Permit . = V
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
A-tow DEVELOPMENT SERVICES PERMIT #: ELR2006 -00020
' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/12/2006
PARCEL: 2S112DD -00701
SITE ADDRESS: 15854 SW UPPER BOONES FERRY RD BLD.0 ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK II LOT: JURISDICTION: TIG
Project Description: Low voltage 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 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 1/12/2006 $75.00
[TAX] 8% State Surchart 1/12/2006 $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 -0 1 -0100. You may obtain copies of these rules or direct questions to OUNC at 5 3- 246 -6699.
Issued By: 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.
E1.ectrital Permit Application FOR OFFICE USE ONLY
City of Tigard ��I��® Date/By / 46' Permit Nog/ oev
Tigard, 13125 SW Hall Blvd., TI , OR � �6 '"'`"'VV
g Plan Review
Phone 503 639.4171 Fax: 503 598.1960 Date /By Other Permit
Inspection Line: 503.639.4175 JAN 12. 2O 6 U , , e l I Date Ready /By a El See Page 2 for
Internet www ci.tigard.or.us N L Notified/Method- _ Supplemental Information
ClaPit OF WD PLAN REVIEW
❑ New construction P,; tahmbt tYt>at 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 ® 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 mole
['Occupant load over 99 persons ❑Manufactured structures or
. JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
❑Health - care facility DOther.
Job no.: 8807 Job site address: 15854 SW Upper Boones Ferry
Submit 2 sets of plans with any of the above
City /State /ZIP: Tigard Oregon The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Build. C Project name: (2) Cool 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: Lot no.: Ea add'l 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
Thermostat and low voltage wireing 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'l branch circuit 6.65 2
• City /State /ZIP: Portland Oregon 97222 Miscellaneous (service or feeder not included)
Phone: (503) 519 -6199 Fax: : (503) 2389767 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: Page 2 ( 2
Business name: Same as above
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: (503) 519 -6199 Fax: (503) 238 -9767 Industnal plant per hour 73.75
ELECTRICAL PERMIT FEES*
• CCB Lic.: 38868 Electrical Lic.: 26 /
1063CRE $uprv. Lic.: 3948LEB Subtotal
�
Suprv. Electrician signature, required: /l 11 ( fl /,i , ». Plan review (25% of permit fee)
A
` `y' W/ State surcharge (8% of permit fee)
Print name: \ � n 91 1
.. -- Date: 1/12/06 '/ I
A f TOTAL PERMIT FEE n
Authorized signature: �� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: BRV Ce— rt J r��� Date: 1//12/06 ± , Fee methodology set by Tri- County Building Industry Service Board
�+ Number of inspections per permit allowed
I \ Budding \ Perms \ELC- PermitApp doe 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD.
BUILDING DIVISION PERMIT #: I_I R 200G 00020
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/i7J2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/2J2006 TIME: 7:02AM PAGE: 17
SITE ADDRESS: 1 \ Sly+/ UPPER BOONES FERRY RD BLDG. CLASS OF WORK:
SUBDIVISION: OREGt7N BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME: (a) C001.
DESCRIPTION: Low voltagciliVA] This space currently being used for stolage only.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSbCIATES INC PHONE #: ?;03- )33691
Inspection Request Scheduled For: \ Date: 2/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electiical final 026162 -02 M3-519-6199 Y
Corrections /Comments /Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N O8LE Date: 9-2-610 Phone #: (503) 718- 2I - 1 b