Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00204
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/29/2006
PARCEL: 2S 114AA -00200
SITE ADDRESS: 16285 SW 85TH AVE 302 ZONING: I -P
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT: JURISDICTION: TIG
Project Description: Thermostat wiring for HVAC.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIRKEMEIER, BRENT T /JANET D TRS SUN GLOW INC
BY THE BIRKEMEIER FAMILY TRUST 2428 SE 105TH
10573 SW NAEVE ST PORTLAND, OR 97216
TIGARD, OR 97224
Phone: Contact #: PRI 253 -7789
Reg #: ELE 141 LMS
FEES LIC 48131
Description Date Amount
[ELPRMT] ELR Permit 8/29/2006 $75.00
[TAX] 8% State Surcha 8/29/2006 $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.
c�
Issued By: �� Permittee Signature: /V
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 A71 k A j 'il,, , ,-_3k1 IF ji pa k:1 14 6Ni . - . ..• -
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City of Tigard , 7., / Remy- .
DateJB . , ./4,e, 13, Permit Nei? --,2191/
gat 6 t5e
13 125 SW Hall Blvd., Tigard, OR 97223
Plan Rev' w
Phone: 503.639.4171 Fax: 503.598.196AUG 5, ..: 2006 , . 1N.SAlii ii Date/By: Other Permit:
Inspection Line: 503.639.4175 . 4Alfr ra. Date Ready/By: 1 EI See Page 2 for
rn
Inteet: www.ci.tigard.or.us : Notified/Method: Supplemental Informath
, . ,.. 1.
.
*- *
-"TtPE MORK - !' '.." rsA... ,. . . , . . .. . . . ItAN. REVIEW .
. .
0 New construction - on alteration/replacement
tTic iti / • Please check all that apply:
OService over 225 amps, comm'l ['Hazardous location
El Demolition El Other:
Service over 320 amps - rating [1Buildng over 10,000 f.
..... .. .. ........ .... . ['..
"... CATEGORY OF CONSTRUCTION. .., ., _ . of 1- and 2-family dwellings 4 or more new resider
CT 1- and 2-family dwelling Tre 0 Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or
El Multi-family 0 Master builder 0 Other:
- '
DOccupant load over 99 persons 0Manufactured structw
IT
• JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: Job site address: / 6 0 . 8s - ...s- s--ti, OHealth-care facility ['Other:
- Submit 2 sets of plans with any of the above.
City/State/ZIP:
ii1.4-go a R.__ The above are not applicable to temporary construction servic
...,
* . .._,
Suite/bldg./apt. no.."3 Project name: aw4 1'4 c,,,, Ar-15 . FEE SCREDULE .
( ye
/ Description I Qty. I Fee. I Total
Cross street/directions to job site: New residential single- or multi-family dwelling unit.
Includes attached garage.
•
(.. emo f 1.feziliA/1) 1,000 sq. ft. or less 145.15
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40
Limited energy, residential 75.00
• Tax map/parcel no.:
S.-Limited energy, non-residential 75.00
. • , DESCRIPTION OF WORK .. ' , -` -" -=. ' - Each manufactured or modular
,,_l . ,A4~7 dwelling, service and/or feeder 90.90
Services or feeders installation, alteration, and/or relocatie
200 amps or less 80.30
'. '.... ,. 0 PROPERTY OWNER I .. 0 TENANT 201 amps 10 400 amps 106.85
401 amps to 600 amps 160.60
Name:
601 amps to 1,000 amps 240.60
Address: Over 1,000 amps or volts 454.65
Reconnect only 66.85
City/State/ZIP:
Temporary services or feeders installation, alteration, and/
. relocation
•
Phone: ( ) Fax: ( ) 200 amps or less 66.85
Owner 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 10 600 amps 133.75
Owner signature: ate: Branch circuits - new, alteration, or extension, per panel
0 APPLICANT I Ifl'CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each
Business name:"6..tyyt/Ce ?cid fo 3 r- e branch circuit
-
B. Fee for branch circuits 6.65
Contact name:
without service or feeder fee,
first branch circuit 46.85
Address: efo Each addl branch circuit 6.65
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle • 53.40
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40
E-mail: 46Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2
Business name:
Address: 2 4e, e tede?...5-- Each additional inspection over allowable in any of the abo
- _ Per inspection 62.50
City/State/ZIP: 67,2_ 7 Investigation per hour (I hr min) 62.50
Phone: (03 ) ..5 .3 - 7 7 er Fax: (5D3 ) .2-S 76 f ? Industrial plant per hour 73.75 i
, ELECTRICAL PERMIT FEES*
6 1401 CCB Lic.41-1 3/ Electrical Lic.t L rvi 5 Suprv. Lic.: /9/ZM5
Subtotal 75 '
Suprv. Electrician signature, required: -.4k..r.d Plan review (25% of permit fee)
c ..---tr-- -
State surcharge (8% of permit fee)
Print name: S 8/0 c/cf e #
L) Date: g - -,
TOTAL PERMIT FEE
Authorized signature: 7 ' This permit application expires if a permit is not obtained within 1.
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed,
i:\BuildingTermitsELC-PermitAno.doc 12/03 d A fl_AA I Cl'i I n/f11/1,1./11/CO
•
Electrieal Pel mit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑
• •
Burglar. Alarm
❑ Garage Door Opener *.
® Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
•
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
•
(SEE OAR 918-260-260)
Check Type of Work Involved:
❑ „ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication' Installation
❑ Fire Alarm Installation
HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
•
❑ Landscape Irrigation Control* •
❑ Medical
•
❑ Nurse Calls
❑ Outdoor Landscape Lighting* .
•
❑ Protective Signaling •
❑ Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
i:\Bui Iding\Permits\ELC- PermitApp.doc - 04/03
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELR2006 -00204
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/2912006
Phone: (503) 639 -4171 atuby�
Inspection Requests (24 Hrs.): (503) 639 -4175 F L
INSPECTION WORKSHEET FOR DATE: 8131/2006 TIME: 7:00AM PAGE: 49
SITE ADDRESS: 16285 SW 85TH AVE 302 CLASS OF WORK:
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: QUALITY COUNTS
DESCRIPTION: Thermostat wiring for HVAC.
OWNER: BIRKEMEIER, BRENT T /JANET D TRS, PHONE #:
CONTRACTOR: SUN GLOWING PHONE #: 253,.7789
Inspection Request Scheduled For: Date: 8031/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 035867 -01 503-849 -5962 N
Corrections /Comments /Instructions:
szst\1eiR.W1 NO b7ec)c)t.rve
g )
../ .,----/„Z„ ,(..., 3 „:„................ ?-- 2 /
\------
\PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: y NOB . Date: i'' ' 6 10 Phone #: (503) 718- 114)
CITY OF TIGARD V
BUILDING DIVISION PERMIT #: E1R2006 0204
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/200G
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/30/2006 TIME: 7:04AM PAGE: 49
SITE ADDRESS: 16286 SW 85TH AVE 302 CLASS OF WORK:
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: QUALITY COUNTS
DESCRIPTION: Thermostat wiring for HVAC.
OWNER: BIRKEMEIER, BRENT T /JANET D TRS, PHONE #:
CONTRACTOR: SUN GLOW INC PHONE #: 253-7789
Inspection Request Scheduled For: Date: 8/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 035781 -01 503 - 849 -6962 N
Corrections /Comments /Instructions:
S olvoccr - 5`PA`p wiles
A te R t\r MAN()
W V �1 Z6 2 Q) AID 0.3-
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` N 6(6 L' Date: $'1 - Phone #: (503) 718- D I4