Permit A, CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00098
— " 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/29/2005
PARCEL: 25101 DC -04603
SITE ADDRESS: 07405 SW TECH CENTER DR 160 ZONING: I -P
SUBDIVISION: SW COMMERCE CENTER LOT: JURISDICTION: TIG
Project Description: Low voltage for HVAC 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:
WATUMULL PROPERTIES CORP CLIMATE CONTROL
307 LEWERS ST #6FLR 16500 SW 72ND AVE
HONOLULU, HI 96815 TIGARD, OR 97224
Phone: Phone: 503 453 - 4822
Reg #: LIC 62196
ELE 26 -811 CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/29/2005 $75.00
[TAX] 8% State Surchart 4/29/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, St.te of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This p: rmit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATT TION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those r. - .,` se_o4 in OA' 952 - 001 -0010
through OAR 952 -001- 100. You may obtain copies of these rules or dire questio 'o OU • - ;3- 246 -6699.
Issued By: 0, � rj 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 Received ®sa= PermitNo.: ` . i� A A _� y'g
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 -y4 � � a Date/By: l.�
Othe Permit .. y: �` 4 6
Inspection Line: 503.639.4175 c e'� I,. Date Ready/By: 1u ' 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: /Co. 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
DService over 320 amps - rating DBuildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling 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
DOccupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION �" ❑Egress/lightingplan RV park
Job no.: Job site address: .7i/05-5w T et h (�., I-ea OR ❑Health -care facility DOther:
Submit 2 sets of plans with any of the above.
City/State /ZIP: 11 9 and pg q 7 ),A The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: TR f} n sw es+ei n Qty.
Description I Qty. I Fee. I Total
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'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK • Each manufactured or modular
bow vol-1-65e dwelling, service and/or feeder 90.90 2
Co n f C J IS 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: TRAnsweSfeen Pu b l i s hi np 601 amps to 1,000 amps 240.60 2
Address: 7 9 .5 T u- ctnkQ'1) . Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: T r y,w4 OR q7; y 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
lia APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: CI t rnio -t con f 0 1 branch circuit
B. Fee for branch circuits
Contact name:
D g Kin U R fion without service or feeder fee, 46.85 2
q each branch circuit
Address: I ()coo VJ '! fl VQ E ach add'1 branch circuit 6.65 2
City/State /ZIP: ?0, (I i Et r d 0g g dam Miscellaneous (service or feeder not included)
Phone: (503) 453 l f g ? 2 Fax: : (503) q 6g- 7,?, Li Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: i Page 2 7� 2
Business name: C I l m fife - P Co n tK D 1
Address: l 6 S 00 S 7 a nd V2 Each additional inspection over allowable in any of the above
w Per inspection 62.50
City /State /ZIP: PD K f i l,d OR 9-7 , y Investigation per hour (1 hr min) 62.50
Phone: (So3) Lis? - 4 9 a�, Fax: (5- 96 $ • 7 „2%i Industrial plant per hour 73.75
��66 ELECTRICAL PERMIT FEES*
CCB Lic.: p1g'iCt, 6 Electrical Lic.: Suprv. Lic.: Subtotal 75. —
Suprv. Electrician signature, required: fil 1,,) f Plan review (25% of permit fee)
Print name: Ill Pd W �' Date: State surcharge (8% of permit fee) it, Oct
I t l TOTAL PERMIT FEE V ,
Authorized signature: /_ I • I Oh�vV This permit application expires if a permit is not obtained within 180
�`' days after it has been accepted as complete
Print name: I l l ry GZ k - Po v 2l + Date: Lu 10 f • 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- 4615T(10/02/COM/WEB
Electrical Permit Application - City of Tigard
• Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical -
❑
•
Nurse Calls
❑ Outdoor Landscape Lighting*
0 Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required .
•
for all other installations
i:\ Building \Pennits\ELC•PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005-00098
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/29/2005
Phone: (503) 639- 4171 11�Ip�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/24/2005 TIME: 7 :09AM PAGE: 64
SITE ADDRESS: 07405 SW TECH CENTER DR 160 CLASS OF WORK:
SUBDIVISION: SW COMMERCE CENTER LOT #: TYPE OF USE:
PROJECT NAME: TRANSWESTERN PUBLISHING
DESCRIPTION: Low voltage for HVAC wiring.
OWNER: WATUMULL PROPERTIES CORP, PHONE #:
CONTRACTOR: CLIMATE CONTROL PHONE #: 503 - 453-4822
Inspection Request Scheduled For: Date: 5/24/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 007518 -01 503-453-4822 N
Corrections /Comments /Instructions:
( 414 )- -)
1//
fID LPASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
FAIL 111 CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: D at2 r Phone #: (503) 718 -
1 -