Permit q CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00330
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/5/2007
PARCEL: 2S113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 375 ZONING: I -
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: OREGON STATE BAR
Project Description: HVAC 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 STE 1100 5188 SE INTERNATIONAL WAY
PORTLAND, OR 97201 MILWAUKIE, OR 97222
Phone: Contact #: PRI 503- 462 -4822
FEES Reg #: ELE 26 -571 CLE
LIC 50897
Description Date Amount
Total REQUIRED ITEMS AND REPORTS
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: , 42755 ) 1 2 47cij..e_. Permittee Signature: Q '//
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.
rctrical Permit Application FOR OFFICE USE ONLY
. ,...
City of Tigard Received 7 .
Date/By. '0 • , 5 ' pennirt E-Lk2o 1_ g30
13125 SW Hall Blvd, Tigard, OR 97223 Plan Re , i/
i a.
Phone: 503.639.4171 Fax: 503.598.1960 tillite
•" II ' Date/By.
, Iry 11 Other Permit:
Inspection Line: 503.639.4175 Date Ready/By. ions: Fd See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
• ''..," . t4f.': '. .., ':. TYPE OF -- • - :-."4-Pli-: . :; , :j.'i , - ' .:, ::.... iREVIEW - .." -: :i . ';' - :;'' ,: t:- ; :4-!.' , ti:e.,-4.,,c." .i
0 New construction 411-Additio alteratio eplacement Please check all that apply: .
0
0Service over 225 amps, comml ['Hazardous location
Demolition Other: 0
0 Service over 320 amps - rating El Buildng over 10,000 sq: ft.,
• !.......:_;,-_.:7 '..:::;.:1: CATEGORY OF CONSTRUCTION --- -.:::, • ;-:,.. •-..„... :. -.. of I- and 2-family dwellings 4 or more new residential
0 1- and 2-family dwelling tniercial 1 dustrial 0 Accessory building OSYstem over 600 volts nominal units in one structure
El Building over three stories 0 Feeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other:
1:Occupant load over 99 persons 0 Manufactured structures or
% - ' - - •:: .. - .".10B SITE INFORMATION AND LOCATION ' - 0Egress/lighting plan RV park
-., ,..,. --, 0 Health-care facility ['Other:
Job no.: 356 3 Job site address: I Co 0-3 ( `-ozo 0 A.v./, 1 7 a
Submit 2 sets of plans with any of the above.
City/State/ZIP: - rt • j„) OrE5 CY1 .5 •Vfelf 31.5 The above are not applicable to temporary construction service.
-=,......,....4......1-..;:.:! .. .;.., FEE*. SCHEDULE ',";.... 1'-:
Suite/bldg./apt. no.: ai l/ / A Project name:P\
L ) V ey:71 S A,7Jr Description I Qty. I Fee. I Total I ..
s
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. addi 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
... .. . -::::. .. OF WORK --- . ' -....:.: -, -. -. Each manufactured or modular "
dwelling, service and/or feeder 90.90 2
"D DC_ CA-rD ( s sell SD' --- Services or feeders installation, alteration, and/or relocation
i 200 amps or less 80.30 2
— 201 amps to 400 amps 106.85 2
'..J - ..-.i..0 PROPERTY :OWNER --- . . !-:( . .. ' : 0 TENANT
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
0 APPLICANT • 0 CONTACT PERSON • - 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,
46.85 2
each branch circuit
Address:
Each addi 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-mail: Signal circuit(s) or limited-
, .y.: -. .._ , .. energy panel, alteration, or
extension. Describe: / Page 2 2
Business name:
1 :71-4‘0._.—
Address:
/ ___,-- , s. /0 Each additional inspection over allowable in any of the above
Si8‹ 5e 4\1 Per inspection 62.50
City/State/ZIP: M 1 (AL) cu..'J Li2 I OY'e,:\ Investigation per hour 0 hr min) 62.50
Industrial plant per hour 73.75
Phone: 5 4 Li --)....)_ Fax: --- 3)
CCB Lic.: 5 7 Electrical Lic.A,_57/e/ Suprv. Lic.:605LEA Subtotal
Suprv. Electrician signature, required: a(9 F ,) Plan review (25% of permit fee)
^
SC86 aa — Date: . 7/ q /07 State surcharge (8% of permit fee)
Print name: ,4( TOTAL PERMIT FEE - In ---
• Authorized signature: 7._....._,,„,,,„, This permit applicatioa expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: (p.o,„,,,,st.„(-) Date: 71 / • Fee methodology set by Tri Building Industry Service Board
•• Number of inspections per pennit allowed.
i: \ Building\ Permits \ ELC-Perm itAppdoe 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #:d o0 7 -CO 330
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 "1410 Ill
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: `t 0 37 Ger do)ua 3 7S' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: MI / 1 1 /p 7 Pour Time:
Code # Inspection Description Confirm # Contact # Message
/33 °S7y43 - b(
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ CA FOR INSPECTIO■ ❑ ADDITIONAL FEES ASSESSED
/
Inspector: Date: 1 1 1 1 O Phone #: (503) 718- 19' V
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I RR :1.007 -00330
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9f,/
Phone: (503) 639 -4171 Z, ,II,„prIi
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/9/2O00 TIME: 7 :01AM PAGE: 19
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 376 CLASS OF WORK:
SUBDIVISION: FANNO (,REEL! PLACE LOT #: TYPE OF USE:
PROJECT NAME: ()tzt- t.,t)N STATE BAR
DESCRIPTION: HVAC Controls, sensoas.
OWNER: OP11�7 NORTHWEST LLC, PHONE #:
CONTRACTOR: HVAC INC PHONE #: + &)3462 -4822
Inspection Request Scheduled For: Date: 1/9/20013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 EIectric:al final 0E.;2840-01 503 \ 'Y
Corrections /Comments /Instructions:
C NN\ f,----,,,,
r
vV l
;g1DASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I 1 FAIL n CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: G\ �'VV Date: 1' U 6 1 Phone #: (503) 718- 10 i