Permit Ai CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00351
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/2/2007
PARCEL: 2S 112AD -01100
SITE ADDRESS: 06670 SW BONITA RD ZONING: I -P
SUBDIVISION: PAUL SCHATZ FURNITURE LOT: 001 JURISDICTION: TIG
PROJECT: PAUL SCHATZ FURNITURE MAJ. MOD
Project Description: Phase 2 - Low voltage wiring for 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:
PACA PROPERTIES LLC HVAC INC
6600 SW BONITA RD 5188 SE INTERNATIONAL WAY
TIGARD, OR 97224 MILWAUKIE, OR 97222
Phone: Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
FEES • Reg #: ELE 26- 571CLE
LIC 50897
Description Date Amount SUP 605LEA
[ELPRMT] ELR Permit 10/2/2007 $75.00 .
[TAX] 8% State Surcha 10/2/2007 $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 questio s to OUNC at 503.246.6699 or 1.800.332.2344.
i /
Issued By: 'j / � / _ / ` Permittee Signature: , �'l'1 r 2 _ h 6 6-.).-,
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 Applicatiwk.,e% . .
'FoRoFFict: USE ONLY ' . 2 , . -..
- . .', ;= A, ,p, • ' . - . . ,
it of Tigard ' - Received
titUE1 _, 0,......1
Date/By. -/ 1‘..7 i Permit No.: e&a 7 ...551
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 SEP 1 , ..,,,,IL, , D Plan Review
Other Permit:
--
Inspection Line: 503.639.4175 -1-Ir '74 - 11 - Mat : inns: El See Page 2 for
Internet: www.ci.tigard.or.us CITY() - - 4:. . ,r Notified/Metho Supplemental Information
- BUILDINGDIVISION ,
.- '
0 New construction ii Additio(alteraticreplacement Please check all that apply: .
12
0 Service over 225 amps, comm'l 0 Hazardous location
Demolition 0 Other:
OService over 320 amps - rating 0 Buildng over 10,000 sq. ft.,
:. • ":„ 2i.;. Ekii6Z):::_if-rii '
C, NSilliJCI101■1 ', ..:.--":-- :- of 1- and 2-family dwellings 4 or more new residential
0 1 - and 2-family dwelling iv, Commercial/id
p ustrial 0 Accessory building
_.,
DSystem over 600 volts nominal units in one structure
0 Building over three stories OFeeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
DOccupant load over 99 persons 0 Manu factured structures or
. . ,.
, '-. -',' = -....•.!..:••,',-- 40B SITE INFORMATION AND 'LOCATION - . ]'- ' :' .2 0 Egress/lighting plan RV park
Job no.: 3 7 Job site address: Cogio SU) Bo„...„-tk_. p...ei 0 Health-care facility DOther:
Submit 2 sets of plans with any of the above.
City/State/ZIP: • 1 c 4a,, reAer")/7 The above are not applicable to temporary construction service.
i \ •‘" ".
Suite/bldg./apt. no.: L-) Projt name:? S l pf, •2_
• •
Description 1 Qty. I Fee- 1 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
.. • ... OF :WORK - 'L:=r :-."-- ' ':"' .?, -,. . 1 ' , ''. 4.7 1 , :.:,.::: - ':2- --- -'. Each manufactured or modular
dwelling, service and/or feeder 90.90 2
L..\) CU C/11(..411 a \ -1-6,L, p s . 6 -I-
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
,.....:: .. ,PROPEITidOWNER 1!'. - -, - El TENANT , - 5''...:t.. 7_-•...i-'-1-.7:- 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
N ame: - - 7 .'= :: :' ."'....: ',: ':- -
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 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
T.".:,:' CI 'APPLICANT '''. : ' .- ' -.. : . .' 0 CONTACT. PERSON. ':.-- ..- ":-" A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
2
each branch circuit 46.85
Address:
Each addl branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
-I ''•-=.'2•• . --:= 1 .f•`:;$::-;' , :".:• - r;;: , : - ..M:.4 . 6::' , 1 1. 7CONTRACTOR ., •: • • ,--- 'L - '' - - • - . --Ol:;= : -;:--..-..-: energy panel, alteration, or
extension. Describe: / Page 2 2
Business name: 14-V/6Q,
/
Address: -,- _4) , .„ Each additional inspection over allowable in any of the above
Si g 5 E j..... 4 ( kJ 4 Per inspection 62.50
City/State/ZIP. (V\ I
• al..) Q(..)...k k/2 -, i-e clo-y-\ Investigation per hour (1 hr min) 62.50
l Industrial plant per hour 73.75
Phone: 5C-: ) 4 4 g.-- Fax: 3) w s
:.q;,-k-;•,--T. smamELEcnticAopER 4
CCB Lie.: 5 Electrical Licab...5-71C&& Suprv. Lic.:6,05•LEA Subtotal
Suprv. Electrician signature, required: F ) Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: 1 4.,( 1'77:
SColo 6.2- Date:
TOTAL PERMIT FEE
,
Authorized signature: This permit application expires if a permit is not obtained within 180
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.
iNBuilding\Permits1ELC-PertnitApp.doc 12103 440-4615T(10/02/COMANEB
i
CITY OF TIGARD
BUILDING DIVISION 0 PERMIT #: ELR2007.00351
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 101212007
Phone: (503) 639-4171 i�u�h �
l' Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 315d2006 TIME: 7:00AM PAGE: 16
ADDRESS: 06570 SW BONI1 DDRESS: gG�70 Lam` Dt Nlfi A, RD CLASS OF WORK:
SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: PAUL SCHATZ FURNITURE MAJ. MOD
DESCRIPTION: Phase 2 - Low voltage wiring for thermostat
OWNER: PACA PROPERTIES LLC, PHONE #:
CONTRACTOR: HVAC INC -''\‘ PHONE #: 603 - 462.4822
Inspection Request Scheduled For: Date: 315120013 Pour Time:
Code # Inspection Description C ' Contact # \sage
199 Electrical Final 06613F° 01 503- 462 -4822 Y
Corrections /Comments /Instructions:
. \\\\ , V \ \
` �1
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
❑ FAIL _ CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: V ' iits Date: 3'6 v Phone #: (503) 718-