Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
j PERMIT #: ELR2008 -00231
`= '`` COMMUNITY DEVELOPMENT
Tic RO 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/4/2008
PARCEL: 2 S 113AC -00101
SITE ADDRESS: 16655 SW 72ND AVE 800 ZONING: I -P
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: 029 JURISDICTION: TIG
PROJECT: COPYTRONIX
Project Description: Thermostats and wiring.
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: : X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES PROTEMP ASSOCIATES INC
15350 SW SEQUOIA PKWY #300 -WMI 9788 SE 17TH AVE.
PORTLAND, OR 97224 PORTLAND, OR 97222
Phone: Contact #: PRI 503- 233 -6911
FAX 503 -238 -9767
FEES Reg #: ELE 26- 1063CRE
LIC 38868
Description Date Amount SUP 2613LEB
[ELPRMT] ELR Permit 8/4/2008 $75.00
[TAX] 12% State Surch 8/4/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 e . • 6.6699 or 1.:'0.332.2344.
Issued By: j 4'— ' ermittee Signature: , ^ G .o.`,
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.
/6 55 7 - 1,
Electrical Permit Application v , FOR OFFICE LSE O\.1,�,
. City of Tigard /P Received 7 ,reuniters.: AR " •
• 13125 SW Hall Blvd., Tigard, OR 97223 \ \, Ran Res-lien
C Phone: 503.639.4171 Fax: 503.598.1960 �'` C N. ,� r Other Permit:
Inspection Line: 503.639.4175 l f l� ' e ReafiB + y: See Page 2 for
I t t; n it u Internet: www.tigard- or.gov Cl GV1� Notifr�:Method: r S ® pptemental lnformatk*
TYPE OF WORK VP PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sous of plans ev5tems checked bdow):
❑ Senior or feeder 400 amps or more ❑ Building over throe stories.
❑ Demolition ❑ Other: where the available built current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10000 amps a 150 volts or ❑ Floating buildings_
ommercial/industrial Accessory building
less a ' x all other installations. ons. 14.000 ❑ b Commercial-use
kbegs al use agricultural
❑ 1- and 2- family dwelling ® C
❑ ���}' g amps fix all artier imstallationv. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ fire pomp_ 0 lnsiallatirmof75 KVAor
dOB SITE INFORMATION AND LOCATION ❑ �ency systun. larger separately derived system.
®Addumn of new motor load of ❑ A ". "E . °I - , "t - ".
Job no.: 9433 Job site address: 16655 SW 72` AVE 100HI' or mom occupancy.
❑ Six at more residential units. ❑ Raaeatiomal vehicle parks.
City /State /ZIP: TIGARD OREGON 97224 ❑ filth -care facilities, ❑ Supply voltage for more than
0 tlarandous locations. 604) volts nominal.
Suite/bldg. /apt. no.: 800 _L Project name: COPYTRONIX ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: r 1 rte. 1 Fee. 1 Total 1 .
Ntu residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 s4 li or leas 145.15 4
Tax map /parcel no.: Ea. add'/ 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK 2 (nvh abuse sq. ti..)
THERMOSTAT &WIRING
Limited emragy,multi- Family
r 75.00 2
idential (with above sq. R.)
Services or feeders installation, alteration, and/or relocation
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 Etta — new, alteration, or extension, per panel
A Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee,
first brsaneh circuit 46.85 2
Address: Each add'/ branch circuit 6.65 2
hUsee ancons (service or feeder not included)
City /State /ZIP: Eada manufsetu e+d or modular
dwelling,. service and/or feeder 2
Phone: ( ) Fax:: ( ) Recomiect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or o udine lighting 53_40 2
Business name: PROTEMP ASSOCIATES Signal eQCVit(s) or limited -
energy panel, alteration, or
Address: 9788 SE 17 AVE extension. Describe: 1 Page 2 7 P
THERMOSTAT &WIRING
City /State /ZIP: PORTLAND OREGON 97222 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 519 - 6199 Fax: (503) 238 -9767
Investigation per hour (1 hr min) 62.50
CCB Lic.: 38868 Electrical Lic.: 261063CRL Suprv. Lic.: 2613LEB industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: t„sc.\ Subtotal: - 75 — , c_cc.,
Print name: MONTY SCHROEDER Date: 7/29/08 Phan review (25% of permit fee):
State surcharge (12% of permit fear): 9 CA)
Authorized signature: Z vex TOTAL PERMIT FEE: 1 3[.r, cr o
Print name: BRUCE BUTNER Date: 7/29/08
This' permit a n canes if a permit s not obtained within 180
days after it has been accented as complete.
CITY OF TIGARD A;
BUILDING DIVISION PERMIT #: ELR2008- t)D2:31
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4 /2008
Phone: (503) 639 - 4171 °' '. , ;,rl�l� 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00A` PAGE: 5
SITE ADDRESS: 16655 SW 72ND AVE 800 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: 029 TYPE OF USE:
PROJECT NAME: COPYTRONIX
DESCRIPTION: ThorrastatM and wiring.
OWNER: PACIFIC REALLY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 233.6911
13 -
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description fit= # Contact # Message
199 El e trical final 076700-02 503 519 6199 , r'
Corrections /Comments/ Instructions:
4‘
PA ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: n - NOg L Date: 9 I Phone #: (503) 718- 1_L(L