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Permit
! • _ R !� v CITY OF TI GA R D ELECTRICAL RESTRICTED ENERGY PERMIT ' `� ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00073 r I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/31/2008 PARCEL: 2 S 112 D A -00800 SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 ZONING: I - SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG PROJECT: CAMBRIDGE INTEGRATED SERVICES Project Description: Low voltage for HVAC. 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 GOHMAN MECHANICAL 15350 SW SEQUOIA PKWY #300 -WMI 412 S BEAVERCREEK RD #602 PORTLAND, OR 97224 OREGON CITY, OR 97045 Phone: Contact #: PRI 503- 650 -1588 FAX 503- 655 -0514 FEES Reg #: ELE 3- 495CLE LIC 119952 Description Date Amount [ELPRMT] ELR Permit 3/31/2008 $75.00 [TAX] 12% State Surch 3/31/2008 $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 Notifica - - _ ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0110. You may obtain copies of these rules or dir- ct question o OU ■ at 503.246.6699 or 1.800.332.2344. Issued :y: �� Permittee Signature: _ A`A7I 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. r ow a • Electrical Permit Application FOR OFFICE USE ONLY Received if D �i L 2 City of Tigard Date : / ► Permit No.: Q X73 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C . Phone: 503.639.4171 Fax: 503.598.1960 DateB : Other Permit: f I G A li D Inspection Line: 503.639 Date Ready/By: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ 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 ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I- 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 ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A", "E", "I - 2 ' l - 3", IOOHP or more. occupancy. Job no.: Job site address: 5// , 5 w l/ 0 /A Pell ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: p - 0 7 aa t� ❑ 7 Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.r /00 Project name: LARegi - � p��0 ❑ Service or feeder 600 amps or more. 1^' rN "' T 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: 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 �, Limited energy, multi- family 75.00 2 P� LOS' AND Pe p(�� L 7 SPA..? �S �/� ? residential (with above sq. ft.) 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 Name: PA t/ s 7 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 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 1 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, er 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: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit _ 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: ( ) 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: ivin oN energy panel, alteration, or Address: / i,.5.-0 -587. i1/410 Gv a extension. Describe: Page 2 2 City /State /ZIP , g4» 45 ?-7015.- J7 ©f 5 Each additional inspection over allowable in any of the above r Per inspection 62.50 Phone: (SDI) 6.6 - - f Fax: (503) - '0 'P0?..7 Investigation per hour (1 hr min) 62.50 CCB Lic.: // q95 Electrical Lic.: 3- Sup . Lic.4/O37 453 Industrial plant per hour 73.75 _ ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: -7 6p Print nameLfrM /G v g ",44/ Date: �� /07 _ Plan review (25 %of permit fee): a_ State urcharge (I2% of permit fee): . 7 Authorized signature: .'" TOTAL PERMIT FEE: .DC) This permit application expires if a permit is not obtained within 180 Print name: V x za„. I' Date: Sib days after it has been accepted as complete. • Number of inspections allowed per permit. I \ Building \Permits\EI.C- PermitAppdoc 05/23/06 4404615T(II /O5 /COM/WEB CITY OF TIGARD BUILDING DIVISION PERMIT #: EL.R2008.0t3073 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/31/2008 Phone: (503) 639 -4171 'I f` Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/17/2008 TIME: 7:02AM PAGE: 9 SITE ADDRESS: 15116 SW SEQUOIA PKWY 100 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: CAMBRIDGE INTEGRATED SERVICES DESCRIPTION: Low voltage for HVAC. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: GOHMAN MECHANICAL PHONE #: 503. 660.1588 Inspection Request Scheduled For: Date: 4/17/2008 Pour Time: Code # Inspection Description �©nfirm # Contact # Message 199 Electrical final 068557 -03 503. 830.9691 N Corrections /Comments /Instructions: • ,., I LI N K ASS ❑ PARTIAL APPROVAL El CANCEL El NO ACCESS ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CT's 06Q) L Date: 9I11I ZYt Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008-00073 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3131/2009 Phone: (503) 639 -4171 �u „ ;, rt\ Inspection Requests (24 Hrs.): (503) 639 -4175 "I �� INSPECTION WORKSHEET FOR DATE: 4/3/2008 TIME: 7:02AM PAGE: 42 SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE: PROJECT NAME: CAMBRIDGE INTEGRATED SERVICES DESCRIPTION: Low voltage for HVAC. OWNER: PACIFIC REALTY ASSOCIATES. PHONE #: CONTRACTOR: GOHMAN MECHANICAL PHONE #: 503- 650 -1688 Inspection Request Scheduled For: Date: 9/3/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 057821- 503-830-9691 N Corrections /Comments /Instructions: Y SDASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4\)(V?) Le Date: '1' act Phone #: (503) 718:116b