Permit ~i' r 4 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
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L7 COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00296
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/24/2007
PARCEL: 2S 112 DA -01300
SITE ADDRESS: 06640 SW REDWOOD LN 302 ZONING: I - P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 001 JURISDICTION: TIG
PROJECT: PORTLAND CLINIC
Project Description: Low voltage for HVAC wiring. Job No. 07133
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 HUNTER DAVISSON
15350 SW SEQUOIA PKWY #300 -WMI 1800 SE PERSHING
PORTLAND, OR 97224 PORTLAND, OR 97202
Phone: Contact #: PRI 234 -0477
FEES Reg #: ELE 26- 682CLE
LIC 1612
Description Date Amount
[ELPRMT] ELR Permit 9/24/2007 $75.00
[TAX] 8% State Surcha 9/24/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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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 -00 00. Y ay obtain copies of these
rules or direct questions to OUNC - • ' 46.6699 or 1.800.332.2344.
Issued By: i/ //// //, /// , Permittee Signature:
4 0
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.
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Electrical Permit Application FOR orFlc u se o � l ..�
City of Tigard - n 13125 p l;� Vikr.--
Received Oi Q7 PermitNo.: g (07.—COA94 125 SW Hal Blvd. "/2 3 -_-1 Plan Review
3 960 Plan R
12 Phone: 503.639.4171 ax: Sf19': 960 DateB : Other Permit:
T 1 G A It D Inspection Line: 503.639.4175 C�1 n 'tool Date Ready/By: lug.. ® See Page 2 for
Internet: www.tigard - or.gov A/1 f+ J Notified/Method: Supplemental Information
1 - � � .
TYPE
{{ eeii v "• N:1 PLAN REVIEW
El New construction AddFiie�>#rlt ` aktityl c filar in�� Please check all that apply (submit ?sets of plans w /items checked below):
�p��p�� ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Q_ (�� 0 3.�' where the available fault current ❑ Marinas and boatyards.
• CATEGORY OF CONSTRUCTION exceeds 10,000'amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
2 /� I OOHP or more. occupancy.
Job no.: i33 Job site address: �S/e s f , j/� • ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP "V �` ❑ Health - care facilities. ❑ Supply voltage for more than
(CJ. /a / � � ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 3 or Project flamer-Pori/64 4 U r S/st' /� 0 Service or feeder 600 amps or more.
h' �' FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee- I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
�/( ,j / Limited energy, multi - family 75.00 2
- � •A Q 11,/,..., t 2 mil., '/ hee-n7D
A/9 �jYs i residential (with above sq. ft.)
� — �/ Services or feeders installation, alteration, and/or relocation
&/I( r�i&C,D,k / �v 7 a0 1C/7?0 f 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: , Ct, V 601 amps to 1,000 amps 240.60 2
Address: ‘g( l b gait i ` n • Over 1,000 amps or volts 454.65 2
City/ State/ZIP. 7 / ' ``�, n Tem ors services or feeders installation, alteration, and /or
�Q /P�r �/C 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: u JJ,,ee —MY/ B. Fee for branch circuits
Contact name: it r k
without branch n crvi ir or feeder fee, 46.85 2
first branch circuit
Address: / 7---- Each add'I branch circuit 6.65 2 Sr f s Miscellaneous (service or feeder not included)
City/State/ZIP: • b r t. (aid D 9 72.62_ Each manufactured or modular 90.90 2
I dwelling, service and/or feeder
Phone: (Co)) 23</, Q 7 Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: c;,t ' QUO
energy panel, alteration, or 7
Address: extension ee: Page 2 / 5 • 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: / f / °j_ Electrical Lic.: Suprv. Lic. :3 f 4 Industrial plant per hour 73.75
lr ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require : e66 Subtotal: �5U0
G�
Print name: /!/ f / //J ate: ' -. � ? ,�7 Plan review (25% of permit fee):
�, State surcharge (8% of permit fee): 69 ,0 0
Authorized signs v%y'
� ! re: ,/ TOTAL PERMIT FEE: g 1 .60
CA
?a
This permit application expires if a permit is not obtained within 180
Print name: ,. a ��,�/� / / Date: 7 Z3 '�, days after it has been accepted as complete.
• Number of inspections allowed per permit.
1 ABuilding\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: ELR7007••00296
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9124/2007
Phone: (503) 639 -4171 '11�:�1�
Inspection Requests (24 Hrs.): (503) 639 -4175 . IL.
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7 :00AM PAGE: 80
SITE ADDRESS: 06640 SW REDWOOD LN 302 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: PORTLAND CLINIC
DESCRIPTION: Low voltage for HVAC wiring. Job No. 07133
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: HUNTER DAVISSON PHONE #: 2340477
Inspection Request Scheduled For: Date: 11/9/2007 Pour Time:
Code # Inspection Description - anfir• • Contact # Message
135 Low voltage 059311 -01 503 -793 -9802 N
Corrections /Comments /Instructions:
. 1\ )
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GM v Date: U- Phone #: (503) 718 - 2- itti'D
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2007 -00296
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9124i2007
Phone: (503) 639 -4171 4;
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 9/27/2007 TIME: 7:00AM PAGE: 35
SITE ADDRESS: 06640 SW REDWOOD LN 302 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: PORTLAND CLINIC
DESCRIPTION: Low voltage for HVAC wiring. Job No. 07133
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: HUNTER DAVISSON PHONE #: 234.0477
Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description ,C-onfirm # Contact # Message
135 Low voltage \ 056478 -01 503 -793 -9802 N
Corrections /Comments /Instructions: .
R A ./c v ", to , ,
TA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY, 9 II Date: 91 2.`ll('n Phone #: (503) 718- .2_4q6
_ .
r ,