Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00080
DEVELOPMENT SERVICES DATE ISSUED: 4/8/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 250 ZONING: I -P
SUBDIVISION: PP1996 -048 LOT: 002 JURISDICTION: TIG
Project Description: Relocate (4) thermostates.
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 REALTY ASSOCIATES PROTEMP ASSOCIATES INC
15350 SW SEQUOIA PKWY #300 -WMI 9788 SE 17TH AVE.
PORTLAND, OR 97224 PORTLAND, OR 97222
Phone: Phone: 503- 233 -6911
Reg #: ELE 26- 1063CRE
LIC 38868
FEES SUP 2613LEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/8/2005 $75.00
[TAX] 8% State Surcha 4/8/2005 $6.00
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: p: re Permittee Signature: �, •
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 Application FOR OFFICE USE ONLY
City of Tigard Da ° t�yy V - 265 -96- -, Permit No.: A� em O6
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ///111
Phone: 503.639.4171 Fax: 503.598.1960 r li - Date/By: Other Permit:
Inspection Line: 503.639.4175 . 1 e_ Date Ready/By: Iar 65 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: '` (7 Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ?Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location
OService over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential
❑ 1 and 2 family dwelling €ommercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building Multi family Master builder 0 Other: Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: S MS S Job site address: 4cro 0 Health - care facility ['Other: .
� C o►e t�t01►. -e ..V Submit 2 sets of plans with any of the above.
City/State /ZIP: fynm D/LL • The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 2 5 —� I Project name: fiS,le L 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: 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
DESCRIPTION OF WORK Each manufactured or modular
R n / C.g / dwelling, service and /or feeder _ 90.90 2
ole -/� f Theto ,ost a 41 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ 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: ( ) 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
0. APPLICANT I "CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: PRA re, 4.f.cpG ,,„,.. branch circuit
Contact name: B. Fee for branch circuits
,QRvt -- ,e -- c., - without service or feeder fee,
each branch circuit 46.85 2
Address: 9' 7 7( s /7r4
/9.,,c,.._ Each add'I branch circuit 6.65 2
City /State /ZIP: rikr4 DA Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: col ) '61?-4./7 I Fax:: 6'4S ) 23 fr_. 77t: Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 i 2
Business name: S° A f 4.4-_
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Investigation per hour (I hr min) 62.50
Phone: ( ) I Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic WC g' I Electrical Lic.:2eieV Ui Lic. S yr t �
Subtotal 7 J t)
Suprv. Electrician signature, require /� Plan review (25% of permit fee)
Print name: O 1' fjJ�eA �r !� Date: Lj/._g" --(�� State surcharge (8% of permit fee) 6- 6t) /" TOTAL PERMIT FEE (!4 60
Authorized signature: This permit application expires if a permit is not obtained 180
days after it has been accepted as complete
Print name: a ) , ._ 40 iiv•e Date: yam- 8' -0s • Fee methodology set by Tri- County Building Industry Service Board
•
Number of inspections per permit allowed.
i:\ Building \Permits \ELC- PermitApp.doc 12/03 440.461 5T( I 0 /02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005.00080
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/8/2005
Phone: (503) 639 -4171 /u �p'� I II
Inspection Requests (24 Hrs.): (503) 639 -4175 `:
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 2
SITE ADDRESS: 06650 SW REDWOOD LN 250 CLASS OF WORK:
SUBDIVISION: PP1996-048 LOT #: 002 TYPE OF USE:
PROJECT NAME: HOUSEHOLD FINANCE
DESCRIPTION: Relocate (4) thermostates.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503233.6911
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 004664 -02 503. 5146199 N
Corrections/Comments/Instructions:
M PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /1 �'""" Date: - 45 -- c_s - Phone #: (503) 718 -