Permit CIT O F I ° T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00114
'�� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2006
PARCEL: 2S 113AB - 00101
SITE ADDRESS: 16101 SW 72ND AVE BLD.A ZONING: IP
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: HVAC (2) roof top A/C units.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
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
[ELPRMT] ELR Permit 6/2/2006 $75.00
[TAX] 8% State Surcha 6/2/2006 $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 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: - t Permittee Signature: Zfi
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 A :tic ' FOR OFFICE USE ONLY /� 21 I /
City of Tigard ac _ Red
� o , Permit No.:6 6 . C" /! y
13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 2006 Plan Review V
Phone: 503.639.4171 Fax: 503.598.1960 . W 1. Date/By: Other Permit:
Inspection Line: 503.639.4175 7 Date Ready/By: , a IL, HI See Page 2 for
Internet: www.ci.tigard.or.us � n OF avr •' ^' l
Notified/Method: l ( Supplemental Information
BI PpDTG l kTrg PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION 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
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: 8647 Job site address: 16101 SW 72ND ❑Health care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: TIGARD OREGON 9 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: 191 BUILDING FEE* SCHEDULE
Description I Qty. 1 Fee. I Total I **
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'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
DESCRIPTION OF WORK Each manufactured or modular
DISCONNECT AND RECONNECT LOW VOLTAGE ON TWO 35 TON ROOF dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
TOP A/C UNITS 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: PACTRUST 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: ( ) Fax: ( )
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 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
® APPLICANT ® CONTACT PERSON A. Fee for branch circuits with
• service or feeder fee, each 6.65 2
Business name: PROTEMP ASSOCIATES branch circuit
B. Fee for branch circuits
Contact name: BRUCE BUTNER without service or feeder fee,
first branch circuit 46.85 2
Address: 9788 SE 17 AVE
Each add'I branch circuit 6.65 2
City /State /ZIP: PORTLAND OREGON 97222 Miscellaneous (service or feeder not included)
Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Pump or irrigation circle 53.40 2
. Sign or outline lighting 53.40 2
E -mail: BRUCE@PROTMP.COM Signal circuit(s) or Iimited-
CONTRACTOR energy panel, alteration, or
extension. Describe: 1 Page 2 2
Business name: SAME AS ABOVE
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 38868 Electrical Lic.: 261063CRE Suprv. Lic.: 2613LEB Subtotal
Suprv. Electrician signature, required: , l _ " Plan review (25% of permit fee)
,L . - --rteF :a. , -�;N i.,- , :.z: 'V
j State surcharge (8% of permit fee)
Print name: (--" , Date: 6/2/06
Al �J C � ' � A .0 ' TOTAL PERMIT FEE
Authorized signature: J This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: / ft (J"LC___ A,, Date: 6/2/06 • Fee methodology set by Tri- County Building Industry Service Board
Number of inspections per permit allowed.
i:\ Building \Permits \ELC- PennitApp.doc I2/03 440- 46I5T(10 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION . . #: ELR2006.00114
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/2006
Phone: (503) 639 -4171 j�l
Inspection Requests (24 Hrs.): (503) 639 -4175 =� ` __..
INSPECTION WORKSHEET FOR DATE: 7/612006 TIME: 7:03AM PAGE: 17
SITE ADDRESS: 16101 SW 72ND AVE BLD.A CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: PACTRUST
DESCRIPTION: HVAC (2) roof top NC units.
OWNER: PACIFIC REALTY ASSOCIATES PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 233 - 6911
Inspection Request Scheduled For: Date: 716/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 032738-01 503- 519 -6199 N
Corrections /Comments /Instructions:
\ Ass ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
' ❑FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �' 6 Date: 1 ()It) Phone #: (503) 718- 21446`