Permit ,u CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
- -` -. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00306
DATE ISSUED: 7/31/2007
T,N,W 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AB - 01200
SITE ADDRESS: 07325 SW BONITA RD ZONING: I -L
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HORIZON RESTORATION
Project Description: Low voltage for HVAC wiring. Job No. 3775
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TENNANT INVESTORS HVAC INC
PO BOX 1658 5188 SE INTERNATIONAL WAY
PORTLAND, OR 97207 MILWAUKIE, OR 97222
Phone: Contact #: PRI 503- 462 -4822
FEES Reg #: ELE 26 -571 CLE
LIC 50897
Description Date Amount
[ELPRMT] ELR Permit 7/31/2007 $75.00
[TAX] 8% State Surcharl 7/31/2007 $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 suspende fir ore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those es are set o in 0 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503. 6.6699 or 1.800.3'
I
By: Issusd B : / � 4 ' ' Permittee Signature: ' QLA-�2 _ ‘ AAA dl
. •
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 Application FOR OFF1c t'e O\I.)
City of Tigard _ ed 7 07 0 Permit No.: Fe 7 -D
13125 SW Hall Blvd., Tigar0, OR ;97223. • ' Plan Review �� /' a �
.:
Phone: 503.639.4171 Fax: 503 li ' Date/BY Other Permit:
Inspection Line: 503.639.4175 i l� 1 7001 J„ Date Ready/By: ® See Paget for
Internet: www.ci.tigard.or.us J V 1 -- Notified/Method Supplemental Information
G7 1)
.... - -, t' , TYPk OF WORK' .. r.-I, - PLAN REVIEW •
❑ New construction Mort/alteration/ Ia Please check all that apply: .
❑ Demolition ❑ Service over 225 amps, come! 1:1 Hazardous location
Other: ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling a ommercial ustrial ❑ Accessory building El System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ['Building over three stories El Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
• JOB SITE INFORMATION AND LOCATION �f ❑Egress/lighting plan RV park
Job no.3175 Job site address: 732 5 ,e0. J!' ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/ State/Z)P: Td -) () 97 _ The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Proje name: RI Y. FEE* SCHEDULE
Description 1 Qty. 1 Fee. I Told [ ••
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'I 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
Il ems, lR.� .0 s4A l W cci L • Services service and/or feeder 90.90 2
-�.yt_,-rt_�I 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
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or Tess 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 1 ❑ 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'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fa+c:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
. CONTRACTOR energy panel, alteration, or
Business name: �V1� c____ extension. Describe: / Page 2 2
Address: S(8 SE
/ T 4 (, �(� Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Mk_ 1ij) Cwl-1t ,.Q r QY>° C� Investigation per hour (1 hr min) 62.50
Phone: 516) lk2 4 Fax-&) Industrial plant per hour 73.75
. _ .. ELECTRICAL PERMIT FEES' . _
CCB Lic.: 50 ' 7 Electrical Licad Suprv. Lic.:,0 Subtotal
Suprv. Electrician signature, required: F Plan review (25% of permit fee) �`J .o
Print name: AA esee10 alz Date: State surcharge (8% of permit fee) (p, p D
TOTAL PERMIT FEE 1 . Qd
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i :t Building \PennitslELC- PamitApp.doc 12/03 440-4615T(10/02/COMAVFB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Eis 2007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 71'if ff,07
Phone: (503) 639 - 4171 °'r,., . I
Inspection Requests (24 Hrs.): (503) 639- 4175'.I• °...
INSPECTION WORKSHEET FOR DATE: O/2912007 TIME: 7 :OOAM PAGE: 28
SITE ADDRESS: 07326 SW BONI'fA RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HORIZON R 7101 AT1 ON
DESCRIPTION: Low voltage for HVAU wiring. Job No. 3775
OWNER: TENNAN f INVESTORS, PHONE #:
CONTRACTOR: HvAt:'. INC PHONE #: 503 4624I822
Inspection Request Scheduled For: Date 8/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final OEA -0'1 ,L 603.462 -1822
Corrections /Comments /instructions "" �CDO' 5� � 5- 3
G C/ fr e/1 4-8--
z ,4 ° r 111
PASS n PARTIAL APPROVAL ❑ CANCEL U NO ACCESS
n FAIL 1 1 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: _( �(�/ Date: 0 2 Phone #: (503) 718-