Permit p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° • COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00311
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/10/2007
PARCEL: 2 S 112 DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: COMMON SENSE
Project Description: T - stats and wiring.
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: Contact #: PRI 503- 233 -6911
FAX 503- 238 -9767
•
FEES Reg #: ELE 26- 1063CRE
LIC 38868
Description Date Amount
[ELPRMT] ELR Permit 8/10/2007 $75.00
•
[TAX] 8% State Surcha 8/10/2007 $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 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 ques 'ons to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: .elk
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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I
lectrical Per.FEGE1 lll►>ED FOR OFFICE USE ONLY
L1 t g of Tigard Recei DateB Y : ved t O Q tZ
�� rJ i Permit Nl�i: ' Q ) ' I
13125 SW Hall Blvd., Tigard, OR 9 — tit 2007 Plan Revie
Phone: 503.639.4171 Fax: 503.59 I D at eBY: Other Permit:
Inspection Line: 503.639.4175 CI TIG a e' II Date Ready/By: 1a : / El See"Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method: ' Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction A Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location
❑Service 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 pit-Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ 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.: ler yd Job site address: i '3 �'� s S QQk� ❑Health - care facility ❑Other:
- v 0 //a ■ 0 Submit 2 sets of plans with any of the above.
City /State /ZIP: 79,44._ owe • p Z Z y / The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.:s��r ci0 Project name: � y A.� 1 , 9 FEE* SCHEDULE
���' /�' /o/� sea) 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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Thermostats& Wiring dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ 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: ( ) 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
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Protemp Associates branch circuit
B. Fee for branch circuits
Contact name: Bruce Butner without service or feeder fee, 46.85 2
Address: 9788 SE 17 Ave first branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP: portland oregon 97222 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503 Fax: : (503
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: / Page 2 2
Business name: Same as above 7 i11r/WOS' t f - !l// q
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: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 38868 Electrical Lic.: 261063cre Suprv. Lic.: 2613 leb Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: /� /rd / V r S /
/ � �
State surcharge (8% of permit fee) ,,
c, j'! � [ Q Date: r•-/ 0 _�7
(/ \ TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained w MM
hin 180
days after it has been accepted as complete
Print name: B A AO c e 13u 'A , r. it.._ Date: g_ a —O , • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is \Building \Permits \ELC- PermitApp.doc 12/03 440.4615T(10/02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007.00311
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/ 10/2(1U7
Phone: (503) 639 -4171 � �
Inspection Requests (24 Hrs.): (503) 639 -4175 s ' PA � ..
INSPECTION WORKSHEET FOR DATE: 10/9/2007 TIME: 7 : 00AM PAGE: 5
SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: COMMON SENSE
DESCRIPTION: T-stats and wiring.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-233-6911
Inspection Request Scheduled For: Date: 10/9/2007 Pour Time:
Code # Inspection Description ( Confirm Contact # Message
135 • Low voltage 057233-02 ) 503 519 -6199 N Y
19 q i^,NAL—
Corrections /Comments /Instructions:
r
'• /, .
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C7--r V %'4 Date: lb 1601 Phone #: (503) 718- 14k
CITY OF TIGARD
BUILDING DIVISION A... PERMIT #: ELR2007- 00311
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/102007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 p`._..
INSPECTION WORKSHEET FOR DATE: 8/21/2007 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: COMMON SENSE
DESCRIPTION: T-stats and wiring.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 -233 -6911
Inspection Request Scheduled For: Date: 8/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 054404 -02 503. 519.6199 Y
Corrections /Comments /Instructions:
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' 6 ‘bW - Date: 2 J V') Phone #: (503) 718- VitI0