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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT .. I DEVELOPMENT SERVICES PERMIT #: E-10009 _,,'' DATE ISSUED: 3/8/2006 8/2006 *--� 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: HVAC /Thermostats. 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: • RREEF AMERICAN HEATING 720 SW WASHINGTON ST STE 630 1339 SW GIDEON ST PORTLAND, OR 97205 -3508 PORTLAND, OR 97202 Phone: 503- 224 -9450 Contact #: PRI 503- 239 -4600 FAX 503- 239 -7038 FEES Reg #: ELE 26- 993CRE LIC 33135 Description Date Amount [ELPRMT] ELR Permit 4/1/2006 $75.00 [TAX] 8% State Surcha 4/1/2006 $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: ,�� c) , \� ��j 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. 1 Electrical Permit • ii - i - 1 t .. e: ' ' FOR OFFICE USE ONLY . , 3 City of Tigard Date /By: i —(6 . MI PermitNo.. Lit, /01 /8 13125 SW Hall Blvd., Tigard, OR 97223 Q r� Plan Review Phone: 503.639.4171 Fax: 503.598.196( AR U LO OU / ill ' .. Date/B : Other Permit. 1, Inspection Line: 503.639.4175 r ` w �! Date Ready/By: lini 0 See Page 2 for Internet: www.Ci.tigard.or.us �� 1 I A fit/' Notified/Method: Supplemental Information t ,t : u C '; • _ � �zf., � �,�rd 1 S _ Fay F axi: o-'r a:�,.f: + r '.sV:t t ., , F'i?' t 3tr z v{a ._ t•~.`. .',*s.. r- ` iY` .,,.,%�..,z .'::'� ' _ �. � .. ci g + ¢ `` µ `-^. - '.'..,Pk a, = - ,, ;. �, - W yLAN:..RE IEVI:'� : ;n. s�' z��i`�,jx:.e�.°`� : .!§.,.�.... - �'�'s.u: _ w . �.e'�.� ` �`�,s..s�- � .,rte: .N. ��y�. �, ,s.m.- ,cc:3_v.. �t -;.�. w.< �r.. ,.,. ❑ New construction f�11 • • in/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: Sery ce over 320 amps corn Buldn over 10 sq f ❑ i comm'l ❑ i P rating ❑ t., k iw � , ,r et . . �' r , 4 C � ; T � .ri of 1 -and 2 dwellings 4 or more new residential ❑ 1 and 2 family dwelling 121 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi - family Master builder Other: ['Building over three stories ['Feeders, 400 amps or more ❑ Y ❑ ❑ OManufactured structures or " -a ['Occupant load over 99 persons ;. t t ro • RV .: iff ' - 4 NOI T I?E IP7 OK .p- 4k . ,,/2i ,i fl Az iViit :4 A, ° ❑Egress/lightingplan park P Job no.: I Job site address: ` 2 U e5 (i 3 6 L P 1 ❑He -care facility ❑Other: " Submit 2 sets of plans with any of the above. O A. q -7 a a The above are not applicable to temporary construction City/State/ZIP: Ti �, 3 PP P ry tion service. -•'- - 4 9 � t r �: \V Q-L E e � ( rj Description I Qty. I Fee. I Total I • °` " '` ` `` " °' "` ' ` (! .t'* Suite/bldg. /apt. no.: Project name: 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: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 � P p. +- �d�3}/ 1 �' "�' r ' �.:.�- � ` z, .. ' �21�c ^++„C, Xt�� `� �,. � 'v A_ ' x Each manufactured or modular t — I t„ n � a4 ei C � S I erv service or feeders ins ta 90.90 2 6 1 �v ��( rn- © Servces rs insllation, alteration, and/or relocation 200 amps or less 80.30 2 4 . 60106t, 0 a 1;,^ t ; .. t t 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 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 Phone: ( ) I Fax: ( ) relocation 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 1 00.30 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 ' :. * 4* ''"s +MSI t _„ ,a t " '_ , . A. Fee for branch circuits with �- 1sf T � i 11 " 4N' ln n N �f service or feeder fee, each 6.65 2 � Business name: R ►t�' p,vi Cwa t r 1 f branch circuit � t' ," t1 � - ` � e B. Fee for branch circuits Contact name:l('i alk 5 1 1p- without service or feeder fee, 46.85 2 Address: ttltl����� each branch circuit `1- _ ( 1 t � �� Each addd''l l branch circuit 6.65 2 City/State /ZIP: "(.7 c( O1e_. cria oa Miscellaneous (service or feeder not included) ( Pump or irrigation circle 53.40 2 �� Phone: `J'rJ) D (D C� U Fax: : 3) ,-- ?.:36i ,`7Q-6 O Sign or outline lighting 53.40 • 2 E -mail: Signal circuit(s) or limited - siT s y ';.•^ g;;.' .?r^ :} s ,, ; ."" r r uy y u >. ,�s,.e. .,s '�s�,�, a.i - . m �� y n t ;-s '? r energy P anel alteration or t �,2�� �• ��, ����, J s�°';' "� ener , , / Uati:5+`es.::;S�n". ts :;';,, ; :s,.� Hi..y'''.'C -0 >aw.: ,. ;,�,� x z <.,•'lsz,;:�,= w,. = <:f- =:;ISM 1 2 extension. Describe: Page 2 Business name: � (fl'1Qi l C�l GL Imo. 1 . R. C - g , _ Each additional inspection over allowable in any of the above Address: (3 � ( l � l Per inspection 62.50 City/State /ZIP: (JL ( W.,. . Qe. a-Q O Investigation per hour (1 hr min) 62.50 • Phone: (cj( a" ) ( 0 0 I Fax: ( ) Industrial plant per hour 73.75 »�' )rlt L O O sE I:; 3 I?FE 1 S *� ;„t;:.= "; CCB Lic.33 Electrical Lie.: Suprv. Lic -(0 Subtotal Suprv. Electrician signature, required: ,� a (11 Plan review (25% of permit fee) Print name: + tev�v�q oun Date. , State surcharge (8% of permit fee) c� TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 f � , / days after it has been accepted -as complete i Print name: Otto_ ` j. vl b'C C (M Date: .-- -"Q (O * + Fee methodology set by Tri- County Building Industry Service Board Number of inspections per permit allowed. i:\Building\Pe:mits\ELC- PermitApp.doc 12/03 440 4615T(10 /02/COM/WEB CITY OF TIGARD eZ2 BUILDING DIVISION PERMIT #...09-)104' ADD 6 ` 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 kapho l A l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: (L 67 & i,i f --` CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: • OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 — / ` – D ` � Pour Time: o• - Inspecl Desc ) ption Confirm # Contact # Message 61.7 L0q - 6 96 -ctions /Co • ents /Instructions: C PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: �`.' y 1 r Date: 3 ` 06 Phone #: (503) 718- 1-911 CITY OF TIGARD DIVISION PERMIT #: ZcO(, — /O 6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 4 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: N m DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # InsArcription Confirm # Contact # Message iqv Corrections /Comments /Instructions: IA C)P S e sINT oao(AM- svCFS I Vk S C-(A0bkit6 e2((. c-43 \\4 DO Rcy cz. 1.3NA �.l s Lam. v N`T (L. '11A s 5 57 1_5 J i P•sep Rz\S Fok, cz\re.-,aa 4 • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL 12 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: � V6 L Date: 311 O 6 Phone #: (503) 718 - 2.19