Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
isaFt +'r� DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00194
..� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/18/2006
PARCEL: 2S114AA-00200
SITE ADDRESS: 16285 SW 85TH AVE BLDG - 400*** ZONING: I -
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT: JURISDICTION: TIG
Project Description: Roof top. Wiring for wireless internet using std. RG - 6 coaxial. No voltage on line.
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: WIRELESS S X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIRKEMEIER, BRENT T /JANET D TRS PARADIGM OF EDMOND, INC
BY THE BIRKEMEIER FAMILY TRUST 393 W. GORDON #2
10573 SW NAEVE ST LAYTON, UT 84041
TIGARD, OR 97224
Phone: Contact #: PRI 503 - 519 - 3744
Reg #: ELE 164145
FEES
Description Date Amount
[ELPRMT] ELR Permit 8/18/2006 $75.00
[TAX] 8% State Surcha 8/18/2006 $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: Permittee Signature /de
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 Aup- hil
hc Rio .A -I' 1: ()R ()mu: tisr: (,,El .l'
r 1.
Received
City of Tigard $ 1 2006 Date/By bl 1 4/ 0& Permit No.:�L o � — v 0/f ,
° 13125 SW Hall Blvd., Tigard, O 3 U Plan Review ,�/ ''
' C ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
- r i G A R D Inspection Line: 503.639.4 U� �� p Date Ready/By. tam �/ 65 See Page 2 for
Internet: www.tigard or.g�✓I Notified/Method c �/ Supplemental Information
;An 7 ni-,\ - -- . . 1 TTY'Tfll' OF WORK PLAN REVIEW
❑ New construction ❑ Addit ion / alteration /replacement Please Bieck all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ 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
❑ I- and 2- family dwelling gir Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", 'I - ", "I - 3",
Job no.: Job site address: & 2 6 sty ' 6 Six or more more. occupancy.
1 ❑ Six or more re idential units. ❑ Recreational vehicle parks.
Cat) / State/ZIP Ti 5 c,.r \ O ❑ Health -care rati es. ❑ Supply voltage for more than
(� ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
IUXC FEE SCHEDULE
Cross street/directions to job site: 85+1, mck 14 a it 0, e1y h}- std Description I Qty. I Fee. I Total I •
`
New residential single- or multi- family dwelling unit.
o SA acros & eX vrr tQr -rfrr Sd.od Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
4/11/07 Limited energy, residential 75.00 2
DESCRIYTION OF WORK (with above sq. ft.)
{ �� Limited energy, multi - famil 75.00 2
Vs1 1 f ( 0 Pit;L O r I C e. cor W or2.1255 (M2.Ct't�T l U s v n residential (with above sq. ft.)
11 1 Services or feeders installation, alteration, and/or relocation
5'FC(KdcYtl R(-( C.X
CO%a ` W C VI O V 01kje. Of'- I(AQ, . 200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ 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 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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ 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'l branch circuit 6.65 2
Miscellaneous (service or feeder n of 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
J Signal circuit(s) or limited -
Business name: a rA d ►9m of Ed m o n ci � A C energy panel, alteration, or
Address: 31 3 W & ordor) *a extension. Describe: / Page 2 2
City/ State/ZIP: LA14 -o n UT $ 01-11 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (5U3) S (,1 li Fax: ( )
l siPyN Investigation per hour (1 hr min) 62.50
CCB Lic.: g ( 57 Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: - 7 r
Print name: :.e;4 Jo c c -Son Date: 8 //e/06 Plan review (25 %of permit fee):
. State surcharge (8% of permit fee): ,
Authorized signature: f1,a TOTAL PERMIT FEE: 7'1 �� This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pe+mitAELC- PermitApp.doc 0523/06 ' 440- 46I5T(I1 /05 /COM/WFB
Electrical Permit Application - City of Tigard r •
• Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
El Burglar Alarm
El Garage Door Opener*
El Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
El Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
•
El Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: Building\Pamib\ELC- PamitApp.doc 03/23/06
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
/MO DEVELOPMENT SERVICES PERMIT #: ELR2006 -00194
J I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/18/2006
PARCEL: 2S 114AA -00200
SITE ADDRESS: 16285 SW 85TH AVE BLDG - 400 * ** ZONING: I -P
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT: JURISDICTION: TIG
Project Description: Roof top. Wiring for wireless internet using std. RG - 6 coaxial. No voltage on line.
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: WIRELESS S X
TOTAL # OF SYSTEMS: 1
Owner: Contractor: -It.
BIRKEMEIER, BRENT T /JANET D TRS PARADIGM OF EDMOND, INC
(71V
BY THE BIRKEMEIER FAMILY TRUST 393 W. GORDON #2
10573 SW NAEVE ST LAYTON, UT 84041 Ede/ PORED
TIGARD, OR 97224
Phone: Contact #: PRI 503 -519 -3744
FEES Reg #: ELE 164145
Description Date Amount
[ELPRMT] ELR Permit 8/18/2006 $75.00 0
[TAX] 8% State Surcha 8/18/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00 0
0
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: x/11 Permittee Signatur /1- /I L,
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.
INSPECTOR'S SIGNATUkES ARE NOT
Inspections Required for: ELR2006 -00194 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By I ✓ Code I Inspection Description I PASS Date I By 1
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading/footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls X 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry X 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up _ MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbin rough -in
998 Alarm final 322 Shower pan
999 Sprinkler final _ 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:'Building\Inspection Cards\Forms\AOP- InspCard- Blank.doc 12/09/2005