Permit iri n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00177
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/27/2008
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 170 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: COMMON CONFERENCE
Project Description: Installing thermostats and (1) low voltage protective signaling system.
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: PROTECTIVE SIGNAL: X
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
Reg #: ELE 26- 1063CRE
FEES LIC 38868
Description Date Amount SUP 2613LEB
[ELPRMT] ELR Permit 6/27/2008 $75.00
[TAX] 12% State Surch 6/27/2008 $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 t. • - NC at 503.246.6699 or 1.800.332.2344.
Issued By: �' /� /�� _�— ` • • Signature: ezz,a
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 Applrca , F "►zOFF :� r_� • _ -- - -- - _
• City of Tigard r• Permit re: p
131 W Hall Blvd, Tigard 9722 \k\ � • 0 �a "� � ` nn om ,, . ,,, D r `
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑2 ❑ ❑!�@❑ ❑❑ 1 = . sro� �..,_; t7ihtxPamiL ; � mi 1. -- • ,.
l i C : r u 1' Line; 503.639.4175 `' Date Road. ® See Page 2 for
Internet: www.tigard-or.gov G r it _` 1 0 ® b Information
�
TYPE OF '• ;',, - PLAN REVIEW .
❑ New construction ® Addition/aheratioa/replacement Please check an that apply (submit 2 sets of plans suit ns Bred below
❑ Scarce or feeder 400 amps or more ❑ Bolding ow: throe stories.
❑ Demolition ❑ Other: none the amiable fault natant ❑ Minims and boatyards.
• CATEGORY OF CONSTRUCTION exceeds 10,000 acme at 150 uilis or ❑ wing buildingg&
less m ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2 -famil y dwellin g ®Com mePCial/industria! ❑ Accessory btrihlin g 1 acme for all other instaltanOns. buildings.
❑ Multi -family ❑ Master builder ❑ Other. ❑ rue pimp_ ❑ Installation 475 KVAor
❑ PADe
• JOB SITE INFORMATION AND LOCATION , ' , A". s - 1 r
❑ motor rand of ❑ - - n , - e'. -1 -z^, -t -3^.
Job no.: 9422 I Job site address: 12909 sw PARKWAY MOW or roore. occupancy.
❑ Six or hence tee meats. ❑ Roaratioaal rdticJe parks.
City/State/ZIP: TIGARD OREGON 97223 ❑ tteahh-ame tam ❑ Supply voltage for more than
,rp ❑ R ri betimes, d as a nits. 600 eels nominal
Suite/bldg. /apt. n0 0 Project name: TIGARD TRIANGLE CONFEREN ❑ or fader 600 amps w use.
FEB SCHEDULE
Cross street/directions to job site:
'
1 Qty. 1 Fen t Total 1 •
New maenad > sr multi-family dwelling unit
Includes at sepal garage,
Subdivision: I Lot no.: 1,000 sti R e$ less 145.15 4
Ea_ add`I 500 sq R or portion 33.40 1
Tax map/parcel no.: Limited enrrgr, residential
• . DESCRIPTION OF WORK (wait ante sq. II) 75.00 2
RING
Limited (a otnmdg
THERMOSTATS & WI
zesi�oial (with abase sq. It) 75.00 2
Senior or feeders lea, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Nettle: 401 amps to 6110 moots 160.60 2
1 1 601 mops to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/StateIZlP: Temporary service' s or er feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) , !! i 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is riot ; 12!)1 anIPS 10 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. I 401 amps to 599 amps 133.75 - 2
Branch circling - new, alteration, or extension, per panel
Owner signature: Date: I A. Fee for branch circuits with
—
IN APPLICANT - ' 1 .. . ® CONTACT PERSON above hence or feeder fee,
each branch circuit 6.65 2
Business name: PROTEMP ASSOCIATES B. Fee for branch circuits
Contact name: BRUCE BUTNER without scxriaaG or feeder fee, 46.85 2
lust 176aaldt atrial
Address: 9788 SE 17 AVE Each adds branch circuit 6.65 2
(service or feeder not included)
City/State/ZIP: PORTLAND OREGON i Each ,aanttlawand or modular ,
90.90 2
dotting, service and/or feeder
Phone: (503) 519 - 6199 I Fax: : (503) 238 - 9767 I Reconnect only 66.85 2
E-mail: 1 Pump or irrigation circle 53.40 2
- CONTRACTOR Sigh or outline lighting 53.40 2
•
Sigatal t(s) or hmited-
Business name: SAME AS ABOVE
many panel, aeration, or
Address:
extension. Dewar: 1 Page 2 77. 2
THERMOSTATSdtWIRING ,
City/ State / ZIP: Each adentiouttl i peetion over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) )ruvestigaUOm per boor 0 br min) 62.50
CCB Lic.: 38868 Electrical Lic.: 261063CR I Suprv. Lic.: 2613LEB Inmuuial plant per tour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Sum: 75 --
Print name: MONTY SCHROEDER 1 Date: 3/3/08
Plan resiew (25% of permit fee):
Stale surcharge
of
T7b of permit fee): L
Authorized signature: AL PERMIT FEE:
Ibis Print name: BRUCE BUTNER I Bate: 3/3/08 t loss Mier it bap expires d a perms is trot °btidmd ai 180
twain smeared as conaiete.
CITY OF TIGARD •
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: E 27/200 Op177
Phone: (503) 639 -4171 4,o i A 612712001
Inspection Requests (24 Hrs.): (503) 639 -4175 p'I JI
INSPECTION WORKSHEET FOR DATE: 7/30/2008 TIME: 7:01AM PAGE 61
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 12909 SW 68TH PKWY 170 LOT #: TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE CENTER
DESCRIPTION: COMMON CONFERENCE
Installing thermostats and (1) low voltage proterliye-sigrraiirt .g-systern.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 233 -6911
Inspection Request Scheduled For: Date: 7130/200[3 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 073416 -02 503 - 519 -6199 Y
Corrections /Comments /Instructions: HALL vJA
l W s VISIT 41 • 1 S 'mutt. S utt. F&
''C• si Kt • A N 1M • P 5 r Ala Ng
P L.o./.) \fin ,A x; c rEc? I kg s, NALAN
S' :? Al L ,0w i Q DO 71 AiS IP �� 0
C.6 gRs.at . bo- DoT AV E
Li s &--
NO Na. g ibt l
J
j
1
/ 1
PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 'Z3 • N (Vis Le" Date: 1 . Phone #: (503) 718- 2--1196