Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
I
DEVELOPMENT SERVICES PERMIT #: ELR2001 -00238
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/25/01
SITE ADDRESS: 15865 SW 74TH AVE 110 PARCEL: 2S112DC -01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: Controls for 3 HVAC systems.
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: 3
Owner: Contractor:
PACIFIC AMERICAN PROPERTY EXCH CLIMATE CONTROL
PACIFIC SANTA FE CORP 3315 NW 26TH AVE
17700 SW UPPER BOONES FERRY RD PORTLAND, OR 97210
PORTLAND, OR 97224
Phone: Phone: 223 -4393
Reg #: SUP 311S
LIC 62196
ELE 26- 811CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 9/25/01 $225.00 2720010000 Elect'l Final
5PCT CTR 9/25/01 $18.00 2720010000
Total $243.00
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by .l. - i Permittee Signature I ( t_ . �/�,�� -p
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
~... Electrical Permit Application .
Date received: 9/25/60/ :::: � City Of Y T igard j /6 Project/appl. no.: :
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97 Date issued: By Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
\: , . , : , TYPE O F PERMIT ., : ... •
❑ 1 & 2 family dwelling or accessory El Commercial /industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
. JOB SITE INFORMATION,-
Job address: , , , vl " i-h 4 0 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: i . ; - m ' J ,l n o VA ; O r\ Description and location of work on premises: G0J77j _S //z. /f /i-e_,
Estimated date of completion/inspection:
,`'CONTRACTOR APPLICATION . : FEE SCHEDULE
Job no: Fee Max
Description Qty. (ea.) Total no. insp
B1 •t - • C I i m fl Q Co '0 New residential - single or multi- family per
Address: 1 6 S oo Stn) , nd TI vc. dwelling unit. Includes attached garage.
City: P t? - /. t,, State: p K ZIP: 9- Service included:
Phone: q - 3 - , a .. - Fax: 96 , - , y E -mail: 1000 sq. ft. or less 4
CCB no.: (, Elec bus. lic. no: o? 6 I C Each additional 500 sq. ft. or portion thereof —_ _—
• a Limited energy, residential ___ 2
Cit lic. no.: Limited energy, non- residential ___ 2
712S/01 Each manufactured home or modular dwelling ME
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders — installation,
. alteration or relocation:
PROPERTY OWNER ' • -> 200 am o less 2
Name (print): 201 amps to 400 amps ___ 2
401 amps to 600 amps ___ 2
Mailing address: 601 amps to 1000 amps ___ 2
City: State: ZIP: Over 1000 amps or volts ___ 2
Phone: Fax: E -mail: Reconnect only ___ 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps ___ 2
Owner's signature: Date: 401 to 600 amps ___ 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
. Name A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: ■■ 2
Phone: Fax: E-mail: Each additional branch circuit: ' ___—
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle ■■■ 2
❑ Service over 320 amps- rating of 1 &2 ❑ Hazardous location Each sign or outline lighting ___ 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* -. ■ 2
O Building over three stories 0 Feeders, 400 amps or more *Descri . tion:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan ❑ Other: Per inspection __
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ a S
❑ Visa 0 MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ /.F, 4z)
Expires accepted as complete. TOTAL $ - o 24/ 3 O U
Name of cardholder as shown on credit card
$
. Cardholder signature Amount 440 -4615 (6/00/COM)
,
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `I Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 I I Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 pi Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 H Garage Door Opener
Services or Feeders n Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 I I Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 I I Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. I 1 Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel pi Boiler Controls
a) The fee for branch circuits
with purchase of service or IT Clock Systems
feeder fee.
Each branch circuit $6.65 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service
or feeder fee. Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 HVAC
Miscellaneous rI Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 I Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over [7 Medical
the allowable in any of the above
Per inspection $62.50 r7 Nurse Calls
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting
Fees: I] Protective Signaling
Enter total of above fees $ 1 Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ Enter total of above fees $ i`` S'
❑ Trust Account # 8% State Surcharge $ / r , o v
Total Balance Due $ YE '
All New Commercial Buildings require 2 sets of plans.
is \fists \forms \elc- fees.doc 08/30/01
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST -
. 44 -flour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / 1 0 1—,�G0 I AM PM BLD
Location / cg‘; 5. tj . r /7�1_, Suite /1 0 MEC
Contact Person IDa r ir►. Ph 1 -/c8 - PLM
Contractor C( v),-t* ( » ,-f- a Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR ' c / (5e,
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation • Drywall Nailing 4 J4c- Loc.() L)o ft-pax to/ b'Iyi4(
Firewall
Fire Sprinkler
Fire Alarm /
Susp'd Ceiling . CO 11/4a �I/ � 14-- A �J��p7- 077-2-710A ,,�o /
Roof /� �ry /
Misc: 2 0-1 C f (91 `� V!
Final
PASS PART FAIL
PLUMBING
Post & Beam -
Under Slab 7 e ;, 17,1
Top Out
Water Service Dc r- Code
Sanitary Sewer P`
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam /
Rough In
Gas Line
Smoke Dampers
' Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
ow o a > ivAC
Fire Alarm
A na
- 41 PART FAIL
SITS
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 1' (7 �j —Di = .+ A I - ,
Other Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.