Permit 3;i. .
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
:. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00118
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/4/2007
PARCEL: 25101 DA - 00102
SITE ADDRESS: 13221 SW 68TH PKWY 401 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
PROJECT: HEALTH NET
Project Description: Low voltage for t - stats
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: Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
FEES Reg #: ELE 26- 993CRE
LIC 33135
Description Date Amount
[ELPRMT] ELR Permit 5/4/2007 $75.00
[TAX] 8% State Surcha 5/4/2007 $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 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: � ` / " 7e. "'""`
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.
i r A , _
Electrical Permit App1i 'atian ",i ; . - ; FOR OFFICE USE ONLY
City of Tigard Receive /� PemutNo. — /
Of) / ,
! I
1312
Hall Blvd., Tigard, OR 97223 �':r t , t 1 L. % Date/By: : / // IOp f Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 '
/�. 1 ,1,,r l 1 Date/By: Other Permit:
Inspection Line: 503.639.4175
:' I J uror 65 See Page 2 for
CI, i r „ ,� a�.� �_,,., Date ReadyBy: g
l . , `mil i ' t 1 �J , Notified/Method: 1 Supplemental Information
Internet: www cl hgard onus �( ffff
.ts:` YJf - . -47 a c v. ,r m, y - 7y . � r;� 1°�' .r_ k r -U ..t.Evf' 2fz, w '� 3`rir'I ��i v 0 • ° r n ipI , k �.�+ N i er r :
`�iR a ' s � f 7_ � - � "i.'L. }. � ._ ��>° c��ff�. taF' �'-.., z��/ �r`' �c r' �. Jt1`i"!lY�,.,�'.Y``:tic,.'i� - — .1 T.z'
❑ New construction :1 Addition/alteration /replacement Please check all that apply:
El Demolition ❑ then: ❑Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
`` . 1 �y ' 3 t p I '.' s ; of 1- and 2-family dwellings 4 or more new residential
4� ,.:.<^�'• '`s r...• 6� ?qa"��.',���� u�- ,H Ei�,� 9.�..�'a�d2�= l.�t�;. 0 �� x �� h ` � v`. �i Y g
❑ 1 - and 2 family dwelling ■ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑ aster builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
T n % j ,. ;' S Es t'_.. t4." 'a-- - 1 P .�r Via. 4.41'' ,I ❑Egress/lighting plan RV park
Job no.: 507 / 76 Job site address: /32 21 SW k 0 /
/ ,�h a ,-hvq ❑ Health care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: r e at - c 0 2 ' - 72 2.3 The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: �0 ` I Project J / 11 4 , A/ -f — ?lit* - :- ,�; ryIP1, {
ect name:
Daerlptlon 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'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: y� Limited energy, non - residential 75.00 2
e J T F o ` ST i v t �E lli G qpi A @� 8fC¢r`'�i�' ° t. ° 1 4 1 Each manufactured or modular 1
� r r � ' � r ,f i b !gip A� FilF.�3m:.€1.+...:...:s.::,az_� � +..� . :^�'.
e.fiE..6'..•�.� f_. L�1a.,` :+.�:fuL..`���'�'�1���7 iHd w1�3..v. e_+..d
,V,9 - /OW ✓C7 / f j G f S 1 1— dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
kV / 1 e 200 amps or less 80.30 2
. r �, y �, ,. n mod' " 3 ,,r * y ,.. �� f T r; , - 201 amps to 400 amps 106.85 2
fr s�./ • 21 6� , : r l ,:.4.:it'V'3„ "b ..... . : ;s t r ;� - ,a J_.;f 5- �"S9y.#?�a 1 k.fs "F i
.::b..�,.:- ._�� � .a�,_W:�;�," ,� �/. � F �_��:�y .5�., - -�` � � .V�rz,"'.1.1's,-:r.-`-�` 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
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
( /nor installation: This installation is being made on property that I own which is not _ 201 amps to 400 amps 100.30 '
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
} r �> a.. b,�.�. i E c i. r u Gr , . I rilx �' y +r' Ig.itit 'N> . A. Fee for branch circuits with
. u . e ' � `.. A:, ,. z �5 � S+ • _ h3t� `_. ....- .�- -:.t 1 service or feeder fee, each
Business name: �mp ( ( c ofk .c.(421 n G �(, ( ,
branch circuit 6.65 2
/ 1 B. Fee for branch circuits
Contact name: ,rri raj e (00 � Jp e i without service or feeder fee, 46.85 2
each � branch ..�� 1 5 E &. I (� ! I S4 Each a dd'1 branch circuit
Address: 0 � 1 circuit 6.65 2
City/State/ZIP: ) 0 �(`-1 i t 0 q- a 0 O• Miscellaneous (service or feeder not included)
a( � p Pump or irrigation circle 53.40 2
Phone: ( ) D ..--0 1 _ b600 I Fax: )a D .- y ! 6�0 Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
z s' a 2 a '�', I(, � r r ° energy panel, alteration, or 1
,• ' F s i 2s i Y r ,, e. L 0 P tY ht, _ . .. y � 1..„, ' . g, ,,�,,,f1 8Y P
_ extension. Describe: Page 2 2
Business name: 19 11 ('. • r -� ( J _(1 C .
Address: � 3 Se (; 0 ) ' �.3T r Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: " -4 / 0 4 q--) ova Investigation per hour (1 hr min) 62.50
Phone: ( ) �(..l 0 0 I ( ) � ,,033 Industrial plant per hour 73 75
Fax• � 7s ro,
' iii� . d.' .g. Lk *V rsc. ,rs 1 � _ - its ::-. . 4 ri. .. s
CCB Lic.: 33 t 35 Electrical Lic.: 64 3 C e Sup Lic.: .( -10 LEE Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
r� 16e/it., _O 7 State surcharge (8% of permit fee)
Print name: � �(� � 0 ( / Date: 5 - �/
t TOTAL PERMIT FEE
Authorized signature: � I / , _ 4 ` 'A MN permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: �j / Date: 5 —4--0 • Fee methodology set by Tri County Building Industry Service Board
V m m l �l U d •• Number of inspections per permit allowed.
is\ Building \Pennits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION A— PERMIT #: ELR2007-00118
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2007
Phone: (503) 639 -4171 I�+�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/4 /2007 TIME: 7:01AM PAGE: 90
SITE ADDRESS: 13221 SW 66TH PKWY 401 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEALTH NET
DESCRIPTION: Low voltage for t -stats
OWNER: TIGARD TRIANGLE I LLC. PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 503 -239 -4600
Inspection Request Scheduled For: Date: 6/4 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 1 946302 503 - 513.0534 N
Corrections /Comments/ Instructions:
_ TAT wia.:IN w,pi cuy4,A
ti 1j P'
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -�• I v V A Date: b. +03 Phone #: (503) 718- 1A
•
CITY. OF TIGARD
BUILDING DIVISION - • PERMIT #: ELR2007 -00118
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7:01AM PAGE: 91
SITE ADDRESS: 13221 SW 68TH PKWY 401 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEALTH NET
DESCRIPTION: Low voltage for t -stats
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 503-239-4600
Inspection Request Scheduled For: Date: 6/4/2007 Pour Time:
Code # Inspection Description Confirm_ # Contact # Message
135 Low voltage l / 049483.01 503.519.0534 Y
Corrections /Comments /Instructions:
- r- s`FA1' d (et Not f∎pPN''
AASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` W 08 Date: 1Y " J Phone #: (503) 718 - 1—