Permit „:„ .F.._, a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00300
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/30/2007
PARCEL: 2S 113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 300 ZONING: I - L
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: PROFESSIONAL LIABILITY FUND
Project Description: Controls, sensors.
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:
OPUS NORTHWEST LLC HVAC INC
1500 SW FIRST AVE SUITE 1100 5188 SE INTERNATIONAL WAY
PORTLAND, OR 97201 MILWAUKIE, OR 97222
•
Phone: 503- 916 -8963 Contact #: PRI 503- 462 -4822
FEES Reg #: ELE 26- 571CLE
LIC 50897
Description Date Amount
[ELPRMT] ELR Permit 7/30/2007 $75.00
[TAX] 8% State Surcha 7/30/2007 $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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
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.
% Ele4rical Permit Application 1. 0R o rricv I sr 0. I .1
-
City of Tigard
Received-AMMEll Pe.
Date/B • f • 0 • nult 1.1 , la 00 —0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax 503.598.1960 .,....,..,,, I,
Datc/B
Inspection Line: 503.639.4175 - ' '1 J. Date Ready/By: lial El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Methoct Supplemental Information
1:1 New construction Q_Additio altera • placement Please check all that apply:
0 --
0 Service over 225 amps, comm Ei Hazardous location
Demolition Other: 0
0Service over 320 amps - rating 0 Buildng over 10,000 sq. It,
CATEGORY a li :sriiuerioig .- ::-,:1, - -•,-.Ffe , .=:':' , --7!?-:±; . : -.1 7,. --.;-. of I-and 2-family dwellings 4 or more new residential
El 1 - and 2-family 7
ily dwelling -Co 111Co me rcia • dustrial 0 Accessory building
r
OSystem over 600 volts nominal units in one structure
0 Building over three stories 0 Feeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other:
DOccupant load over 99 persons 0 Manu factured structures or
•••:''''; :i. ';', -. .-.- JOB SITE INFORMATION AND LOCATION .'-.!;"! 0 Egress/lighting-plan RV park
Job no.: 3553 Job site address: /603'7 s 0 totaaV Po
, i 0 Health-care facility 0 Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: '
r S I f)l'e56 - The above are not applicable to temporary construction service.
l t. - . :I ;.;4'Wrgi4 i4i 7, :': WITEE!'et , SCHEDU,LE - i: 6 &i:\ : M.7.4Y..t .-
Suite/bldg./apt. no..
A Project nameTa
Description I QV' I Fee I Theil I ..
Cross street/directions ro 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. addi 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
";:',.;',.t;.;;;; ;,..;. 7- Each manufactured or modular
dwelling, service and/or feeder 90.90 2
D DC- co-n-1,- a (S. .Sevl Sac- Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
• ;0 ,.,z 3. itsfAt:;:ng ,,,,,,, I ....,.„ : - 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
13 APPLICANT '`;'.:'• ' ;;`. :`..'-` CONTACT'PERSON 5.:,,.';:=--.':.::'; A Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address:
Each addl branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included) _
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
i ;'..a. , ": s .:” . '-: CONTRACTOR .;;Tif,. 3 . - c.,7-F-A.F,4.;;' ,- -14.; , ;`, - .5:::2 7 .1,V..; , _ energy Panel, alteration, or
extension. Describe: / Page 2 2
Business name: 14t) AC._ I —.../.40.--
Each additional inspection over allowable in any of the above
Address: SI, %- g S E 4 uk3, cr.,
Per inspection 62.50
City/State/ZIP: M_k_ Lt.A.) CL-8-t U i OreAny, -I/ ,X-D Investigation per hour (1 hr min) 62.50
Phone: ( ) L I ca--(1 .)-3-- I ea.( V tgoa- (05 Industrial plant per hour 73.75
4
CCB Lic.: 50 gq 7 I Electrical Lic.4 ag Lic.: ori,o9 Subtotal
Suprv. Electrician signature, required: 1 717 040'd' Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: 4 ECC) kcara2.—. Date: 7/q /67
- TOTAL PERMIT FEE 41 180
th
Auorized signature: j tA j This permit application eeplies if a permit h not obtained • •
R-0(.41116Y
days idler it has been accepted as complete
Print name: ,. ...Se.,v(ve..., Rok(Jnser--..,-) Date: '-? / 5 /6 • Fee methodology set by Ili-County Building Industry Service Board
•• Nber of inspectims per permit allowed.
r■BuildingTertniis \ELC-PermitApp doc 12/03 440-46I5T(1002COMAVEB
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: ELR2007 -00300
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 7/30/2007
Phone: (503) 639 -4171 I C I
Inspection Requests (24 Hrs.): (503) 639 -4175 ...: `__—
INSPECTION WORKSHEET FOR DATE: 9/4 /2007 • TIME: 7 :01AM PAGE: 34
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 300 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE L #: TYPE OF USE:
PROJECT NAME: PROFESSIONAL LIABILITY FUND
DESCRIPTION: Controls, sensors.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503- 916.8963
CONTRACTOR: HVAC INC PHONE #: 503 - 462 - 4822
Inspection Request Scheduled For: Date: 9/4/2007 Pour Time:
Code # Inspection Description - onfirm ° Contact # Message
135 Low voltage 055049 -03 503-462-4822 N
Corrections /Comments /Instructions:
r PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` 0 b Date: RI 4 (01 Phone #: (503) 718- V111/0
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: ELR2007. 00300
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/300007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .,' I �..
INSPECTION WORKSHEET FOR DATE: 1/9/20013 TIME: 7:01AM PAGE: 17
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD :i00 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: PROFESSIONAL LIABILITY FUND
DESCRIPTION: Controls, sensors.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503-91G -8963
CONTRACTOR: HVAC INC PHONE #: 503462-4822
Inspection Request Scheduled For: Date: 1/9/2008 Pour Time:
Code # Inspection Description Cghf # Contact # Message
199 Electrical final 062860 -01 503 - 459-9226 N. Y
Corrections /Comments /Instructions:
\,\.,
i
N.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C N O U LG Date: II OR Phone #: (503) 718- AL_