Permit 7 .----/ /�
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
�► D EVELOPMENT SERVICES PERMIT #: ELR2005 -00120
,' II DATE ISSUED: 5/20/2005
13125 S W Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 500 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: HVAC low voltage.
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:
TIGARD TRIANGLE I LLC AMERICAN HEATING
4650 SW MACADAM AVE STE 220 1339 SW GIDEON ST
PORTLAND, OR 97201 PORTLAND, OR 97202
Phone: Phone: 239 -4600
Reg #: LIC 33135
ELE 26- 993CRE
FEES SUP 2640LEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/20/2005 $75.00
[TAX] 8% State Surchar€ 5/20/2005 $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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
through OAR 99,001-0)00. You may obtain copies of these rules or direct • -lion to / NC a, 246 --6699.
Issued By: ; G 4: .L� Permittee Signature: (G' U' nc Cc7e r
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.
P IIF'...----
trical Permit App
llCat1011 FOR OFFICE USE ONLY
7 Received
i Permit No.:
city of Tigard EV E® Da[eB : i i 4 . , /.
13125 S W Hall Blvd., Tigard, 0�� Plan Revi
Phone: 503.639.417 Fax: 503.598.1960 `F°" 1414 Date/By: Other Permit:
Inspection Line: 503.639.4175 -« i ' Date Ready/By: to . a See Page 2 for
Internet: WWW.Ci.tigafd.Or.US ,V���( ® 2005 Notified/Method: ( i4 Supplemental Information
' . '(; 0K)bk iC Q ' ..s ,:, ,,, REYIE W :. :
.,' : v _ _: .. . .. , ... � ` +iice,�
❑ New const ' f �Vn'� ®(laltitMlacement Please check all that apply:
['Service over 225 amps, comm'1 ❑ Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
u 1 r` " s r{ f CATEGORY O CO1�,STR1JCTIOPI tT of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling ' Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑ Building over three stories ['Feeders, 400 amps or more
❑ Master builder ❑ Other:
['Occupant load over 99 persons ['Manufactured structures or
? ' :I- r (- JDB'$I1TE INFO) MATION. ? AND LOeATLOIY 4' _ . ❑Egress/lighting plan RV park
Job no.: I Job site address >a / Sew 65P 1,0 ❑Health care facility ❑Other:
7 Submit 2 sets of plans with any of the above.
City/ State/ZIP: jecle The above are not applicable to temporary construction service.
•
Suite/bldg. /apt no.: Project name: / , � 7 2 / • sc , . ' : FEE *;.SCHEDULE._
eV/ , ;
�- n/ ✓�°/s �7L/ D es cri ption 1 Qty. 1 Fee. ^ 1 Total 1 ••
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: Lot no.: Ea. add'I 500 sq. ft or portion 33.40 1
Tax map/parcel no Limited energy, residential 75.00 2
., ` , , z y �� : 4� v Limited energy, non - residential 75.00 2
':, `. .�.wc a .. `a i pESc0:1.0[Ol�t �AR , 0:i.. C`
., ; ? *. . •-,? •,� __ s .: � •' dr Each manufactured or modular
dwelling, service and/or feeder 90.90 2
N/the - 7A e r - r - Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
';. a '[ ijit(i R wN L4 4 t w ,+ , jk y ? ' , �) ' - E A�VT ft t ,:. LL 201 amps to 400 amps 106.85 2
- 401 amps to 600 amps 160.60 2
Name: 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: ( ) I F ax: ( ) relocation
200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 I 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
' :xr -r $ _ y ,--
,a i: A. Fee for branch circuits with
.
,1 :. 's , E- , - , ...
-.5 a _> -, ° ,:.:-4",_,','5e l?01!ITACT �tSONs x f� ,: service or
h circuit
der fee, each
Zerlear) 'y / bran C 6.65 2
Business name: Contact name: / B. Fee for branch circuits
° �a ," m e without service or feeder fee, 46.85 2
Address: A33 9 ..C''.4 d pn ,71 each branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: 0• J 4€ 7 � 471 Miscellaneous (service or feeder not included)
Phone: (s()3) a3 ? !>✓p '� I Fax: : ad) 239'...702.43 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
i ' e r Y ' .. CO CTOR ` ' '"t `t _ energy panel, alteration, or
extension. Describe: ,i - Page 2 2
Business name: ,42,..,, Pe ,. ` c /o,g J 2i a
Address: /3 3 9 r l ✓ �� Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: �d L fit,) ci ae "7200 Investigation per hour (1 hr min) 62.50
Phone: (,,$Z3 39— 7 6 Fax :, j) a3 9_ 7088 Industrial plant per hour 73.75
, { Ogi :PERMIT. FEES* s . ,
CCB Lic.: 33 / - I Electrical Li� " / �� Suprv. L ic.: a b S/ Subtotal
Suprv. Electrician signature, required:°r' "a A--- Plan review (25% of permit fee)
Print name: S'. t_V'E r 0 ttin 1 Date: S- / /6 /,� State surcharge (8% of permit fee) ., / TOTAL PERMIT FEE 4 Authorized signature: ,-'/J/� This permit application expires if a permit is not obtained within 180
����'"////fCCCX/ days after it has been accepted as complete
Print name: / p /` Q ,. ) ,.., m , e' D ate: 3 /Jg/ • Fee methodology set by Tri- County Building Industry Service Board
Nurnber of inspections per permit allowed.
is BuiIding \Permits\ELC- PermitApp.doc 12103 440- 461ST(10 /O2/COM/WEB
CITY OF TIGARD
t DIVISION PERMIT #: ELR2005 -00120
j 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/20/2005
Phone: (503) 639 -4171 4orai�
Inspection Requests (24 Hrs.): (503) 639 -4175 -_..
INSPECTION WORKSHEET FOR DATE: 6/3/2005 TIME: 7:09AM PAGE: 71
SITE ADDRESS: 13221 SW 68TH PKWY 500 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: UNIVERSITY OF PHOENIX EXPAN
DESCRIPTION: IVAC low voltage.)
OWNER: 11GARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 239 -4600
Inspection Request Scheduled For: Date: 6/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 008265 -01 503-209-0731 N
Corrections /Comments/ Instructions:
11-or ca.* , pP. v1 g, k- to.e. rV6 4"L
- / A A / 1 00 _, Q _ A H J • 1 t
1 / ASS ', PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 614 - Date: „k Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00120
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/24/2005 TIME: 7 :09AM PAGE: 57
SITE ADDRESS: 13221 SW 613TH PKWY 500 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: UNIVERSITY OF PHOENIX EXPAN
DESCRIPTION: HVAC low voltage.
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 239 - 4600
Inspection Request Scheduled For: Date: 5/24/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 007573 -01 603- 209-0731 N
Corrections /Comments /Instructions:
C-J0 kl \t LTV ? 1Z\ \OM* [-\)\W
k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � Date:S`° Phone #: (503) 718 -