Permit F ,� CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
ill ; . 2 COMMUNITY DEVELOPMENT Permit #: ELR2009 -00103
Date Issued: 04/09/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 parcel 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 200
Subdivision: Lot: 0
Project: Allstate Insurance
Project Description: Low voltage for HVAC
FEES
Owner:
Description Date Amount
BEHRINGER HARVARD WESTERN
PORTFOLIO LP, BY EASLEY MCCALEB & Restricted Energy Permit 04/09/2009 $75.00
ASSOCIATES I, PO BOX 190700 12% State Surcharge - Restricted Energy 04/09/2009 $9 00
PHONE.
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202
PHONE: 503 - 239 -4600
FAX: 503 - 239 -7038
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo Boiler Controls
CCTV Clock Systems:
Data & Telecommunications: Fire Alarm:
HVAC: Y Instrumentation Total $84 00
Intercom /Paging Landscape /Irrigation
Landscape Lighting Medical Required Items and Reports (Conditions)
Nurse Calls Protective Signal:
Security Alarm. Other:
Other Desc
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 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
the 180 d ys AT E lO • Ore. • r law requires 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- 401-01'1 You may obtain a co y of the rules or direct questions to OUNC by calling 503 246.6699 or 1 800 332 2344
/ , I B((c/ / -ic h e 5 7 e^
Issue By: �1 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 . : _- _ FOR OFFICE' USE ON
C of Tigard pEC'E DE Da Perin ` i No , r IN 1 3125 SW Hall Blvd , Tigard, OR 972
,, . Other Permit
C
Phone 503 639 4171 Fax 503 598 1960 Date/By
TIGA -RD Inspection Line: 503.639 4175 - 9 2009 Date Ready /By !uns ® See Paget for
Internet www tigard -or gov APR Notified/Method /� Supplemental Information
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❑ New construction ZAddition/alter:;� 1&16dR1@li# V 1j1O1 • - - 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 ❑ Mannas and boatyards
i.-'z [, ":�cd »:,i~ °:'�.,4;y - , ' a; ,° Vfir, ; �5.
,� %5_. _ "�:a., ^ ^ � ;�«,,,,�,.�, ,�'-' - - ;� ,� - �=,z.�, ^:���> , exceeds 10,000 amps at 150 volts or Floating buildings
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z.. T,,. ' -, ,, .- •,CATEGORY`OF } CO1V$TRUCTION , ill 1 i ^; %1 t - S.> less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
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El 1- and 2- family dwelling [�] C ommercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
n . ,,,,9r z N •, ' ,;,,' aF ,, „ _ , , ,� - ,h� : ❑ Emergency system. larger separately denved system.
<.1ra x JOB °'r. - RM A'_TIO N - _ : A N D ' '• LO C A I O Nr ,, ; k i .
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�':xr..r� ��a �r:� ,..:�"s'�� , ,i S1TE��O ...- -- . _„ ... . ..... .. . .... .:. ..�.�-,.. h. ,- ;� . ❑ Addition of new motor load of ❑ .. .. ., 3 „
Job no.: Job site address: 7( $W Dv h Nm Rd Si more re
xH more occupancy
❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: T gar,/ O� ❑ Health -care facilities ❑ Supply voltage for more than
( ❑ Hazardous locations 600 volts nominal.
Suite /bldg. /apt. no.: ( "pa Project name: ,4 /15 fe TIT ❑ Service or feeder 600 amps or more `* ew. , y
rt
" `..w ”? 4 : : »O :',. , SCHEDUI.EC a :t -:
Cross street/directions to job site: Description I Qty. } 1 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
Tax map/parcel no.: Ea add'l 500 sq ft or portion 33.40 1
Limited energy, residential 75 00 2
Ar :i> j t :' s.u -- ' Asa r
t,,' : s', .'" �; ram, . , fisi ,..,, i v: €° : ,, (with above sq ft
- .rr, :
� � ''�u� " ��.`; �:- .. 3t .,r,.. �Y'��_ 7 �.r-r:,:. . ; :�;° ( q )
Limited energy, multi - family
NV A G h i od i f /c4 17 a ✓15 �' �0 VI/ VO �7 y G residential (with above sq ft ) 75.00 2
w% Services or feeders installation, alteration, and/or relocation
K7
'FSV ®;O 200 amps or less 80 30 2
PERTY; O:VY**gq -3.M-' • -��:, ; *(:1 NANT �, ;n:, r ,;: �_ c . amps 106 85 2
201 amps to 400 am
?��?:`... »,xl,� . 5 ,> �., ..F ..„...,,M , ...�. _...., „ ,: �a�r�. �� , . ,.. , . „.,..��,��3�.,.u,ti: ,.mot, . .....,. P P
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
Mel fS.. ° "; zi ' ; `; is"a *; W :, ' " r.: ';K` =' a bove service or feeder fee
r .. [v�' tAPPLICAIVT. ;: :t..,,.. "= = ',t;. "� ,;'CONTACT; PERSON, 4 ..- t.., 65 2
�v „._ :..... r. „_ , , .< °r .,,aea:' ._ -, ..;.. ; . , each branch circuit 6 6
Business name: AMC!' I C O4 ff m -/-) n y B Fee for branch circuits
Ear S 7 I S CJ
Contact name: ))-- V r without service or feeder fee,
first branch circuit 46 85 2
Address: 133 / 5 E ' 1 ci eon .--/-- Each add'I branch circuit 6 65 2
P o r � ��1(� OR ? 2 O2 Miscellaneous (service or feeder not included)
Ci ty /Sta / ZIP: Each manufactured or modular 90 90 2
c 50) 23'1- I/ (o 0O (s 3 2 - 3 S dwelling, only and /or feeder
3
Phone: Fax: � (7 ) 3 9 0 Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53 40 2
4 `, , "~3; z. „; ;; rfr; , . "r ? ;.,, �,;. �"°,. �:xx. i:<' lighting 53 40 2
�; +�,�..�„;�;;^' �,� :_��. >,.� =�.w�_ ,CONTRACTOR�i:��'f�'rra� ��z,.Cb, >��3�s.� k, :�_: Sign lgnorouthneli g t g
Y ,Lf Signal circuit(s) or limited-
Business name: ✓h e/' C ��'1 / i e4 �7^ �i^t energy panel, alteration or
Address: /33 9 ,5E' r�'/ eleo,. S exten i n A es,�ribe• Page 2 �
alteration, � , 2
City/State /ZIP: fO r' --/- / (' OR 972o 2 Each additional inspection over allowable in any of the above
(503) 231 1 / '00 ( 23 - 70 3 8 Per inspection 62 50
Phone: (503) F�� Investigation per hour (1 hr mm) 62 50
CCB Lie. 33 /3 5 Electrical Lic.:Z6 773arE Suprv. Lie. Z0y0 LE6 Industrial plant per hour 73 75
,. e. s'y :o / ELECTRICAL PERNITP.:FEES, µ:: W, y'✓_ Vii'_
Suprv. Electrician signature, requir Subtotal
Print name: 7" St ve ✓) YO v h Date: y- q- 0 7 Plan review (25% of permit fee)
/ State surcharge (12% of permit fee).
'Re ��h'
Authorized signature: � 1 -' TOTAL PERMIT FEE S 4( ,QC
Print name: B rqd M es I et- D a t e: y / - - 0 9' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit
I \Budding\Permns'ELC- PermiApp doc 05/23/06 440- 4615T(1 1/05 /COM/WEB