Loading...
Permit i, 11 P h CITY Or TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00042 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/26/2008 PARCEL: 1 S 135AB -01003 SITE ADDRESS: 10300 SW GREENBURG RD 530 ZONING: C - P SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG PROJECT: HARRIS & BOWKER Project Description: Low voltage T -stat wiring 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: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: T - STAT X TOTAL # OF SYSTEMS: 1 Owner: Contractor: SHORENSTEIN REALTY SERVICES AMERICAN HEATING ONE SW COLUMBIA ST #300 1339 SW GIDEON ST PORTLAND, OR 97258 PORTLAND, OR 97202 Phone: Contact #: PRI 503 -239 -4600 FAX 503- 239 -7038 Reg #: ELE 26- 993CRE FEES LIC 33135 Description Date Amount SUP 2640LEB [ELPRMT] ELR Permit 2/26/2008 $75.00 [TAX] 12% State Surch 2/26/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Al Issued By• / ���� Permittee Signature: ,- A c l G i n G - By...---- c/- •• OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • Electrical Permit Applicatio " .:, - , FOR OFFICEUSE , ,:-' r „' • City of Tigard Re e ived X11 PemritNo.: 13125 SW Hall Blvd., Tigard, OR 97223 Cj QD Plan Review `L � . Other Permits /0 4 _ —0 • Phone: 503.639.4171 Fax: 503.598. 6 Cp '! ? °: +� DateB Ins ecti Line: 503.639.4175 ` •� L Juris: H See Page 2 for p ` , 4 '61 - =.� Date Ready/By: Internet: www.ct tigard or us 0 / Notified/Method: Supplemental Information N. ' fir r' rd si`� •�{ :#' 00 ^ 4 •rf 0 w ti., , t S CM �5 ' r ` .' `rh ' �,,:z; >? �L$ � �rvze��a <' va.,_"'u� a rS • r' � s��s. -:` c ❑ New construction 1_d Addition /steWreplacement Please check all that apply: OService over 225 amps, comm'1 C] Hazardous location ❑ Demolition \V ■ Other: �+ ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., ry * _ spat -W4tV_ d " W g6 # P e i , -1 h1S91 of 1- and 2- fami ly dwellin gs 4 or more new residential ❑ 1 - and 2 - family dwelling Commercial/industrial over 600 volts nominal units in one structure industrial ❑Accessory building ❑Feeders, 400 amps or more OBuilding over three stories • ❑ Multi family Master builder ❑ Other: _ ❑Occupant load over 99 persons ❑Manufactured structures or -fix " - '",,,,' a f -, d ' r �„ g :.�.. rte:. •,'u - c` a i; RV park ,.l c . N t`6 9 8� r P p aDS- r E : . H �`r s ', I', ❑Egress/Iighting plan ❑Health -care facility ❑ Other: Job no.: Job site address: 030 Q '�6 (fin (�/ �, o ♦ Submit 2 sets of plans with any of the above. City /State /ZIP: 'J V aa-3 The above are not applicable to temporary construction service Suite/bldg./apt. .: 6� I Project ‘S �0� a D Gi � no.: " ` i - Description Q t y. Fee. Total Cross street/directions to job site: `"'� ^ i ` J {lat 'fs , L New residential single or multi - family dwelling unit. i 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 Limited energy,. residential 75.00 2 Tax map /parcel no Limited energy, non - residential 75.00 2 ryt rn v� � „ t,) f °- +�- f'^ i ff + j-e � W ` V sg5 P W ti s '' Each manufactured or modular ( a� ,1 I a !� , dwelling, service and /or feeder . 90.90 2 VV \fd L S , t_. 1 �.�� L Services or feeders installation, alteration, and/or relocation ((JJ 200 amps or less 80.30 2 .� x � A ;L E ra' en zf: x i:r.� : s �w s = - ir$ rte': 201 amps to 400 amps 106.85 . 2 d'� L i '^, iii-, : . .> d , �� g 21 -: g `° -t -- - ` Ltt.t � �'` ' Y _,� 160 __ 2:__�.�. �+. � � �� t -`"�'� 401 amps to 600 amps 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: ( ) I 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 r• : , 1 a y. r'" G" ¢ '9 , 5TZ F to n ^J ' t a a - 0 t ' `' „ x r � , ,,,.1' 8 t \f I\`,7 i"a 4 r. r 6, 1_ A. Fee for branch circuits with �"� w . } �d.,...,i .ter : �- - s;« y.. - .::: r +dl .:+..a• L - -. rLa .,, :.-- 1e,FS��i.z�•"e 1 'w' service or feeder fee, each 6.65 2 Business name: ((co JA ,[ I ,,,._ . 1 1 - r x bra nch circuit l't / si- .j" , B. Fee for branch circuits Contact name: t�, (� /I �►1 without service or feeder fee, 46.85 2 it Address: '.-3t t q V r r i `^/� Ll I ��,CCC���333 ch brabrcu \ �1 Each a dd'1 braa ncch h circuit 6.65 2 City/State /ZIP: " y t, Gil d t 0 rL q� a V p- Miscellaneous (service or feeder not included) • � Pump or irrigation circle 53.40 2 Phone: ) a3� - Goo I Fax: : ) - - 1 6�g Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - f (t y RM Rd 1,11rNefeWriPMEAPNRIBIE energy Pa, a or extension. Describe: 1 Page 2 2 Business name: Alm is / 4-j n 1t1 C . Address: - 3-CI se a; (1�-a o Y i t Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: ''c ` f n o q—) '30 Investigation per hour (1 hr min) 62.50 (5n) � 6 0 U I Fax ( ) ^ -� o3 p Industrial plant per hour 73.75 Phone: d O a t` ;." i• i , E A ''k_1, : ��yy s1 CCB Lie.: 33 ` 3 5 I Electrical Lic.: 046q Car Sup . Lie.: ,( O L Subtotal ?a,t-$U Suprv. Electrician signature, required: a � � ,l/ /2 `"' Plan review (25% .f permit fee) lc CO J State surcharge �:' • •� •etmit fee) Print name: . • Yo Date: � . - ,_ C Js l� � TOTAL PERMIT FEE � dU - Authorized signature: A „ / / . AN 4 , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete - Print name: `� Date:• (, • Fee methodology set by r has be my Building Industry Service Board 3 �U • �� `• Number of inspections per permit allowed. is\ Building \Permits\ELC- PermitApp.doc 2 /03 440.4615r( I0 /02/COM/WE8 - • V City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: American Heating DATE: 4/14/08 1339 SE Gideon Portland, OR 97202 REQUESTED BY: Dianna Howse Attn: Brad Manchester TRANSACTION INFORMATION: Receipt #: 2008 -612 Case #: L b3 r ELR2008 -00042 Date: 2/26/08 Address /Parcel: •}3Q.FW Greenburg Rd #530 Pay Method: CreditCard Project Name: Harris & Bowker EXPLANATION: Per applicant's request as low voltage is not required for pneumatic controls. Refund 80% of permit fees. F > N O:RMATI .,ice., aM `< ktrI °<xa .:4, _�r- T:��e:...�.... 1 «• `� x ::,y n;f >� ; %3 N..c •�� ,* %'. • ire % .� �2 LT1Z,D ,Per>ntt�Fee' �'��� �� �: ��:: _v . �. -, " - , <Exam le. 245. - 0000 =43� 0: `= ;,`:':;�':� '. = •� ".P .- r�,.�.,� :.]�- .,. -,.. � • "��� x;�i- ':_,, .�,..,���. < >.., ". - -. t ,.. �QO��.. 1�����rn`ourit�, [ELPRMT] ELR Permit 220- 0000 - 431510 $60.00 [TAX] 12% State Surcharge 100- 0000 - 207020 7.20 TOTAL REFUND: $67.20 APPROVALS: If under $500 Professional Staff f if under $7,500 Division Manager T, °r✓` �'� If under $22,500 Department Manager if under $50,000 City Manager If over $50,000 Local Contract Review Board ,- : VOTtT =ID EIVIAR @K "'SYS I EM�ADMINNS# 'TtI'0N-' a �`= _ °" .w. ._,,.., ^ w." � � -, . _ s ,RA � ,I7S °EONLY Case Refund Processed: Date: - ` : /frA f' e - By: I: ABuildin g \ Refunds \RefundRequesi.doc 05/23/07 i li - q Community D meet S.Vi S) y p � Request for Permit Action pti0 _TIGARD„ MPS 2 TO: CITY OF TIGARD 0 G Building Division Services Coordinator 0)10 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ❑ Owner ❑ Applicant 0 ontractor ❑ City Staff (check one) REFUND OR Name: / INVOICE TO: (Business or Individual) 1 m er/ C �i Ne T i,-, y . \if 0 I D . Mailing Address: /33 SE . / c. CEO,-? City/State/Zip: Pr r'//.4d OR 77ZoZ V trA' I Phone No.: S 03 - 2 3 - y Y O n PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): CANCEL PERMIT APPLICATION. X REFUND PERMIT FEES (attach receipt, if available). n INVOICE FOR FEES DUE (attach case fee schedule and explain below). n REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: EL- / zoo 8 _ cc C '-7 Site Address or Parcel #: / 0 3 co S IA/ 6 C rI b L)(. p --s 3 0 / Project Name: l 1� C r l S I- n (,v J e .� 1l Subdivision Name: Lot #: EXPLANATION: f 0 t ) O ) +44 C. ° n see_ ci 1 I �J►n 0 � p ne�J�i�, Co 1 S Signature: (- Date: 3 `Z0 08 Print Name: B ( �i ci rl G h e.s e Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR,.OFFICE USE ONLY, . ... - .. Rte to S s Admin: Date j , • Ui B 771 Rte to Bld• Admin: Date /. , ,• B ,mAl. Refund Processed: Date '}/ /q al By 4 Invoice Processed: Date By Permit Canceled: Date j✓'/ " By. Parcel Tag Added: Date By Receipt # Q lo,,,,, Date o246 /pe Method CC, Amount $ c f-'Y, or) I \ Building \ Forms \RegPermitAction. oc Key 07/26/07 drr' CITY OF' TICARD r , `:, SW Hall ul,,i. 4/14/2008 ' �: I I z; s � Tigard, 12:2 n d, 012 97_23 12:29:40PM , 'a Refund Receipt #: 27200800000000001218 f Date: 04/14/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid ELR2008 -00042 Reversal - [ELPRMT] ELR Permit 220-0000-431510 ELR2008-00042 (60.00) Reversal - [TAX] 12% State Sur 100- 0000 - 207020 (7.20) Refund: Line Item Total: ($67.20) Method Payer User ID Acct. /Check No. Approval No. I P How Received Amount Paid Credit Reversal BRADLEY M MANCHESTER 3162I B In Person (67.20) Refund Total: ($67.20) Q g C C .,9_, ° 1 o .o w +� v cis pg �i V) G' tar 61 c0 . D x `� L.' O 6I Q ' u) ° ix a z ..= J J a i 4J a •••• to 5 3 �' gi q m fi cr 3 v i , 1 0---..(4 73 u . o ,� o Er �, .. x N V W y -,\ 4 8 , 80 a Q w! 2 € ■ is v w a of I CITY OF TIGARD 3/20/2008 13125 SW Hall Blvd. 9:13:10AM 1 !! Tigard, OR 97223 503.639.4171 zTIG - A'RD r 1 Receipt #: 27200800000000000612 C /iC -/A/ 9 4.._- Date: 02/26/2008 Line Items: Case No Trait Code Description Revenue Account No Amount Paid ELR2008 -00042 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 ELR2008 -00042 [TAX] 12% State Surcharge 100- 0000 - 207020 9.00 Line Item Total: $84.00 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard BRADLEY M. MANCHESTER BTT 31621 B In Person 84.00 Payment Total: $84.00 • • • cncccipl.rpi Page I of I City of Tigard, Oregon ® 13125 SW Hall Blvd. 9 Tigard, OR 97223 I ' El -49 . GARDq April 14, 2008 American Heating 1339 SE Gideon Portland, OR 97202 Attn: Brad Manchester Re: Permit No. ELR2008 -00042 Dear Mr. Manchester: The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the following: /d3 o° Site Address: l -033 SW Greenburg Rd. #530 Project Name: Harris & Bowker Job No.: N/A Refund: n Check # in the am ount of $ . Credit card "return" receipt in the amount of $67.20. n Trust account "deposit" receipt in the amount of $ . Notes: Per applicant's request as low voltage not required for pneumatic controls. Refund • 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I: \ Building \ Refunds \ Administration \LtrRefund- CancelPermit.doc 01/16/07 Phone: 503.639.4171 0 Fax: 503.684.7297 ® www.tigard- or.gov © TTY Relay: 503.684.2772