11c� ac > E .. , = ; a s ;
Muir _ f// 24 Subtotal: 75.00
( plan review (25% of permit fee):
Print name: Melvin L. Jackson 11/16/07 .
i 1 � .. L State surcharge TOTAL of permit fee): 6.00
Authorized signature: TAL AL PEf RMIT FEE: 81.00
Print name: Melvin L. Jackson Date: 11/16/07 s penult ep�pliearion expire. ifs permit is not obtained within 180
days seer it has been accepted as complete.
• Number of inspections allowed per permit
1 ' 151 01CRIkR 10 EC..Pumjt4pp.dec 05/21/06 440- 4615T(I l/05/COMIWEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00428
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/19/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/11/2006 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD V05 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: I.UCY
DESCRIPTION: LOW voltage for fire alarm.
OWNER: WASHINGTON SO. LLC, PHONE #:
CONTRACTOR. TREK ELECTRIC LLC PHONE #: 503- 430 -8984
Inspection Request Scheduled For: Date: 3/11 Pour Time:
Code # Inspection Description onfirm Contact # Message
199 Electrical final 06€476 -01 503 -367 - 7079 N
Corrections /Comments/ Instructions:
PrtAL s Q ■IVs AttA { �o�_ g
L.,►. i N ► 6�Q1
(4) ')gt u
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CT-• W tQ Le Date: ' 'It " O Phone #: (503) 718 -, . FV
.