Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
•
� DEVELOPMENT SERVICES PERMIT #: ELR2006 -00039
:a DATE ISSUED: 2/14/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S 113AB -00600
SITE ADDRESS: 16195 SW 72ND AVE BLD.D ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: LV thermostat.
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 REALTY ASSOCIATES PROTEMP ASSOCIATES INC
15350 SW SEQUOIA PKWY #300 -WMI 9788 SE 17TH AVE.
PORTLAND, OR 97224 PORTLAND, OR 97222
Phone: 503 - 624 =6300 Contact #: pRI 503- 233 -6911
FAX 503- 238 -9767
FEES Reg #: ELE 26- 1063CRE
LIC 38868
Description Date Amount
[ELPRMT] ELR Permit 2/14/2006 $75.00
[TAX] 8% State Surcha 2/14/2006 $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 Taws. 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: r� Permittee Signature: i
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.
Etectrical Permit A s i r '' ''1VED FOR OFFICE USE ONLY
City of Tigard Date /B / Q . D • Permit No.: .. / 4 ‘ /, 4i9
13125 SW Hall Blvd., Tigard, OR 97223r 1 3 O 2006 Plan Review
Phone: 503.639.4171 Fax: 503.598.1 Date /By: Other Permit:
Inspection Line: 503.639.4175 e I - , Date Ready /By: herb El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified, ethod: 04 Supplemental Information
ll
,rn ra,! I 1 i1 r • _, •
1 W/ Mre/ PLAN REVIEW
❑ New construction ® Addition /alteration /replacement / / Ph ase check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. R.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I - and 2 family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: 8804 I Job site address: 16195 SW 72 AVE ['Health facility ['Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: TIGARD OREGON 97224 The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: BUILD d I Project name: OPTION CARE FEE* SCHEDULE
Description I Qty. I 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
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
THERMOSTAT WIREING AND THERMOSTATS dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER 1 ❑ TENANT 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 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 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT 1 0 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, 46.85 2
Address: 9788 SE 17 AVE first branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP: PORTLAND ORE . 97222 Miscellaneous (service or feeder not included)
Phone: (503) 519 -6199 I Fax: : (503) 238 -9767 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
Business name: SAME AS ABOVE extension. Describe: f Page 2 75 - . 4)C1 2
THERMOSTATS &WIREING /
Address: Each additional inspection over allowable in any of the above
City /State /ZIP: Per inspection 62.50
Phone: ( ) I Fax: ( ) Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
CCB Lic.: 38868 I Electrical Lic.: 261063CRE I Suprv. Lic.: 3948LEB ELECTRICAL PERMIT FEES* •
, _\
Subtotal 75.
Suprv. Electrician signature, require ,
Plan review (25% of permit fee)
Print name: ; ' ' Date: 1/27/06 State surcharge (8% of permit fee)
v (y • �°c2 - —
Authorized signature: 1 ` i' A' TOTAL PERMIT FEE g t. i0
This permit application expires if a permit is not obtained within 180
Print name: 6 R ut;o. ehfijum Date: 1/27/06 days after it has been accepted as complete
• Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \ELC- PermitApp.doc 12/03 440-46I5T( I 0/02/COM/WEB
I CITY OF TIGARD r ..
BUILDING DIVISION PERMIT #: 2,2vo6 -0003S
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 40 P111111 1\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: �' 7V' Ave- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: (9)3 S1 S— 6 1 ' 9
CONTRACTOR: G2 PHONE #:
Inspection Request Scheduled For: Date: 3 - oZ — Co. Pour Time:
Code # Inspection Description Confirm # Contact # Message
3
C rrect+erish,ommeen tructions:
s B ATS 03/44
•
N 14 PASS ❑ PARTIAL APPROVAL ❑ CANCEL [1] NO ACCESS
ALL FOR INSPECT ❑ ADDITIONAL FEES ASSESSED
Inspector: %/ �' Date: 5 7 1 -1/06 Phone #: (503) 718- 2
CITY OF TIGARD 4P
BUILDING DIVISION PERMIT #:
cLR1a0E.F.0cci39
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2114/2007
Phone: (503) 639 -4171 u "'gliI�1�11
Inspection Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 2/23/2006 TIME: 7 :01AIvl PAGE: 90
SITE ADDRESS: 16195 SW 72ND AVE Bi D.D CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: LV thermostat.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.624.. 6300
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: i s 3. ••
�{f3 -1:�` E�91 i
Inspection Request Scheduled For: Date 2/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13E Low voltage 027352.02 503-619.6199 Y
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL lACALL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Z 642 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #:E/42006-060.3_6? 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 I I ?�
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I ...
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 6;1 79- /` P/ e- CLASS OF WORK:
SUBDIVISION LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE 023)5 - ( 191
CONTRACTOR: e * PHONE #:
Inspection Request Scheduled For: Date: 4 -7 - 00$ Pour Time:
ode # - section Description Confirm # Contact # Message
P
Correc . '- -' . ents /Instruc' ons:
•
Q
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A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr . N be l- Date: .4.• Phone #: (503) 7181