Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
- - COMMUNITY DEVELOPMENT Permit #: ELR2011 -00141
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 220
Project: Archibald Subdivision: PACIFIC CORPORATE CENTER Lot:
Project Description: Low voltage for HVAC
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 233 -6911 PHONE:
FAX: 503 - 238 -9767
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/21/2011 $75.00
12% State Surcharge - Electrical 06/21/2011 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
•
HVAC: Y Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in • -- - - with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT' NTION: Orego • law = =•'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 '010 through OAR 95 '.1 -009'. o obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issu By: ' ' Permittee Signature: 4
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 Application FOR OFFICE USE ONLY
City of Tigard RECEIVED Received
Date/B : "/ at // 1191 Permit No.: L/2„„foly-ea
. .1 13125 SW Hall Blvd., Tigard, Tigard OR 97223 Plan Review
1111
. .
Other Permit:
' ' ' Phone: 503.639.4171 Fax: 503.598.1960
2011 Date/B
TIGARD :
Inspection Line: 503.639.4175 JUN 21. Date Ready/By: turis: f?1 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
.
,.:( =" 7-
'', , ,1, 4 ,,,,itjatm ,
-.. , - mk: - - ll'IGDIVISION "'' ' iir ' ' ''Plese check all that apply ( sets of plans w/iteMschec)ied below):
0 New construction Ei Addition/alteration rep accmcni
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: , where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
tlit 4 4 1 4 7- ',-:':':: '-'- "A ' 12 5 i,Cq.4 )7 - -' ,Y; 1 .i. 0 .0- '6 : 6 - ;*0: ' ' '' .:-,v i4,1;1Qftf: .;', 14
less to ground, or exceeds 14.000 0 Commercial-use agricultural
0 1- and 2-family dwelling Z Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family El Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
,,,..,,, 0 Emergency system, larger separately derived system.
41;t4§L,Tt ,11,1)P,SAIA1101,1 - , :; ,--,..:,;;?; ';:-,, 0 Addition of new motor load of
Job no.: 3096 Job site address: 6650 SW Redwood Ln 100HP or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: TIGARD OREGON. 97224 12 Health-care facilities. El Supply voltage for more than
13 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 220 Project name: Achibald El Service or feeder 600 amps or more.
FN T.' 17-4;.Ekooktop.1,,c
Cross street/directions to job site: Description I 00. I Fee. I Total I *
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. ft. or portion 33.92 I
Tax map/parcel no.:
d
Limite energy, residential
67.84 2
tROVIIV :"ACW ' 5t:i*SO415 Ij ,,,- -:1:2 (with above sq. ft.)
Limited energy, multi-family
67.84 2
Relocate thermostat & wire . residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
- Mir' K = '-'iNSAlt: n irgrgi Arl.74"' 201 amps to 400 amps
iniiiiiatYrR,Omt,pil-oW,?':; L-. :...._ .. -;:',9,-,,,Fir.-..p: . amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts . 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) • 200 amps or less 59.36 , 1
201 amps 10 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
rcEeNfActAligbN ,,IA above service or feeder fee,
7.42 2
each branch•circuit
Business.name: PROTEMP ASSOCIATES B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: BRUCE BUTNER branch circuit
Each add'l branch circuit 7.42 2
Address: 9788 SE 17 AVE Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: PORTLAND OREGON 97222 67.84 2
dwelling, service and/or feeder
Phone: (503) 519 Fax: : (503) 238 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E bruce@protmp
Sign or outline lighting 67.84 2
., ,,,wr: .t1I45 'r':,..fiW, tcmd_RATefgkg!P' .:47.-cet'.'-',7 . Si circuit(s) or limited-energy
Business name: SAME AS ABOVE panel, alteration, or extension. Page 2 / "J 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr _
Investigation (1 hr min) 66.25/ hr
-
City/State/ZIP: ,
. Industrial plant (I hr min) 78.18/hr
_
Phone: ( ) Fax: ( ) • Inspections for which no fee is
90.00/ hr
specifically listed CA hr mm)
CCB Lic.: 38868 Electrical Lie.: 261036 Suprv. Lie.: 2613LEB 7:'"' iN: 'kEitgllatteRiffMt . 'W "--
Subtotal:
Suprv. Electrician signature, required: N...__ ),,, ... (...-------
NN %-1 - -..._. Plan review (25% of permit fee):
Print name: MONTY SCHROEDER Date: 6/21/11 State surcharge (12% of permit fee): 9..°°
TOTAL PERMIT FEE: tgel. 00
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 6/21/11 * Number of inspections allowed per permit.
1: \ Budding\ Permits\ ELC-PermitApp doe 10/01/09 440-4615T(11/05/CONEWEB