The URL can be used to link to this page

Permit IN .;., CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2012 -00009 Date Issued: 01/26/2012 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1 1/2 6CD01002 Jurisdiction: Tigard Site address: 7910 SW PFAFFLE ST Project: Wenyi Jia Dental Office Subdivision: 2006 -016 PARTITION PLAT Lot: 3 Project Description: Low voltage for HVAC Contractor: OREGON HEATING & AIR CONDITIONING Owner: PFAFFLE OFFICE, LLC PO BOX 241 PCCC LLC DUNDEE, OR 97115 915 NW TORREYVIEW LN PORTLAND, OR 97228 PHONE: 503 - 691 -9699 PHONE: FAX: 503 - 691 -8556 ' FEES Description Date Amount Specifics: Restricted Energy Permit 01/26/2012 $75.00 12% State Surcharge - Electrical 01/26/2012 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: y Instrumentation: N Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Total $84.00 Other Desc: Required Items and Reports (Conditions) 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 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OA 9 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ? Y Permittee Signature: e" A 2 . .976/36/ C "9-7 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' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. 01/13/2012 11:27 503 - 691 -0556 OREGON HEATING PAGE 01/03 Electrical Permit ApplicatPF N FOR OFFICF• : I1SE O!NL' $ City of TTigard N 1 3 2012 Received Date/13y; I / Permit No.' fi.R. go /o2 - a ofJJ ' lig " 13125 SW Hall Blvd., Tigard, OR 972 Plan Review . Othtr Permit: Phone: 503.639.4171 Far: 503.59$.1960 . Date/t3: - in spection Line: 503.639,4175 ''� ®� «�� 3U Date Ready/13.y; El See V °ge 2 for !' l t i A KID Vi i® Notifie,d/ iethe : Snpplemerial Information Internet: wvva.tigard- or.gov R I [� " us v r `� • TYPE OlF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction ►� • ddition /alterationlreplacemt tat C] Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or Q Floating buildings. less to ground, or exceeds 14.000 ❑ Corrmeroiat -use agricultural ❑ I - and 2- family dwelling 1.2 ommercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi-family Master builder ❑ Other: ❑ Fire pump. D lr�stallation of 75 KVA or Y ❑ Emergency system. larger separately derived system. JOR SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ ",A " "E" '•1 -2" "1 �3" 100KP or more. occupancy. Job no.: 1 2, Job site address: 9 9i, 5(.,j p > . , / 1:3 Six or mare residential units. ❑ xccreati4nal vehicle parks 9 rn► 3 ID Health-care facilities. ❑ Supply voltage for more than City /State /ZIP: / / ! 1,9,V 7 ❑ Hazardous locations. 600 volt, nominal. Suite /bldg. /apt. no,: 0 Project name; , W GN >r 3-16- ❑ Service or feeder 600 amp: or more I FEE SCHEDULE • Cross street/directions to job site: o0fCii•tio5 ILTIMMIGCMMIEMIMIN New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft, or less MI 4 � i D DO Ea. sdd•I 500 sq, ft. or portion MI 33.92 II Tax map /parcel no -: C..."? Limited energy, residential III 75.00 DESCRIPTION OF •WORK with above se. R. Limited energy, multi family 75.00 III residential with above s.. ft.) Services or feeders' installation, alteration and /or relocation 200 amps or less 10Q Gitiiit�� • 0 PROPERTY OWNER ❑ TENANT • 20: amps to 400 amps Ippitilit 401 amps to 600 amps . M 200.34 IIM.0 , Name: 601 amps to 1,000 amps 301,04 Ell Address: Over 1,000 amps or volts IMMI 552.26 IIIMM© .. ' • Temporar•services or feeders installation, alteration, and /or City /State /ZIP: relocation 200 amps or less MR 59.36 MEM Phone: ( .) Fax: ( ) • 201 amps.to.400.amps 1111 125.08 M, Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168, Ill intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch dreuits – n leer xt Owner signature: Bate: _ . A, Fee for branch circuits with ❑ APPLICANT • • ❑ CONTACT PERSON above service or feeder fee, each branch circuit 13usine55 name: 0 ,/ • B. Fee for branch circuits without r / ( ' ' service or feeder fee,'first Contact name: / branch circuit , - — Each add'i branch circuit , — Address: kX Miscellaneous service or feeder not included Q-7/./ Each manufactured or modular 67.84 City /State /ZIP: 411 d / ! o e dwellin:, service and /or feeder Phone: c 5 , a r / . � 6,, Fax:: - ► � ! (1755-6, 4 / Reconnect only 67.84 pump or irrigation circle 67.84 II /_ I / ( / / ad / /_/_ ` .. ! !� _. Sign Of outline lighting 67.84 Ell CO • CTOR Signal circuit(s) or limited- energy . .anel, alteration, or extension. - Page 2 Business name: _ Each additional ins.ection over allowable in any of the above Address: 'tom' Additional inspection (1 hr min) — 66.25/ hr _, 66.25/hr City/State/ZIP: industrial plant (1 hr min) ME 78.18/ hr MIME Inspections for which no fee is Pho ( ) Fax: ( ) -- specifically listed V2 hr min 90.00 / hr CCB Lic.: '( a.u Electrical Lic.:Lg r 410 Suprv. Lic,:) 915 ELECTRICAL PERMIT FEES r Subtotal: ACIM Suprv. Electrician signature, required: •- -- „ - r Plan review (25% of permit fee): . Print name: / 3 _ / 9- State surcharge (12% of permit fee): — 6 l h r at e: ` � r 00 rte II TOTAL PERMIT PEE: r Authorized signature' �,,, ,� jf ! J This permit appticatiun expires if a permit is not obtalne. xri hi I80 days after it has been accepted as complete. \ / Print name: ` O/ / M l Date: / --/ 3 / 9-, " Number of inspections allowed per permit. _ ---- 440-4615T( I /bS /COM /WEB 01/13/2012 11:27 503 - 691 -8556 OREGON HEATING PAGE 02/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: . RESIDENTIAL WORK ONLY: Fee for all residential systems combined..... • • • $75.00 Check Type of Work Involved: Audio and Stereo Systems* Burglar Alarm LI Garage Door Opener* Heating, Ventilation and Aix Conditioning System* — I Vacuum Systems* C Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: • Audio and Stereo Systems Li Boiler Controls Clock Systems n Data Telecommunication Installation O Fire Alarm Installation ril TVA C fl Instrumentation Q Intercom and Paging Systems [] Landscape Irrigation Control* • Medical n Nurse Calls [] Outdoor Landscape Lighting* LI Protective Signaling n Other ) Total number of commercial systems: l *No licenses are required. Licenses are required for all other installations