Permit ...
J. _
CIT OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
i 4, DEVELOPMENT SERVICES PERMIT #: ELR2006 -00254
�' " A Ii 13125 SW Hall Blvd., T igard, OR 97223 503 -639 -4171 DATE ISSUED: 10/20/2006
PARCEL: 1 S136DD -03400
SITE ADDRESS: 11740 SW 68TH PKWY 100 ZONING: MUE
SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG
Project Description: Low voltage for HVAC 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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC NW PROPERTIES AMERICAN HEATING
PO BOX 2206 1339 SW GIDEON ST
BEAVERTON, OR 97075 PORTLAND, OR 97202
Phone: 503- 626 -3500 Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
FEES Reg #: ELE 26- 993CRE
LIC 33135
Description Date Amount
[ELPRMT] ELR Permit 10/20/200E $75.00
[TAX] 8% State Surchar€ 10/20/200E $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 suspended for more than 180 days. ATTENTION: Oregon law requires
you to fo ru e . dopte y the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
throug OAR 952-061- 00: •u may obtain copies of these rules or direct questio to OUNC at 5 3- 246 -9699.
Issued y: C j ).1_6t- - Permittee Signature: V (C at / y es E—
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 OFFICE USE ONLY
City of Tigard R ed r MOM Pem'tNo.• ca, /eD!` ad�SJ `
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 ��" "`, "r `\ Daten) .
■ '' L Date •
Ready/By lu ® See Page Ifar
Inspection Line: 503.639.4175 ,.. J
Internet: www.ci.tigard.or.us . Notified/Method: , (.22 Supplemental Information
S : - i i.K S 9.. f . i wr / 7 5, E' q i , r ^ i �r {, y � •>r.. 51 is l y r t7'. ! 1 f s fr _ fir Sti= } � r t .Fi •+f . rq. 1 ? , �'
13 S i i d /
N � d -, Y r ` . s , - t 1'b`,F _ � -t -. I 9 u � � �r 4 s f L a! r�� ,,' ! ._ --
t,: ._ ....�:.i.rs- �'u__.�...;� r.� .y � „tf_ �1 � ..._...._ s _ . � i:..,..:,L�,,_�..,v, Please check all that apply:
❑ New construction , ,j2
Addition/alteration/replacement DService over 225 amps, comm'l ['Hazardous location
❑ Demolition / Other ❑Service over 320 amps - rating ❑ Buildng ova 10,000 sq. ft.,
1 ' ` 5(^`i li",!:1:11:',7.72'3,17.,77,
lr° ;� r �i u` i7 k j r f ' w r <' ` r ` '+ of 1 - and 2- family dwellings 4 or more new residential
System over 600 volts nominal units in oneso'ucture
❑ 1 -and 2 family dwelling P'CommerciaUindustrial 0 Accessory building DBuilding over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: DOccupant load over 99 persons ❑Manufactured structures or
F!F".J k 1 park
ITr } r + ' r `r 'f ii �., T F1t 1 .2"1 / ` 4 _ "., r 4r.1- .12 . " /'g ... R' 1 r f AIS) 94 f e.Ll { 1 :1 : : F.a' JVI ❑ E�ssflighting plan RV
�I. :,t _ _ _ �..� DOther:
� Healthcare facility
Job no.: Job site address: 11'1 0 (f .) - J'i � ❑
/ ... _ ;, Submit 2 sets of plans with any of the above.
City/State/ZIP: t' • * g I Q..)-..3 The above are not applicab temporary construction service.
Suite/bldg./apt no.: 00 Project name: • • l� - t Desertpdon Qty. Fee. Total
Cross street/directions to job site: a `J oe . 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
Limited energy, residential 75.00 2
Tax map /parcel no � Limited energy, non - residential 75.00 2
.. + A.. t F ry t .-: U � b : , ` 1,- ■J , _: .., s .:'a•; r tN ,rrn
i y'i i `a r r l n t = '' ^' ti y,'"::: : Each manufactured or modular
n _.:.�_, ' .-.:` . . '4r:`_`i` ` ; . � f r .` ' .'. ; _ t ..__ __ dwelling, service and/or feeder 90.90 2
I4 ! `- L �/0. ( �' r 1) t { Services or feeders installation, alteration, and/or relocation
C r a IP 200 amps or less 80.30 2
`^
106.85 2
, 201 amps to 400 amps
i . }-' j 7r Ji xUb0li11113aG of }lt���1� rw''2 t , � t a
, , ..wwirtK { f 1.r . k i 'r• 160.60 2
. L.:1.,:.2., ..... _..,..s.,.,12. f ft1, - �,.h_.�a ,. r;.� .._ w. 1 :... _� .... ..... ti 401 amps to 600 amps
Name: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, attention, 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
7 t l �, (j r ; ?/ , w , ;' A. Fee for branch circuits with
n , '''''6% . . ; Y '' - �l r1 lt.it r r t `' w •ir ...) .�tJl t' J ,) , 'i :,C,4 CJ - + - ,0k, V r r� XZyr .'. l
r„ ¢l • --• } service or feeder fee, each 2
,t,.,.. .__ _ 6.65
branch circuit
t. �� �� B. Fee for branch circuits
Contact name: : / • • without service or feeder fee, 46.85 2
r each branch circuit
Address: 1 3� 3e q / . ► y1 Each add'I branch circuit 6.65 2
City/State/ZIP: 1 p y* t ('1 d . 012 gi a ('. Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: •) D , (6Q Fax: • )D. ) Sign or outline lighting 53.40 2
E Signal circuit(s) or Iimited-
t + `�: ? { n , 5 it t c t g , , . ` ! om, �i;' ;, ,' I energy panel, alteration, or
tt� ' »i.1 � > J.r_tx. t.�.'i� +J!�:.- ' F{ L _uZS �' ..... _' L�` - "� , i41 .61' 4' '' '' �. -: '" tf t ?vim: �..�YJ+...!$....{ 4'
4 �, �....::. ,� extension. Describe: Paget 2
II ' ��� e , • t Each additional inspection over allowable in any of the above
Address: ^� Per inspection 62.50 •
City/ State/ZIP: 0 e_ I -) Investigation per hour (1 hr min) 62.50
aa Industrial plant per hour
73.75
Phone: () � ' � O v . Pax ( ) a 703 [ J'i s s Ii110., t 3 a1', 211QP +1 f+ 3 3 d'a`2hryV4: M
3 3135 bq (I Sup ^
CCB Lic.: Electrical Lic. , Su Lic.: '_ d�t/ 0 Subtotal t�
Suprv. Electrician signature, required: - . _ Plan review (25% of permit fee)
I ' %I UCH
State s urcharge (8% of permit fee) 6
r
1 O
Print name: 1 v , _ii 0 _ Da te: b„ . 0 -0 � TOTAL PERMIT FEE
Authorized signature: , , t / Irl This permit appllcadan expires if a permit Is not obtained within 180
_ days after It has been accepted as complete
Date: 8 -- 0 ( • Fee methodology set by Tri.County Building Industry Service Board
1 1 •• Number of inspections per permit allowed.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00254
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2005
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639- 4175II�..
INSPECTION WORKSHEET FOR DATE: 7J20/2007 TIME: 7 :09AM PAGE: 77
SITE ADDRESS: 11740 SW 68TH PKWY 100 CLASS OF WORK:
SUBDIVISION: TI GARD TRIANGE COMMONS LOT #: 008 TYPE OF USE:
PROJECT NAME: OMA
DESCRIPTION: Low voltage for HVAC wiring.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626
CONTRACTOR: AMERICAN HEATING PHONE #: 503
Inspection Request Scheduled For: Date: 2/20/2007 Pour Time:
Code # Inspection Description _ Am irm # Contact # Message
199 Electrical final - 043565 -01 503- 209 -0731 N
•
Corrections /Comments /Instructions:
i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: & , b L� Date: 2 id ' ` Phone #: (503) 718- 2litif'
CITY OF TIGARD . , .
BUILDING DIVISION PERMIT #: ELR2006-00254
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006
Phone: (503) 639- 41714Pgfij�l .
Inspection Requests (24 Hrs.): (503) 639 -4175 F -_..
INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7 004.4 PAGE: 61
SITE ADDRESS: 11740 SW 68TH PKWY 100 — CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE:
PROJECT NAME: OMA
DESCRIPTION: Low voltage for HVAC wiring.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626.3500
CONTRACTOR: AMERICAN HEATING Y. C • PHONE #: 503 - 239-4600
Inspection Request Scheduled For: Date: 12/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 041383.01 503-793 -2240 Y
Corrections /Comments /Instructions:
j11 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C. T. N b6 Lt Date: 1 2 1d 06 Phone #: (503) 718- 1.41-lb