Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00278
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/15/2006
PARCEL: 2S 113AB -01400
SITE ADDRESS: 07376 SW DURHAM RD BLDG G ZONING: I -
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: AMEC. 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: 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: Contact #: PRI 503- 233 -6911
FAX 503- 238 -9767
FEES Reg #: ELE 26- 1063CRE
LEC 38868
Description Date Amount
[ELPRMT] ELR Permit 11/15/200€ $75.00
[TAX] 8% State Surcha 11/15/200€ $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 or 1.800.332.2344.
Issued By: , � Permittee Signature:
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 Application RECEIVE I 'FOR OFFICE USE ONLY
/1 Permit No.' • City of Tigard Date /B (/ \ I L/` _ • __ _Ii 1 k'� "�`
13125 SW Hall Blvd., Tigard, OR 97223 NOV 1 5 2006 Plan Review `
C ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Permit:
"TIGARD
Inspection Line: 503.639.4175 Date Ready/By: See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: �� El Supplemental Information
(���
TYPE OF I NINGIENGINEERING" PLAN REVIEW -
❑ New construction [ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF .CONSTRUCTION, exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ,[LCommercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB' SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
100HP or more. occupancy.
Job no.: Job site address: 23 '6 sa D tA � ❑ Six or more residential units. ❑ Recreational vehicle parks.
Cl /State / "LIP' A ❑ Health -care facilities. ❑ Supply voltage for more than
ty 7 '54 0 V �+ �7Z Z Y ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: R /ye_ c__ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. 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 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
' DESCRIPTION OF WORK " (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
• ?�`lr. 0e ;$ .70 _ I . c60/NfC.._ d t/ I residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
. 200 amps or less 80.30 2 •
❑ PROPERTY OWNER 0 TENANT • 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
, ,git, APPLICANT CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: pt122,Tr /p 4,o C /, B. Fce for branch circuits
without service or feeder fee,
Contact name: /¢ 46.85 2
�V Lie_ / a T MeR first branch circuit
Address: 1 7 S / 7 Ti., ach add'I branch circuit 6.65 2
i C7 ` e_ ��� Miscellaneous (service or feeder not included)
City/ State/ZIP: /7 -a At t,AJ o °Re , 5 7 7 L Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (?) ) 6 9 --G / 5 iC Fax: : (00 ) 2.32 7C) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR , Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name:
,S t Abs 44., s_ energy panel, alteration, or
Address: extension. Describe: , Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
• CCB Lic.:3 S 9'(, 8 Electrical Lic.:2h t 04? Suprv. Lic.: kci 3[c.3 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES . '
Suprv. Electrician signature, required: Subtotal:
Print name/Nom-92 S i eZ Date: // / J Plan review (25% of permit fee):
State surcharge (8% of permit fee):
Authorized signature: / ��/,) -y- TOTAL PERMIT FEE: �-1 a
• y Date This permit application expires if a permit is not obtained within 180
Print name
Q / W �_ a `,, /1/ /G� ww-4� days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building \ Permits \ELC- PermitApp.doc 0523/06 4404615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
r 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:, • . o-
• Fee for each commercial $75.00
•
system
(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 Tighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
• for all other installations
1:\ Building \Pemiits\ELC- PennitApp.doc 03/23/06
• CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200&+00278
,„ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/15/7006
Phone: (503) 63 4 171 � �lu��i�9� ��I
Inspection Requests (24 Hrs.): (503) 639 -4175 s ` __..
INSPECTION WORKSHEET FOR DATE: 11116/2006 TIME: 7 :00AM PAGE: 61
SITE ADDRESS: 07376 SW DURHAM RD BLDG G CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: AMEC
DESCRIPTION: AMEC. HVAC.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC (8gv C-1 PHONE #: 503 -233 -6911
Inspection Request Scheduled For: Date: 11/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 039847 -01 503 -519 -6199 Y'
Corrections /Comments /Instructions: \
\\\ 1Q\
Cf \/\
.tes \IV
PASS I PARTIAL APPROVAL I CANCEL n NO ACCESS
I AIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: N € L, Date: Ili I6 6t Phone #: (503) 718- -2.14t