Permit w
IN
v CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2009 -00032
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/12/2009
PARCEL: 2S112DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 198 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: COMPUTERATION
Project Description: Low voltage for HVAC.
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:
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 1/12/2009 $75.00
[TAX] 12% State Surch 1/12/2009 $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 503.246.6699 or 1.800.332.2344.
Issued By: / .. s i J` _..'...A Permittee Signature: , �I: ? i.c
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 RECE FOR OFFICE USE ONLY
ila Cl of Tigard A N q Received Permit No.:
q City g f ' ► 0 8 L2� DateB : I S 6,41007-0e032
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Ill Phone: 503.639.4171 Fax: 503.598.196 OFTIGARD Date/ : Other Permit:
TIGARD Inspection Line: 503.639.4175 �t/� D e. t.a Date Ready /By: r RI See Page 2 for
Internet: www.tigard -or.gov BUILDING illy a Notified/Method: l/ i ta Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
Demolition ❑ ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ 1 - 2 dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
y g ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1- 2 ", "1 -3 ",
Job no.: 9533 l Job site address: 15350 SW SEQUOIA PKWY 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: TIGARD OR 97224 ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: #198 Project name: COMPUTERATION ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
T-STAT AND WIRING Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation 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: ( ) f 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
0 APPLICANT I 0 CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: PROTEMP ASSOCIATES B. Fee for branch circuits
Contact name: BRUCE BUTNER without service or feeder fee, 46.85 2
first branch circuit
Address: 9788 SE 17 AVE Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: PORTLAND OR 97222 Each manufactured or modular 90.90 2
• dwelling, service and/or feeder
Phone: (503) 519-�g1( Fax : : (503) 238 -9767 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: 1 Page 2 7 5 • � 2
T -STAT & WIRING
City/State/ZIP: Each additional inspection over allowable in any of the above
I Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lic.: 38868 Electrical Lic.: 26 -1036 Suprv. Lic.: 2613LEB Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: N � g � ���� Subtota -76 G�v
Print name: MONTY SCHROEDER 7 Date: 1/8/09 Plan review (25% of permit fee): /,�
State surcharge (12% of permit fee): Q.00
Authorized signature: TOTAL PERMIT FEE: gc(.ta 7
Print name: BRUC E BUTNER I Date: 1/8/09 This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete.
• Number of inspections allowed per permit
I:\ Building \Permits\ELC- PermitApp.doc 0523/06 440.461ST(I1/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2009-00032
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1112/2003
Phone: (503) 639 -4171 A ,t Inspection Requests (24 Hrs.): (503) 639 -4175 .. . "__
INSPECTION WORKSHEET FOR DATE: 1113/20(]9 TIME: 7 :0 Am PAGE: 14
SITE ADDRESS: 15350 SW SEQUOIA PKM' 198 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: COMPUTF_RATION
DESCRIPTION: Low voltage for HVAC.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-233-6911
Inspection Request Scheduled For: Date: 1/13/2009 Pour Time:
Code # Inspection Description Confirm #�. Contact # Message
199 Electrical final 079631 -02 503.519 -6199 Y
Corrections /Comments /Instructions:
N\I
►11 AS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 3 • N\ V Date: 1 - 13 ° 7 Phone #: (503) 718- 14%_______