Permit •
CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
, COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00306
T,t 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/30/2008
PARCEL: 25101 DB - 00103
SITE ADDRESS: 07360 SW HUNZIKER RD ZONING: C - P
SUBDIVISION: HILLTOP BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HILLTOP BUSINESS CENTER
Project Description: Low voltage for thermostats.
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:
ROBINSON DEVELOPMENT CASCADE HYDRO -AIR OF OREGON LLC
PO BOX 91305 PO BOX 10894
PORTLAND, OR 97291 PORTLAND, OR 97296
Phone: Contact #: PRI 503-224-1100
FAX 503- 235 -8540
FEES Reg #: ELE 566LEB
LIC 26- 1222CLE
Description Date Amount
[ELPRMT] ELR Permit 10/30/200E $75.00
[TAX] 12% State Surch 10/30/200E $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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: / —/ 'ermittee 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.
,f, 1, Oct 30 08 12:22p Cascade Hydro -Air 503 -235 -8540 p.l
Electrical Permit Application t , 1 -k1 ' i • v FOR O FFICE JSF OI\LYt q. =.L , ,,c
-' V '''.4: City of Tigard ...: ;CEIN Re c e,1 47-- 1 Permit N.
• ty g Date r .: / ; 0 ck EL � - C.o
71
° 13125 SW Hall Blvd., Tigard. OR 97223 Plan Pr1,rn
„„ Phone: 503.639.1171 Fax: 503.598.19611 , 0 200 D ate $y Other Fermi -
IGA' `RD1
if Inspection Line: 503.639.4175 Rae Reath En .
'O ' ` See Page 2 for
idtlad Internet: www.tigard- or.gov 'otiticd`�tethod: • 7 ;e9 I Supplemental Information
• TYPE OF WORK: '.N •�� 0 � 0 (zo, O 1 PLAN REVIEW
CI New construction ® Addition /alteration4e,pla rltCtlf t� I Please check all that apply (submit 2 sets of plans wraems checked below):
❑ Service or feeder 410) amps or more ❑ Building over ulnae stories.
❑ Demolition ❑ Other: where the available fault current ❑ ■larirras and boatyards
CATEGORY OF C:ON.STR1.UCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to around. or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ® Cottuncrcial/industrial [Ti Accessory building amps for all other installations. buildings.
❑ Multi- lamily ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 K VA or
- - - - -- ❑Emergency system. Larger s p,ratcl+: den"ed system
JOi3 SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ " t" 'F." "1 ' "' I -3"
Job no.: Job site address: 7360 Hunziker 1001-P or more "cc upancy.
❑ Six or more residential units. ❑ Recreational - ehiele pa ks.
City / State/ZIP: Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ hazardous locations. 600 volts nominal.
Suite (bldg. /apt. no.: Project name: Hilltop ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/ directions to job site: 72 nA + Hunziker t �r•,e�rn.,n I pry_ - ] gee i l ..rat I -
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: ' Lot rto.: 1,000 sq. ft. or less I 145.15 I 4 -
- En. ndd'1 500 sq. ft. or portion 33.40 j 1-17.
1 ax map /parcel no.: Limited energy. residential
75.00 2
1ESCRI1'TiON OF WORK forth :iii, it r
Limtt energy. multi- family 75.00 2
Move Low Voltage thermostat on First Floor rcsiticntial (c, I th ats e s. u I
Services ar feeders installation. alter:: iun.:md ;or relocat4.0
200 amps or less 80.30 _ 2
® PROPERTY OWNER 1 ❑ TENANT 201 amps to 400 amps - 106.85 2
Name: Roberson Construction 401 atnps to 600 amps 160.60 2 s
601 amps to 1,000 amps 240.60 2
Address: 213611 NW Anthcrtt'ood Dr.
Over 1,000 amps or volts 454.65 2
C1tciState /ZIP: Hillsboro, OR 97124 Temporary ser'cices or feeders installation, alteration, and /or 1
relocation
Phone ( ) - I Fax: ( ) 200 amps or I ess 66.85 I I 1
^
Owner installation: This installation is being made on prolnrtt that 1 own \cinch is not
20I amps to 400 amps 100.30 I i 2
am j
iintended intended Idle sole. lease. rout. or exchange. accord M.! to ORS 447. 4-19. G711. and %0 401 s to 599 amps 133.75 2
p 1 ?
Branch circuits - new, alteration. or extensimt, per panel
(.)\vier Si anat II re: Date':
_ .A. Fee for branch circuit? »77f;
above service o r feeder f
I:3 APPLICANT 1 El CONTACT PERSON 6.65 2
each branch circuit
Business name: CASCADE HYDRO -AIR 13. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: Kevin Bibler first branch circuit
Address: P.O. Box 10894 Each add'I branch circuit 0.65 2
Afiscell:uteous (se !. r 111' feeder not included 1
City /State/ZIP: Portland, OR 97296 Each manulaaured or modular I 90.90 i 2
dwelling. service and/or feeder
Phone: t 503 2 24-1 100 ev/ (e53k Fax:: (503 ) 23S - $SLfo Reconnect only 66,85 • 2 1
E -mail: - Pump or irrigation circle 53.40 2 _
CONTR1C'TOR Sign or outline lighting 53.40 I 2 1
Signal circuit(s) or limited -
Rusiness name: CASCADE HYDRO -AIR energy panel, ahcratiott. or
extension. Describe: Page 00
Page 2 75 . 2
Address: P.O. Box 10894 H v,1C
City/State/ZIP: Portland, OR 97296 Each additional inspection over allowa in :lily of the alioce
Per inspection 62.50
Phone: ( 503 224 -1100 Fax (543 ) a3S - 8590 investigation per hour (I hr min; 62.50
CCB Lic.: 159918 Aril;) Electrical Lic.: 26- 1222C(,t3- I Suprv. Lic.: 566LEg hldustria{ plant per hour 73.75
( J(t 11 1 ELE( ::R1("AL PERMIT FEES
Suprv. Electrician signature, required: 6.,,,,. t Subtotal: 75.00
Platt review (2S% of permit la)
Print name: Randy Drake i Date: 10/30/08
State surcharge (12% of pennit fee): 9.00
Authorized signature.: TOTAL PERMIT FFF: 84.00
This permit application expires if a permit is not obtained within 180
Print name: Date. days after it has been accepted as complete.
-
,1 Oct 30 08 12:22p Cascade Hdro -Flir 503 - 235 -8540 p.2
Electrical Permit Application - City of Tigard 6
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*
n Burglar Alarm
Fl G arage Door Opener*
1 Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial 575.00
system
;S r: (3_ \_h918 )) t)i.I I'
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
1 Clock Systems
n D ata Telecommunication Installation
n F irc A1aum Installation
® "VAC
TI I nstrumentation
❑ Intercom and Paging Systems
❑ Landscape - Irrigation Control*
❑ M edical
n N urse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
1 Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
CITY e0.FTG ® . A
Mt ONG DOVISO. , N PERMIT ktLV.P016. 0036L
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171����� "�4p��iiif1 °�.I�.
VI �� ,
Inspection Requests (24 Hrs.): (503) 639 -4175 *-214,
INSPECTION WORKSHEET FOR DATE: '.Q • 31 . � TIME: PAGE:
SITE ADDRESS: .9 3 60 5 W V � - 211& (L CLASS OF WORK:
SUBDIVISION: 60 LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
v SS 1 I PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
o b Inspector: Uv Date: I D 31 o Phone #: (503) 718 -