Permit CITY OF TOG14R® ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2010 -00098
T t CARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/28/2010
Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY 140
Subdivision: Lot: 0
Project: Winzler Kelly
Project Description: Low voltage for (2) HVAC systems
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 05/28/2010 $135.68
PORTLAND, OR 97224 12% State Surcharge - Electrical 05/28/2010 $16.28
PHONE: 503 - 624 -6300
Contractor:
ARJAE SHEET METAL CO, INC.
5510 SE MCLOUGHLIN BLVD.
PORTLAND, OR 97202
PHONE: 503 - 231 -7717
FAX: 503 - 230 -4888
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
•
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: Y Instrumentation: N Total $151.96
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days, ATTENTI repo -law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 rough OAR 952 -00-010 Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.246 699 or 1. 0.332.2344.
Issued y: Permittee Signature: k
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' 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.
MAY -28 -2010 FRI 08:05 AM ARJAE FAX NO, 5032304888 P. 02
t VF electrical Permit Application ��1 [[1 i, x ,, ' l �Pi a Cd, l w dr� wi. ?�' , w4, , l . I; ..»,. n ,ti, f \
Rncnlvnd , ■ Permit No.:
ii i' ' - City of Tigard 5 a£s r o Et,QAo lO
Dab.rlly Q
r !" n 13125 SW Hall Blvd., Tigard, OR 97223 MAY 2 8 20 10 pl an ltoview !a ?/
0: ' ® Phone: 503.639.4171 Fax: 503.598.1960 Dale /0y: C)ths +'Permit; tt f �Q l 0 O� t ^ O
'tr.' e Al lt1 1 )° Inspection Line: 503.639.4175 �' /� /t ' 'Ready /Dy: Jude: 0 Sao I? r ii 2 for
r,rr ., r'I? Internee www.tigard- or.gov CITY OF I l vlrir'° Notified /Method: �— Supplomi glut information
A Y° . I ■s:. �1 . ppI� r� iy i r i !� t Id �a� "� 1 °,f rrlf��f��ii�`'`.r .cf � ��ll ' �Ei�r���� '�f�� {il��'I��;��;1 {��i�;
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1tili�i P� i r "
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Please check all that apply (submit a seta of plans w /iu ■ : chocked bnlawl:
❑ New eonstnietion n Addition /alteration /replacement 17I Sa v ICC or feeder 400 amps or more ❑ Building : lr Ikea stories.
❑ Demolition ❑ Other: wl eio the available fault current ❑ Marinas t boatyards.
., r I I w•a u t, o ■ e' i' '" ; nx re gds IO,ODO amps at 1SO veils or 171 F)ontin r Idinga.
1 { 1` I I� i .* 1, , � „N$ i' I!1 Ail, � �1iI� I1�g � wi?i,!fit� Page 1 .. let s a ground, or exceeds 14.000 ❑ Common -use agricultund
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building an pi for all other installations. buildings
0 Multi family ❑ Master builder ❑ Other: 0 FI a pump' ❑ Inatnlhdb .if 75 KVA or
i 1,' it' VEI r r tea tar ` I %.,'. t y ,i
t La tnrg system. larger sal 'Italy derived system.
d1tP ,11� ] E, i, !k 1 1 i '. �r i r �.{„ . r�slr tf l : C. . jlt E d � j , I WZ� I J,: !If, ❑ A, d itiaa of mtcy naw motor load of .. ,.E„ I I-3”,
I C 311P or morn. accupom '
Job no.: Job site address: 15575 SW Sequoia Parkway ❑Sitar more residential units. ❑ Rncreatit r I. vehicle parks.
❑ R a th•care facilities. ❑ Supply v . ge for morn than
City/State/ZIP: Portland, OR 97224 _ n H. rzirdous locations. 600 vote lining'.
Suite/bldg. /apt. no.: Project name: Winzler Kelly El St rt ice or fender 600 amps or mom P i
11ri i� 1 �n J� PiP1IiP119 �,(yy� Q "'�
i��1 i' h�i � it r '.'t rh!,� err; r::nFti�• r _ . �h��M�{�I4Ir „i � i i..l•r ,�' 1'/(1 {11.il i)11,1',
Cross street/directions to job site: DescrL utv. Per 1 Trani 1 •
New residential single- or multi- family dwell i d unit.
incl a las attached garage.
Subdivision:
Lot no,: i ;01. ar less 161i i, 4
E. 141,1'1500 sq. R. or portion 3'2, 1
Tax map /parcel no.: Lim tcd energy, residential 67. 1, 2
S � ,' i ' , 4.1 ` i i ` ,; j� ((r tt 1,94idili ! l i,l�� f 11i 1�I i l inl ill (t ri:h above eq. ft) �� ! It 1^� k1.'. f�!h7N7'i! ,,. ,.� {r I, s,r t .
Lim ad micro,multi•Shinny 61. I 2
Low voltage wiring and thermostats for two new systems. n sidendal (with above sq. fl.)_
Ser'ir:es or feeders inutatlatiokalterution, n t +'or relocation _
J �"�r 200 saps or less 101. .1 2
,( 97[ l I ; 1 rrt tt{ N '{r i -q C ' ' ' (fl'td•�yfpI'{ � 201 tlnpa to 400 mnps 13: °i 2
Ari4 � I (' ' { . . Tn. tr f 1 0 . s Itl�I.�W. {1 , ; ` 1!, 1. ,-- i f ICI . � },f� Ole �r� — 31
401 unps to 600 amps _ 201. '1 2 — Name: Winzler & Kelly 6 01. amps to 1,000 amps 3(1 '1 2
Address: 15575 SW Sequoia Parkway Ovc._. ,000 amps or volts , 55: 6i 2
-- Ter q orary services or feeders installation, t ■ wiratloii, and/ar
City/State /ZIP: Portland, OR 97224 _ reit retina .
Phone: ( ) Fax: ( at 200 slaps or less 5 d; 1
201 amps to 400 amps 12 13 2
Owner installation: This installation is being made on properly that I own which is not , 101 in to 599 amps 16 , ^t 2 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. grt nab circuits — new, alteration, or extenal 11 per panel
Owner signature: Date: A. I e, for branch circuits with
1 � r N”
v I t bnvn service or fender fee, , 2
II : ' 5�'Yl�si . I ;lo ,Z i,1I l4 tlt it' ' ,r ;E' °11111 i� t at:h branch circuit ,Z
Business name: Ar(ae Sheet Metal Inc. D. l for branch circuits without
_ 'e: I et vice or feeder fee, first 5 : B 2
Contact name; Ken Klunder I numb circuit - .
Gas h add' I branch circuit i 2 _ 2
Address: 5510 SE McLoughlin Blvd Ml s eIeo
h inua (service or feeder not i[ICltldl t _
Each EacIT manufactured or modular 6 ,4
City /State/Z1P: Portland, OR 97202 dw� sling„ service and/or feeder 2
6 ; :4 2
Phone: (503) 2317717 Pax: : (503) 230 4888 li y
— o meet only
--
. NIT or irrigation circle 6'. I4
E - mail ken ar ae.eom t I„ r. '` ` g Sig r 'ar outline lighting e : to 2
e j a!�r��p • e !Ii�I r I� �'
r Il � ( e v 91, P' , Y i i, I f1i ��„ . , �,� 111�i.1,o n 6 �ailF!L�ii, a r Si t: I Circuit(9) or limited-energy - • ' / 4s , b$
r'�h � �f;, itf hioi �(y�IJf , '1. °I,� . �r��i �� e 2 7
Business name: Arjae Sheet Metal Inc. at El, alteration, or extension. 1 Pt i 2
En :l additional Ins ection aver allowable i , my of the above
Address: 5510 Se McLoughlin Blvd Adliional inspection (1 hr min) IN 66 rhr
Tnv Option (1hrmin) Mill 66 ilir
Ciry /Statc/ZIP: Portland, OR 97202 Inc uourial plant (1 hr min) _ 711 r hr
Phone: (503) 2317717 I9°
t)'1' �1 1 F ax: (503) 230 4888 in s itcnana for whlclt no fee is 9U 1 / hi'
a�0' . a•tcilicall listed ('hhrmin)
CCB Lic.: 60835 Electrical Lic.: %:19 i Suprv. Lic.: ,/4,17 "7 Li 6 1 "19 1 i' !r. ',Mlil f s,;r:', 1 ; -' 1Cl1k„.,r .„m : 9 �.11iMPA MI,
Suprv. Electrician signature, required: Plan review (25 %ofpermit fns' —6"
Print name: Ken KLundcr Date: May 27, 2010 Slate surcharge (12/0 ofpermit let /(p.,1
J Q - - TOTAL PERMfrFL. /6/• 9 4
Authorized signature: ( 1 hln permit application expires If a permit is at t blamed within 180
days after It has bean accepted es t i mktg.
Print name: Ken Klunder Date: May 27, 2010 • Number of inspoctions allowed pnr permit.
trlRUilding \P rmitnt &LC- Pennitnpp.doc 10!0009 440.46151:11105 /COM/WEB
MAY -28 -2010 FRI 08:06 AM ARJAE FAX N0, 5032304888 P, 03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Rosig .. ' 1, r Qi�� l o < ' meiMM RM ii MIMI
•
Fee for all residential systems combined $67
Check Type of Work Involved:
O Audio and Stereo Systems*
❑
;Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
O Other:
I l` idREi7 "R�? E Rl���x�,, �� S
Fee for each commercial $67.84
system
(SEE OAE. 918- 309 -0000)
Check Type of Work Involved:
O Audio and Stereo Systems
❑
Boiler Controls
0 Clock Systems
❑ Data Telecommunication In.staU.ation
❑ Fire Alarm Installation
® IIVAC
❑ Instrumentation
❑ Intercom and Paging Systems
Q Landscape Irrigation Control*
❑ Medical
n Nurse Calls
[� Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 2
*No 'licenses are required. Licenses are required
for all other installations
I: Uduildin \pormLtl1 permitApp.dEx 1 0/01 /09