Permit ti 7 a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00326
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/1/2008
PARCEL: 2 S 113AA -00400
SITE ADDRESS: 16260 SW 72ND AVE B2 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 018 JURISDICTION: TIG
PROJECT: AMSOIL
Project Description: Low voltage for HVAC wiring.
r
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
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224
Phone: Contact #:
FEES Reg #:
Description Date Amount
[ELPRMT] ELR Permit 12/1/2008 $75.00
[TAX] 12% State Surch 12/1/2008 $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 5o 246. 1.800.332.2344.
Issued By' _ Permittee Signature: .. r.
ADD
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 RECEIVED - - - -- -, t >,: , , ,�,: � ,_ ONLY — City of Tigard NOV 2 5 2008 Dos Ei 0 1 5r Permitblo.: Z I 4 9,0cg 0 7,
13125.SW Hall Blvd., Tigard, OR 97223 Plan Review
• - – - , Phone: 503.639:4171 Fax` 503.598.19 Q Datc/B : Othe ermit
1- –. ;� i7 Inspection.Line:- 503.639.4.1.75 CITY OF TIGARD Date.Ready/By: ®. Sec Page 2 for.
_. Internet: www.tigard- or.gav BUILDING DIVISION Notified/Methnd: Supplemental Informatlnn
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.
' less to ground; or exceeds 14;000 ❑ Commercial -use agricultural'
❑ 1- and 2- family dwelling, ® Commercial/industrial ❑ Accessory building. amps.for alt other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND. LOCATION ❑ Emergency system. larger 1 -21- system.
❑ Addition o of new motor load oY ❑ l "A", "EE"", , "1 -2 "", , " "1 -3 "", ,
Job no.: 9499 Job site address: 16260 SW' 72 AVE 100HP or more.. owupancy. .
❑Six' or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: TIGARD OREGON ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations: 600.volts nominal.
Suite /bldg. /apt. no,: Project name: AMSOIL QService or fonder 600 amps or more.
FEE SCHEDULE'
Cross street/directions to Job Site, Description I Qty. I Fee. 1 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
Fa. actin' 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy; residential 75.00 2
. DtESCRIPTION. OF WORK (with. abnve.sq..11.).
THERMOSTATS & WIRING Limited energy, multi - family 75.00 2
residential (with above sq. h.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30. 2
❑ PROPERTY OWNER D. TENANT . 201 amps.to,400.amps. 106.85. 2
Name: 40 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. Pee for branch circuits with
. Q APPLICANT ❑, CONTACT PERSON above service or feeder fee,
_ each branch circuit 6.65 2
• Business name: PROTEMP ASSOCIATES' B. Fcc for branch circuits
Contact-name: BRUCE BUTNER without service or feeder fee 46.85 2
first branch circuit
Address: 9788 SE l7 AVE F.ach add'l branch circuit 6:65 2
Mlscelaneous (service or feeder not Included)
City/State/ZIP: PORTLAND OREGON. 97222 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
• Phonc: (503-) 519 -6199 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: SAME AS ABOVE Signal circuits) • or limited -
energy panel, alteration, or
1
Address: extension. Describe: Page 2 2
THERMOSTAT& WIRING
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: (, ) - Investigation
per hour (1 hr min) 62.50
CCB Lic.: 38868 Electrical Lie.: 261063 C Suprv. Lic.: 2613LEB Industrial plant per hour 73.75
ELECTRICAL .PER.MTJ FEES
Suprv. Electrician signature, required: �� Subtotal':
.. J e: 11/24/08 Plan review (25% of permit fee):
Print name: MONTY SCHROEDER
]p State surcharge (12% of permit fee):
Authorized signature : N) TOTAL PERMIT FEE:
Ast
Print dame: BRUCE BUTNER I Date: 11/24/OS This permit application expires if a permit is not obtained within 180
days after it has been accepted' as co/Indite.
CITY OF TIGARD
pU1LOING DIVISION PERMIT #: F L R2008-00326
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12J1/2OO8
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,,�'P'�_�I
INSPECTION WORKSHEET FOR DATE: 1/9/2009 TIME: 7 :O1AM PAGE: 1
SITE ADDRESS: 162.60 SW 72ND AVE B2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 010 TYPE OF USE:
PROJECT NAME: Ah ,OI I_.
DESCRIPTION: Low voltage for HVAC wiring.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 1/9/2()09 Pour Time:
Code # Inspection Description : • -• # Contact # Message
199 Electrical final 079553 02 503. 519 -6199 \ Y
Corrections /Comments /Instructions:
\.1
❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
$% PASS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 3m N oe L ; Date: 1- ' 1 Phone #: (503) 718- VA_
CITY` OF TIGARD , ` -`
BUILDING DIVISION PERMIT #: I_R2008 t rl326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: nil/200o
Phone: (503) 639 -4171
A Ap;
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 12/18/2008 TIME: 7:01AM PAGE: 3
SITE ADDRESS: 10260 SW 72ND AVE B2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: ()18 TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Low voltage for I.1VAC wiring.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: .
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 12/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 079117-02 503 -618 -6180 Y I
Correction /Comments /Instructions:
I+t l e
— d v -A
,,
/_
SS ❑ PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION — ADDITIONAL FEES ASSESSED
Inspector:. Date: '4 J / Phone #: (503) 718-
CITY OF TIGARD
QUiLDING DIVISION PERMIT #: F_LR200 &00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211/2008
Phone: (503) 639 -4171 r' '�I
Inspection Requests (24 Hrs.): (503) 639 -4175 .....—
— INSPECTION WORKSHEET FOR DATE: 12/11/2008 TIME: 7 :00AM PAGE: 25
SITE ADDRESS: 16260 SW 72ND AVE R2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 019 TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Low voltage for HVAC wiring.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 12/11/2008 Pour Time:
Code # Inspection Description Confirm - Contact # Message
135 Low voltage 078960 -01 503 - 519 -6199 N. Y
Corrections /Comments /Instructions: N-____
•
y , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cri 4v V€ Le Date: 12111 1 Phone #: (503) 718- IAAL