Permit C ITY O F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00247
DATE ISSUED: 10/11/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 BB -01400
SITE ADDRESS: 12172 SW GARDEN PL BLD3 ZONING: C -G
SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG
Project Description: Relocate 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:
SPIEKER PROPERTIES LP PROTEMP ASSOCIATES INC
4380 SW MACADAM AVE STE 100 9788 SE 17TH AVE.
PORTLAND, OR 97201 PORTLAND, OR 97222
Phone: Contact #: pRI 503- 233 -6911
FAX 503- 238 -9767
Reg #: ELE 26- 1063CRE
FEES LIC 38868
Description Date Amount
[ELPRMT] ELR Permit 10/11/200€ $75.00
[TAX] 8% State Surcha 10/11/200€ $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 erect questions to N at 503 - 246 -6699.
Permittee Signature: Issu d By: � � 2,('� 9 �(i�,�Ga�_
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.
ElectFicalTermit Application . .
F012OF1 ICLI JSE, .-,, • '
City of Tigard Date /By /0 (/ b t ' Permit No . Ea 4ji"(/c-' ,2t f 7 Received
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503 598.1960 ��". �a' 'p+r I`j• i , Date/By Other Permit:
Inspection Line: 503.639.4175 a'' l Date Ready/By IliM ® See Page 2 for
Internet: www.ci tigard or.us Notified/Method: Supplemental Information
. TYPE OF WORK ' - PLAN • REVIEW ,
❑ New construction ❑ Addition /alteration /replacement Please check all that apply
❑ Demolition El Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 -and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi - family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
. JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
f ? �� ❑Health -care facility ❑Other:
Job no.: Job site address:
{ g 2/ / 4 ,c4,/ - t`C ^ ) ('( • Submit 2 sets of plans with any of the above.
City /State /ZIP: '
l .
t'' £ The above are not applicable to temporary construction service.
Suite/bldgJapt —no.: Project name: F4sre -r, _ FEE* SCHEDULE,
Description I Qty. I Fee. I 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
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
�,/�� a 17;-/-- dwelling service and/or feeder 90 90 2
� ��— / //11
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 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
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
APPLICANT I - CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each
Business name: Pil-D f re ,,,� .q c K branch circuit 6.65 2
B. Fee for branch circuits
Contact name: B et u C t— 13t j , y , / � without service or feeder fee, 46.85 2
Address: 5 j 7 _ V(S 17 c/ ,— first branch circuit
• Each add'I branch circuit 6.65 2
City /State /ZIP :f er(- (-1-, 7 e., 92 z z Miscellaneous (service or feeder not included)
Phone: ($3) ) 57 9,- 00 9 Fax: : (4 ) 2 ge ' �/ Pump or irrigation circle 53.40 2
f� Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
• - CONTRACTOR , energy panel, alteration, or C"P
Business name: extension. Describe. I Page 2 75 2
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 3 5 Electrical Lic.:24 I 6431.o, Suprv. Lic.: 2 3 /,. Subtotal 76-, °ct
Suprv. Electrician signature, required: ,� � l Plan review (25% of permit fee)
/ t .
Print name: / /s 1I. S' t °� Date: / g., 11 - - o State surcharge (8% of permit fee) G
n C 20 TOTAL PERMIT FEE e ` , (IC)
Authorized signature: � g /�� ^ � - This permit application expires if a permit is not obtained within 180
J ���///"' ""LLL/// ` / days after it has been accepted as complete
1 w
Print name: i C{__,_ CJ's f Date: /� 7 ' • Fee methodology set by Tn- County Building Industry Service Board
` °° Number of inspections per permit allowed
I \ Building \Permits\ELC- PermitApp doc 12103 440- 4615T(I0 /02/COM/WFB
I •
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
F 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 t`
System*
❑ Vacuum Systems*
❑ Other:
'tOMNLERCIAL WORK ONLY: w _
Fee for each commercial system $75.00
(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 Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \Bwldmg\Pernuts \ELC- PennrtApp doc 04/03
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CITY OF ��mo n ��m� :m��n�mnm��
BUILDING DIVISION PERMIT #: EUR2006.00247
13125 SW Hall Blvd., Tigard, OR 97223 - , ' DATE ISSUED: 10/11/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 �B�N~ «�-...
INSPECTION WORKSHEET FOR DATE: 10/13/2006 TIME: 7:00AM PAGE: 00
SITE ADDRESS: 12172 SW GARDEN PL BLD3 CLASS OF WORK:
SUBDIVISION: PARK 217 LOT #: 002 TYPE OF USE:
PROJECT NAME: PASTENAL
DESCRIPTION: Relocate thermostat_
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 505'293'6911
Inspection Request Scheduled For: Date: 10y13V2006 Pour Time:
Code cripUon Confirm # Contact # Message
L- 038117-01 6�3'619-�19� Y
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' PASS PARTIAL APPROVAL I I CANCEL El NO ACCESS
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CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
Inspector: G--/ N oe ^ Date: 1 0 I ~^( Phone #: (503) 718-
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