Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
f, DEVELOPMENT SERVICES PERMIT #: ELR2006 -10021
T'�I1 DATE ISSUED: 3/21/2006
ma 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 BB -01400
SITE ADDRESS: 12070 SW GARDEN PL BLD5 ZONING: C -G
SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG
Project Description: Three door access system. Job #152.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SPIEKER PROPERTIES LP PROTEC INC
4380 SW MACADAM AVE STE 100 720 NE FLANDERS
PORTLAND, OR 97201 PORTLAND, OR 97232
Phone: Contact #: PRI 503- 235 -4000
FAX 503- 235 -0363
FEES Reg #: ELE 215CLE
LIC 55414
Description Date Amount
[ELPRMT] ELR Permit 4/5/2006 $75.00
[TAX] 8% State Surcha 4/5/2006 $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.
Issued By: Permittee Signature: \'..Q Pf4R.
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.
MAR -21 -2006 12 08 PROTEC 5032350363 P. 03/04
;,Electrical Permit Application FOR OI'FIICE'. UUSlr: ONLY
■
City of Tigard C e n ti ' 1 P'n'tva.. r"�,_ i . 0CZ I
1 3125 SW Hall Blvd., Tigard, OR 97 ,2, P laaRcview
Phone: 503.639,4171 Fax: 503,598.19 60 MAR 2 c �aet Date/B ; Other Permit:
Inspection Line: 503.639:4175 MAR 2 1 2006 _sR IL Date tteady/By: WI 0 5cc Page 2 for
Internet: www.Ci.tigard.or.us Notified/Method: Supplemental Information
a k tt: F': t: 1k: .:e::,'' to VW R 1P' ` :4' a' = PIl:AN RAYiE'W
New construction ❑ it VARAI Ph9pl`acement Please check all that apply:
OService over 225 amps, comsn'I ['Hazardous location
a Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 so, ft., !
.11 " ' ' +'�" ' 'CATEG Y:OF.YCO ' �IOIY', ?; . of I- and 2-family d wel 4 or more new residential u . .'. ; ti4 - ..., ,"'''' '
R, .- s +1 - '
c .. . ,, Y lings nc s
:: ., ... -. :: a ; .., •r ti :'i� :.,., •. ,. .•, .
.,,.; , . .
,. '
El I- and 2 family dwelling 54 Commercial/industrial El Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder Other:
El Building over three stones ❑Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
i '; ,;,:r 4;; 030_B $TTE NORIYI I .p op.i . : ,,;' : ,:; ;..y.. I]Egress /lighting plan RV park
Job no.: (5 i. Job site address: 1 910 5,W. a0 Atbk43 piAce 0Health -care facility ❑Other: ,
Submit -. sets of plans with any of the above.
City /State /ZIP: 'r 1 ,„ az RI 3 The above are not applicable to temporary construction service.
-;;:-. C : •FEE *• SC IEDULE.' .'.
Suite/bldg- /apt- no.: Proj na me: V � A N.! Description I
el( p Qty Fee, Teral
Cross street/directions to job site: New residential single- or multi-family dwelling unit. 1
- — Includes attached garage.
1,000 sq. it- or less ' 145.15 i -
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33,40 I
Tax map /parcel no.: Limited energy, residential 75 - 00 2
I ' CRI 75.00 _
•;_ - + � .::'.�.- ��,,;� • ES P TIO_ N 'OF �VORIC ".' :�:' .. � Each manufactured or modular
dwelling. service and /or feeder 90.90 2
.- .17. , L aecsil. ,;, _ 6( S jam. _ Services or feeders installation, alteration, and /or relocation
200 amps or less 30.30 _
ROPERTY:OWNER ,' , , ' El 201 amps to 400 amps 106.85 I )
�0.. P 401 amps to 600 amps 160.60 i
Name: 601 amps to 1 ,000 amps 240.60 1
Address: Over 1,000 amps or volts 454.65 I 2 '
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, Arid /or
Phone: ( ) . -- -. • - Fax: ( ) relocation
200 amps or less 66.85 l
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 to 600 amps 133.75 • -- '
Owner signature: !Date: Branch circuits— new, alteration, or extension, per panel
>m 'APPLICANT CON . CONTACT ' ' Fee for branc ,
feeder fee, each ���- C YVIL f
- - ^ service or ec er ee, eac t 6 t i 5
Business name: branch circuit - 1
B. Fee for branch circuits W .J.__
Contact name: without service or feeder fee, 46,85
Address:
each branch circuit
Each add'i branch circuit 6,65 _ Fri
i
City/State/ZIP: Miscellaneous (service or feeder not included) j
Phone: ( ) p er; ; ( ) Pump or irrigation circle 53.40 --
- Sign or outline lighting 53.40 : I
E -mail: Signal circuit(s) or limited -
Business name:
: = , ,.,.�:::: -'.: ,, ' ,CONTRet►CT;OR ', - ' .. - ,
energy pan t
en panel, alteration, o'
� - extension, Describe: � Page 2 � _
Address: S ao N , e. FLAN 1) s Each aLlditional inspection over allowable In any of the above
Per inspection 62.50
City /State /ZIP; 't) 14 q 3 - - _ investigation per hour (l lit mill) 62.50
Phone: 6b3),2,3,5= 9 Fax: 6b3 ),Z35--036 3 Industrial plant per hour 73.75 w
'• E: 14ECF .IOCtikt.:1'.tItItYT,
CCS Lic.55iiiy Electrical Lic.a1Ec L Suprv. Lic.3ag6 Leatt, Subtotal "�5 �
Suprv, Electrician signature, required: Plan review (25% of permit fee) I
r State surcharge (8% of permit fee) 6 ,:6b
Print name: Date:
W �_ MFJ TOTAL PERMIT [ i a aD
Authorized Signature: ` This permit applica ezylrex If a permit not it fa not obtained � iihin ISO -- day. after It has been accepted as complete
Print name: b Ary E A ( ' Date:3 . - Fee methodology Set by Tri County Building Industry Service Board
4 :'� -�—�^ � •• t' urnber inspections per permit allowed.
! \ 8uildint;+Pcrmits\ELC- Permir.pp dee 12163 4 40 a6 tyr(loia icohV\vas
CITY OF TIGARD
DIVISION PERMIT #: ���
BUILDING �,� �Z
_ t(
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 - 4171 > ��uo�1 1 i (
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: / ( 06) TIME: PAGE:
SITE ADDRESS: k2_670 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: EST— I 43
OWNER: ( E bebia ps sY6ia PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/Comm ions:
C ....„/ C '\\,:, ,
),-` ti✓
4„,
4 ,,, / \
ix PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G et 1 vt(3L Date: Phone #: (503) 718- z44'0