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Permit C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT Av DEVELOPMENT SERVICES PERMIT #: ELR2005 -00222 .,� I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/4/2005 PARCEL: 1S136DA-02600 SITE ADDRESS: 11140 SW 68TH PKWY ZONING: C -G SUBDIVISION: MLP1999 -00011 LOT: 002 JURISDICTION: TIG Project Description: Limited energy for HVAC wiring. Job No. 95869 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: WEBSTAR VI, LLC ROTH HEATING & COOLING 610 GLATT CIR. PO BOX 1265 WOODBURN, OR 97071 CANBY, OR 97013 Phone: 503 -981 -0155 Phone: 503- 266 -1249 Reg #: LIC 14008 ELE 604LHR FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 8/4/2005 $75.00 [TAX] 8% State Surchart 8/4/2005 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to folio _ adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through AR 952 -00 i 1 % You may obtain copies of these rules or diredswestions to OUNC a 24 6699. Issued y: / � i Permittee Sign at OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 08/04/ 15032632513 ROTH MECHANICAL PAGE 02 E1ectr y Al Permit Application I OI: (*FR": list. Olilt City of Tigard # l 51)6 / Da ' '� � ' ��i n n P No.: i ,.. 9 0 W ��. 13125 SW Hail Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.19. a ' `' -r . �� i ' Da _ Other P Inspection Line: 5 .u.. (1 rt) � I I„ Date Ready/By: . E_s RI See Page 2 for Internet: www.ci.h _,: i . . rl ' Notified/Method.. od.. f Supplemental Information • • • - r' : r � , I,�.-t,,N i, v +i ,i:}rc. i ",$'.8 :'i" I ` t t I��'1 r ,1li : Lisa ' - t ,,ifp ,I,, r i i 1 " y � r ,I..• 1:1 � 'Linn .� �� ,SS'C+l r r ,.� .. �� !7M :�:i'flJ�' w r � A ��, k ,. '"r�lrwl.',v17J�471n�4fw� ;t_�I'Tt�d� '!T�'- K„�y�~ p.��, ��. I� >�d!n New construction ❑ Add ition/alteration/replacemtnf' •' ` - Please check all that apply: Service over c axard location ❑ Demolition © Other ov r 225 am omm'I H ous oca on P� Service ov er 320 - ratio v ul • � , ,_, - Bu' dng over i 0,000 sq. . ,. , . � , .. ❑ amps g ❑ ft., Gl i ' / li. , t , -0 I,",. roz .! , , rais g g .a,4 , 4 .. . mmt - 1 U Y . , � 1n i rt MV.„ � ,' . x l .; ; ie! of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2- family dwelling £ommert ial/industrial ❑ Ac ssctrzbuU(ling. , ❑System over 600 volts nominal units in one atructurc Cl Multi - family ❑ Master builder ❑ ® �iiNC. i);�f ;(;1; ❑Building over three stories ❑Feeders, 400 amps or more � ❑Occupant Toad over 99 persons ❑Manufactured structures or ��] �a w i,i 1 q I , t ,.,.. ^ tW I . I r t''�7W;1��l''h'4 trtir3, `�� !� �� ' ��, . " ^'i -�� I�� Su � Egtvss/lightingplan RV park nT`-"• � iLlcn l .Il: jl': [.1.1f��. P��„ r � n:n�i RA "P Wwn�h�iwl ' ❑ Job no.: aiSg 6c) Job site address: • 1 \ ,i46 SW 0 n . ❑ Health - care facility ❑O�� # ' � . - Submit 2 seta of plan with any of the above, ~ City / State/ZIP: , d Ct 411P .if above are not applicable to tcmpontty construction service. y� is al:l t' Suite/bldg./apt. no.: Project name: a : 911 ' Egr.:RigiNtIE 5CC 1 liiilit,}ti ':. ii i ' '. 1 , r •:.!i 1 C.( j f5 .,^I. ,r ..A i4'ii • t ° I qty. Fee. 1 Total N " , Cross street/directions to job site: 9 New residential single- or multi - family dwelling unit Includes attached garage. 1,000 sq. R or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. tL or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non - residential 75.00 2 'n'Y C �a I,,�GGi�4% k I tii a w'yl.. � I . a :a ' I , i; i " r; - . � s : ,, 0 ': • D�8• , . - O !..,. - - - 4.. , I.,,'''' r ,..... - �' p; r '! 7' -1. I !. E ach manufactured or modular `�� ` dwellia and/or feeder _ 90.90 2 ° Y -' Services or feeders Installation, alteration, and/or relocation 200 amps or less 80.30 2 .ail{ i � a 'i `' ::u �Il ":';7•" itq' , 1t" , : ;ii i;I'IC:.Ii i i . 1� '; cl 201 amps to 400 amps 106.85 2 � ' Y . ti �,1„'1 .� S :ir' ' � . �: !w!� :'i : I I:i�� W W 1 �a ^A lctiit 4 1 i.4 _ 160.60 2 Name: 1 C- �JU�� 401 amps to 600 amps � t a . • t • 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: . 0 4 ■J\Ar i --.. Temporary services or feeders installation, alteration, and /or relocation Phone ( ) l Fax; ( ) 200 amps or less I 66.85 1 Owner installation: This installation is bcing made on property that 1 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 drenits - new, alteration, or extension, per panel .': r•t "9 ` 1 Ir.!.. "i I : �i.+ '� l ' - ,�M'�" s - ;..'. -, . ._ � l,ai: " A. Fee for branch citeuits • •; :, `'� a . 1 `2 it ,;(. 1�7' •. ., � .p• , • , , ,, ...r rr , l :: ':a..:1' . , -. alb �' cacVn44 4 .I y. 1" r 4 ''''r"'''''' ° .? .+ ,,.1 . , iri f.. �:IPI r rzer ,, is .I ∎. service or feeder fee, each 6.65 2 Business name: branch circuit Contact name: B. Foe for branch circuits without service or feeder fee, 46.85 2 Address: each branch circuit Each add') branch circuit 6.65 2 City / State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax; ; ( ) Pump or irrigation circle 53.40 2 I Sign or outline lighting 53.40 2 E -mail: Signal ci cuit(a) or Bruited- C Business name: ;'[['� t1^ "''r'r�''$�Ni i[� Ili:, � , �K;; , I.r::"f. r a q r�t� 1iy616" ' "iti°: ' • � ;ri :i.dli 5'" • �Ik' i k�! �i energy panel, niterdtion, or ( 7 J ill }.. iRf awtl?I.i{I4c7t;.�.Iu:RIi. ioTiiM�i:ny..lillillfl.�7^"71we ii:H.�!il. i.�w.�:'Y.I.i. ^'.i S11.hw�N : I::� i:�i� CA � extension. Describe Page 2 2 Address: ! Each additional inspection over allowable In any of the above �-+ t � Pc inspection 62.50 � f City /State/ZIP: (' le, lot q 7 (� /3 Investigation per hour (1 hr mini 62.50 Phone: (P 2-u, t0 , \ � 1 Fax: ( t( ' -( to . 3 L -Q Industrial plant per hour 73.75 111 J10.# �-` ' ;: [ !'['ri h l d.F.%F CCB Li ^/ L I - >'�! ,I ��,, iii„ c.: I �f ( , �p8 y i ��o�lrlectrlcal I.ic.: r�lf LN Suprv. Lic. �( ( Subtotal ? Suprv. Electrician signature, required: .-7, [A 7 Plan review (25% of permit fee) ; /C- /54#7 5en 1 State surcharge (8 %ofpermit fee) Print name: Date: - _, (J TOTAL PERMIT FEE 7 1 Authorized si( nature: /J'I Ada a u / n ico .,_ This permit application expires If a permit Is not obtained within 180 days after It hal been accepted as complete Print name: Ali 't 01.19k Date: ' ) 3 i t 5 • Fee methodology set byTri-ounty Building Industry Service Board •• Number of Inspections per permit sltewed. isOutwinePennitaNELC- PuntkApp,ebe 12/03 440 -46 tsr(ievocoM#WEa CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR200 .00 2; . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/4 /2005 Phone: (503) 639 -4171 �,, � h I •Inspection Requests (24 Hrs.): (503) 639 -4175 ,,, r_ INSPECTION WORKSHEET FOR DATE: 5/30/2006 TIME: 7:15AM PAGE: 28 SITE ADDRESS: 11140 SW GBTH PKWY CLASS OF WORK: SUBDIVISION: MLIP1999 -00011 LOT #: 002 TYPE OF USE: PROJECT NAME: CASCADE VETERINARY REFERRAL CE DESCRIPTION: Limited onorgy for HVAC wiring. Job No. 95863 OWNER: WEI3STAR VI, LLC, PHONE #: 503-981-0155 CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503-266 -1219 Inspection Request Scheduled For: Date: 5/30 /2006 Pour Time: C de # Inspection Description Confirm # Contact # Message '199 Electrical final 030750.01 971.235.1353 N Corrections /Comments/ Instructions: $PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: --- P\R-).6 OCA Date: Si 30106 Phone #: (503) 718- 2 -44tp 1 CITY OF TIGARD _. BUILDING DIVISION PERMIT #: EL_f22005 -G0222 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2005 Phone: (503) 639 -4171 t■t�l �' Inspection Requests (24 Hrs.): (503) 639 -4175 . '!!� ' I I.. INSPECTION WORKSHEET FOR DATE: 2/9/2006 TIME: 7:0'IAM PAGE: 69 SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK: SUBDIVISION: Ml.-P1999 -00011 LOT #: 002 TYPE OF USE: PROJECT NAME: CASCADE VETERINARY REFERRAL CE DESCRIPTION: Limited energy for HVAC wiring. Job No. 95868 ' OWNER: WEBS 1 AR VI, LLC, PHONE #: 503- 981 -01& CONTRACTOR: ROTH HEATING a; COOLING PHONE #: 603-2661249 Inspection Request Scheduled For: Date: 7/9/2006 Pour Time: Code # Inspection Description - on nTar Contact # Message 135 Low voltage 026520-01 503-559.7350 N Corrections /Comments/ Instructions: CUIporCP CA ‘ett cbal.., ' Cfb ii E • , )4PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS . ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' • 1 Ni , • `ia Date: Phone #: (503) 718- 20