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Permit r a '• CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00041 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/15/2007 PARCEL: 1 S136CD -00100 SITE ADDRESS: 11705 SW PACIFIC HWY X ZONING: C -G SUBDIVISION: PACIFIC CROSSROADS LOT: JURISDICTION: TIG PROJECT: LITTLE CAESARS PIZZA Project Description: Low voltage for HVAC. Job No. 07 - 0083 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: PACIFIC CROSSROADS PROPERTY INC OREGON HEATING &AIR CONDITIONING WYSE INVESTMENTS PO BOX 397 111 SW 5TH AVE SUITE 1100 DUNDEE, OR 97115 PORTLAND, OR 97204 Phone: 503- 294 -0400 Contact #: PRI 503 -538 -2953 FAX 503 -537 -2172 FEES Reg #: ELE CRE -15 LIC 172126 Description Date Amount [ELPRMT] ELR Permit 2/15/2007 $75.00 [TAX] 8% State Surchar€ 2/15/2007 $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 suspen for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those les are s- forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or dired questions to OUNC at 503. 6.6699 or 1.806 3 • . Issu d By: SA, 4.4 4 Permittee Signa . J, Liiragir it 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. let) 14 07 09:42a MS Rentals, Inc. 503 - 537 -2172 p.1 Electrical Permit'A lira 1 o FOR OFFICE USE ONLY . Received Per No.: / City of Tigard � to ` r>zteBY Iv ei 7 lAy 6G 13125 SW Hall Blvd_, Tigard, OR ' 722 Plan Review Phone: 503.639.4171 Fax: 503..598.1960 ' '',; . I''' Date/By: Other Permit: . Inspection Line: 503.639.4175 C1 L ; 20 %� ; l - 'lP D ateReadyBy jam= 21 See Page 2 for r D Internet: www_ci.tigard.oc•us W NooSed/Method Sapp[em ®talInformahoa • .:,•,.., .,...,._.. .r...: .._ ....'.. .0:I..... _ ;�` ... ...,- .._.. ._.... -.. ... '=:. ' . � . .:; • •.:..;= .:,, � vile � ❑ New construction T_/ . :. i . .r' m -n Please check all that apply ❑ Demolition 0 e' „ ❑ Service over 225 amps, cormn'l ['Hazardous location 0 Service over rating 1.0,000 sq. ft., • >:. -' '`• "' CATEGORY .OF CONSFRIJCITON'. ' ,;; ;`.;' of 1- and 2-amity dwellings 4 or more new residential ❑ 1- and 2- family dwelling ` Commercialiindustrial ❑ Accessory building ['Building ova 600 volts nominal units in one structure ['Feeders, Multi • !J Master builder ❑ Other: Building over three stories Feeders, 400 amps or more ❑ Occupan load over persons fa t o 99 Man uc red structures or t- , . - . - -... JOH' SFTE L�IFORMA r pom . 'Arkp LOCATION • ,3 : ❑Egress,1ighting plan RV Park , � . ❑Healtbmit h Z pre f o acili plans ty with any of the above. ©Ocher. Job no.: C 3 Job site address: , � i� uj 4 L Su sets f The above are not applicable to temporary construction service. City /State/ZIP: • 1 101 r �� PP P }: �' " . N'. Y`= i�; a,FFJE�uV,, T"•. +,..t! Yti:k.._A'.r`:'r�:r:.: 'n:.i:'_. .�:•n.•. 5uite/bidg /apt no.: Project name: � --{ ` ' ` "' " ` � t �, 1� ��• �t. 4.� Description 1 Qty- 1 Fee ( Total I .. Cross street/directions to job site: New residential single - or mufti- family dwelling unit. Includes attached garage. 1,000 sq. ft or less I 145.15 I 4 Subdivision: Lot no.: Ea add'I 500 sq. R or portion 33.40 1 _ Tax map/parcel no.: Limited energy, residential 75.00 2 `r • Limited energy, non - residential 75.00 'G,°.�` "ti''r_ i^•-'' `' - :'s5i sn ;.y'''�y;;: _�: r " ;:':,,; §r.._....,... :- >.?r *._ �� rb" ESG' R. IETXON :OF�ryWORK; :�::'-:r,;. <._ �- � ; Each manuctured or modular dwelling, service and/or feeder 90.90 , 2 1 J Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ` ;.ti ._ ' '" ° PR WNEIt ` `' : - ' / . ,!1; 201 amps t°4°{3 amps 106.85 2 j �"� 401 amps to 600 amps 160.60 2 Name: l ( • I l ( (-C1.(' ';, -0,: 601 amps to 1,000 amps 240.60 2 l Address: f j �. L t ' ( LC . 4 t LL:9 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: L. i 9��� /;(`- f ` Termporaryservices or feeders installation, alteration, and/or • 1 I 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 I 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 I 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel f;r:F_g :• a; _ r : -;CO E 1 `;>•:.' .; "',, &Fee for branch circuits with yi +.. ^.` °: ' Ii C . . . ... ? :e .. .. � 1�'i>'A:C'13 RSO service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 Address: each branch circuit Each add'I branch circuit I 6.65 _ 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone ( ) Fax : :( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - e1 alteration, i .. ....' ... : :: .. ,•! : '.: ;:'. C01�ITItAiCTOR:: °: " ::'_ : '. : , •; ::... - .. . energy Par} , ... n; or I' 7 C : extension. Describe: I P age 2 2 Business name: (-.H flame - ( --- Address: Each additional inspection over allowable in any of the above ����,� - • Per inspection 62.50 City/StateJ21P: `�1 •cs (; %1 - k i I \-_s Investigation perhour(l hr min) 62.50 Phone: (tea) 1 c7 -. <---'. I F ax: ( a � -7 y Industrial plant per hour 73.75 �� : ELECTRIC PER.3IIT PEE3t:.;- ' - :. : :: . CCB Lic_: I ° 2 `e� � electrical Lic.: l �� .- ` ,.9 C. j Suprv. Lin: Subtotal C- Suprv_ Electrician signature, required: .\ 1 Plan review (25% of permit fee) ? -- J r State surcharge (8% of permit fee) 1- C L Print name: C ~w t ) I Date: � ��^ ' " TOTAL PERMIT FEE q 1 • C t Authorized signature: J - � - �� This permit application expires if a permit is not obtained within 180 ��` days after it has been accepted as complete. Print name: c• c __ 7 - � f / �( f' 'n - I — Date: ' .11-c:7 • Fee methodology set by Tri- County Building Industry Service Board . ._....___. .....��_.�._. ,...:.: _. ._. - -- _._ - ..._. _. _.__.. - 'iv.unber or Insxmars per Denn .iio,..'n CITY OF TIGARD • BUILDING DIVISION PERMIT #: EI.R2007- 00041 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21'1512007 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 1J1. INSPECTION WORKSHEET FOR DATE: 3/12/2007 TIME: 7:01AM PAGE: 38 SITE ADDRESS: 11705 SW PACIFIC HWY X CLASS OF WORK: SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE: PROJECT NAME: LITTLE CAESARS PIZZA DESCRIPTION: Low voltage for HVAC. Job No. 07 -0083 OWNER: PACIFIC CROSSROADS PROPERTY INC, PHONE #: 503 797.0400 CONTRACTOR: OREGON HEATING & AIR CONDITIONING PHONE #: 603 -63B -2953 Inspection Request Scheduled For: Date: 3/12/2007 Pour Time: Code # Inspection Description . n irm • Contact # Message 199 Electrical final 044641 -01 503- 849 -6162 N Corrections/Comments/Instructions: A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: GT • g L� Date: . \t. al Phone #: (503) 718- 244b