Permit •
CITY TI GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
, DEVELOPMENT SERVICES PERMIT #: ELR2006 -00018
I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/12/2006
PARCEL: 2S101 DA -00101
SITE ADDRESS: 13190 SW 68TH PKWY ZONING: C -P
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 003 JURISDICTION: TIG
Project Description: Low voltage 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 NW PROPERTIES AMERICAN HEATING
6600 SW 105TH 1339 SW GIDEON ST
BEAVERTON, OR 97007 PORTLAND, OR 97202
Phone: 503- 626 -3500 Contact #: PRI 239 -4600
FEES Reg #: LIC 33135
ELE 26- 993CRE
Description Date Amount
[ELPRMT] ELR Permit 1/12/2006 $75.00
[TAX] 8% State Surcharl 1/12/2006 $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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 95 01 -0100. You may obtain copies of these rules or direct questions to / OUNC a 503 -2 6-6699.
Issued By: Permittee Signature: ,G W / er
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.
• e
Electrical Permit App FOR OFFICE USE ONLY
I I V E Received / /
City of Tigard Deem . / — / -06, � PermitNo.: _ ,. 4 04 _ � l',
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
/ /�'�' "'"' t,
Phone: 503.639.4171 Fax: 503.598.1960 JAN Other Permit:
p,,
Date/B •
Inspection Line: 503.639.4175 Altl 2U ���. f••' �� Date Ready/By: ® See Page 2 for
Notified/Method: Supplemental Information
Internet: www cl ngazd.or us CITY OF TIGARD
R3 -. lvL: .. � y'�� . •,,��. • � %i ^ail Sr.i
❑ New construction I Addition/alteration /replacement Please check all that apply:
❑ Demolition • Other: ❑Service over 225 amps, comm'I ['Hazardous location
eke i ell
x,.
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
x `el x , r :. J a i i3n � y "�` d� , E o `�� *S,2 . t f : t:k-t f of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling R Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family 0 Master builder
❑ Other: ❑Occupant load over 99 persons El Manufactured structures or
' ,.; m R- ae : r ro i - r t F , s v 0
AC, _ i � 9,4,,M. 4`41`9. ' P-Y. 1. �r� t s 9 4 - mo � ; is c r e: ❑Egress/Iighting RV park
f plan
Job no.: Job site address: /3
'�� ❑Other:
pQ ❑Health :are facility
/3/ y ow 6� QO' Submit 2 sets of plans with any of the above.
City/ State/ZIP: a .. / 7,e 97223 The above are not applicable to temporary construction service.
i - a efi. is„ t, ` PAR " r ' t .
Suite/bldg. /apt. no.: 1 Project name: t s �;ses �� ' �" ?' "" ` s w s -' ,;'.. z+ ••
v Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 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
j 4 t. , 7. r e 4. -1- y . rCycl :; rt'` _.1. }� 1,1 " - &"- r ',4- ,1 , r x?< Each manufactured or modular
dwelling, service and/or feeder _ 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
4 '
,.:Y 1 ) 3`1 , o � 2 a s `r ` ; a ; ; ;; u 1 ' c w!, T y f ;. . �i ,, 201 amps to 400 amps 106.85 2
.t:u,, .L _ r. ? .- ,...,,�, - ` 1 6,u ,2 /-a �.�L _.. . i�� " 1s� i 401 amps to 600 amps 160:60 2
Narne: 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: Temporary services or feeders installation, alteration, and /or
Phone: Fax: relocation
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 33.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
i, h u , l'z , y % f ':iV r; t � �'( '' Y ` ' 9 `" 1: i a aF,:kN r pl SiF.VljN.. Fee for branch circuits with
,1,��.._�43 3�._L_�,. ei <s.`.�1v:(7 �.i.,....u.._�J.i,�. � �,�� ,t., __a� ,,.e.��d:�_. � A.�:,2,211_s..�- service or feeder fee, each
Business name: ff __ branch circuit 6.65 2
hnP(1 CoriG°li.Tdr10 .�i� t'.. B. Fee for branch circuits
Contact name: caje bane, m - V without service or feeder fee, 46.85 2
each branch circuit
Address: S+' i3 '3 9 s o r�j'Jey1 Each add'1 branch circuit 6.65 2
City / State/ZIP: 'ParOa Nd ale q7aDa Miscellaneous (service or feeder not included)
J Pump or irrigation circle 53.40 2
Phone) ..1.� I Fax:: 3) 2 _ Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
fig' Oral.-'' ? "J i ar `'reI,e M • WIC energypanel, alteration, or
sE4 L�CiI(:$c:Eli;.. . '9',.Y7 F iG.r ^_ 'c••11: .[
extension. Describe: I Page 2 2
Business name: )3 M eci 4, 1
Address: Each additional inspection over allowable in any of the above
' , ► S C GI ` �� 411 Per inspection 62.50
City/State/ZIP: QI .4-4a yl d 61 ci 7 ZQZ - Investigation per hour (1 hr min) 62.50
Phone:�6r3) q _ /M J Fax: ) 2 - 70a 8 Industrial plant per hour 73,75 ^
CCB Lic.: as 13S Electrical Lic. --613 Suprv. Lice 4 _ 0 - j2 7" Subtotal
Suprv. Electrician signature, required ∎ - —...• ...A_ .. Q �/ Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: .eve, y awl Date: l )b 0 6
AA., TOTAL PERMIT FEE
Authorized signature: �(�/ This permit application expires if a permit is not obtained within 180
^^^ ---��� days after it has been accepted as complete
Print name: �a� Date: 4/09 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:tauilding\ Permits u t-C- Pcnnitnpp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD
A .
BUILDING DIVISION PERMIT #: ELR20O6.00010
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12J2006
Phone: (503) 639 -4171 pay f�
Inspection Requests (24 Hrs.): (503) 639 -4175 R '� I I
INSPECTION WORKSHEET FOR DATE: 21 13/200E; TIME: 7 : 03AM PAGE: 72
SITE ADDRESS: 13190 SW 60TH PK - CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPO• •TE. PARK LOT #: 003 TYPE OF USE:
PROJECT NAME: B1JSINF_SS OBJECTS
DESCRIPTION: Low voltage HVAC
OWNER: PACIFIC NW PROPERTIES. PHONE #: 603-626.M00
00
CONTRACTOR: AMERICAN HEATING PHONE #: 239-4600
Inspection Request Scheduled For: D:te: 2/ 13/2006 Pour Time:
Code # • • - '• n Description Con m # Contact # Message
199 Electrical final 02670- 01 503-793-4001 N
Corrections ommen r . s:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
•
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Q Inspector: 6 Nou Lx Date: 1 4 13i 64 Phone #: (503) 718- LL b