Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00312
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/5/2008
PARCEL: 1 S136CD -00500
SITE ADDRESS: 08050 SW PFAFFLE ST 110 ZONING: C -
SUBDIVISION: PACIFIC CROSSROADS CORP LOT: JURISDICTION: TIG
PROJECT: ACCOUNTAX
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:
ACCOUNTAX OREGON HEATING & AIR CONDITIONING
10300 SW GREENBURG RD PO BOX 397
SUITE375 TIGARD, OR 97223
TIGARD, OR 97223
Phone: 503- 619 -1040 Contact #: PRI 503 -538 -2953
FAX 503 -691 -8556
FEES Reg #: ELE LHR40
LIC 172126
Description Date Amount
[ELPRMT] ELR Permit 11/5/2008 $75.00
[TAX] 12% State Surch 11/5/2008 $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.
Electrical Permit •�lpplieatio0Cr) FOR OFFICE LSEONII •
City of Tigard �V 0% ���
13125 SW Nall Blvd_, Tigard, OR. 97223 1� j u 0 + M
Phone: 503.639.4171 Fax 503 595.1960 y'- -', ,�' � '" ` j % � :. Other Permit �� � ,�— �� —•
Inspection Litre: 503.639.4175 . 4 ! t 2 ` ' Date ReadYBy. B see Page 2 for
Internet www.uarigard.or.os C, 1 • - Noliied/Method:
'J Sapp) tal e o0
``A) emco laforwa
tire.. - 1'r' ? >4"' - _i�G - �Y".•::.� - . 2�. . ��•i:. ! >u - ' {•'": �.:•.
- h`r..:/r - :;. � ?L.. r. :6..7 :,;iLC:!LT+�1P'•�i� � � "'i'
u
❑ New construuc on Addition/altcration/replacement Please check all that apply:
❑ Demolition ❑ Other. ❑ Service over 225 amps, c mm'l ❑Hza
ardous location
- .,..,t i; :; ,'. ❑Service over 320 amps - raring ❑Buldng over 10,000 sq- ft,
sfi „q;;_ ;; _ c:,- � : , :'': -
,. ,`4'T>6;ic,C1 'ft OYr: CUIYfiXACJG 'TXON��!a.:- ,;,;`.r'. ":' ; ..• "'r;,./.:• ..:':_: of i - and 2- femiiy dwellings 4 or more new residential
❑ 1 - and 2- family dwelling > Commercial industrial ❑ Accessory building CI System over 600 volts nominal wets in one structure
❑ Multi -family ❑ Master builder ❑ Other ❑Building over three stories ❑Feeders, 400 amps or more
,.. persons d structures or
:y �:,. ❑Occupant load over 99 pets s �+' e
;�, ,;.,`�,; - ;,r: • - 3.OA:,S4 ,INF'O)E<MAT0*A*.:" L',41CATTUNit:: ' _ !: ❑Bgress/lighting RV park
�� Job site address: (`('( ❑Heahtr facility ['Other: Job no.:
.• —. - r' ` �_- � �"`-� ” Submit 2 sets of plans with any of the above.
City /Sttte/Z7P: (D( t ,- 3 The above are not applicable to temporary construction service.
3
Suite/bldg./apt /apt no.: At" ;� ^r % ? s` ' : i_a cn - . `1 ", vsi i ..
Project name: i�e,'0 n p : ;::a.i - C ; 3;
Cross street/directions to job site: New residential single -or multi - family dwelling unit_
Intones attached garage, •
1.000 sq. $ or less 1 145.15 4
Subdivision: Lot no.: Ea_ add'I 500 sq. It or portion 33.40 1
Tax Map/parcel no.: Limited energy, residential 75.00 2
�,,y{ ,-.>,- Lured ooagy, non - residential 75.00 2
� 'Y '"�e'�1F'p'.- °-.'�r� . . #.��"i53xr���yd'',�.`<y:�+.•:P IOP OE Oft' ?:: {. r::: i° 5 ?�S'%�`r:��i�,
,,7i'�,-_ -�. .,.n... ... _.,... .. � .... .. .. ......:... t, .. ... .�.r�' ..,,.r'• -,.- . >.: r....r, :±. a:.r: Each manufactured or modular
dwelling service and/or feeder 90.90 2
r - ° Services or feeders installation, alteration, and /or relocation
• • 200 amps or loss 8030 _ 2
1 a/.'� ,, ti; a ." 4:.1 1 s� , r'. r r,..".'?; 2°1 atnpS to 400 a7»ps L 1(16.85 2 • 401 amps to 600 amps 160.60 2
Name: Ft a tA.-> x 601 amps to 1,000 _240 _ 2
Address: 'r, Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: ° - ^K - -i % ` (Da__ 6 i..4 - ,R9 - 3 Temporary services or feeders installation, alteration, and/or
Phone: ( ) i Fax: ( ) relocation
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 z
•
Owner Signature: • Date: Branch circuits - new, alteration, or extension, per panel
. ri ; Nfi- ;r;,%: .,. J .'. *0:6 �:?:V fir,' :i : " �iai�i s, 0OIA 'A iii*: -0 %•••`' ^ tr, A-Fee f cirenitstvirh
s ce
a ;r..5 4.., e..,...,... c': ,.r .;:.;;; . -u '� :r r:.. feed f b
"' service or er fee, eac 6 2
Business name: D f)v' - 10 n�•4r =v,rte. _A— e _ branch crratir y
B. Fee for branch circuits
Contact name: • a. �.1 ,illi; J `�� ". we/Morava-vice o feeder fee 46.85 2
Address: each branch circuit
T V �L�n Each edd'l branch circuit 6.65 2
City/State/ZJP: ° 7Z ` thib • C.t ._ --'• Miscellaneous (service or feeder not included)
din.. �' � Pump or irrigation circle - ..... ..... _53.40 2 i
Phone: ( "Wm,. - 411,44U Fax: : (S55 (04111— SS C, Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited -
aii,: -. i`• s ,. ' -: ' • Itw r .° � .:COI TRACTO .. - ''� °. . .. . .. pan
energy el alteration, or
extension. Describe: ( Page 2 - 7 2
Business name: •
Address: Each additional inspection over allowable in any of the above
. - -- Per inspection 62.50
City /State/ZIP: - Investigation per hour (1 hr min) 62.50
•
Phone: ( ) I F ( ) Industrial plant per hour 73.75
:. rileTRICAletPX.RNIT . 1c5'.F. :: ':.. ' Ar. .
CCl3 Lit -: l oll, Electrical I.ic:"16 Suprv. Lic.: Subtotal
Suprv. Electrician signature, required: .Q Plan review (25% of permit fee)
Print name: c�_a �l` f2;` :_ Y Date: l' - "`t ' ( - t v State surcharge of permit fee)
TOTAL ?mar FEE t
Authorized signature/ ' ' , 'This permit appcltatioo expires if s perisi is not obtained within 180
• dr yer s it has been acc as eom
Print name: " ' - 1p • Date: ii •--Ai., • + '' Fee methodology set by Tri-County Building Industry Service Board
( � I -�' '• Number ofinspe�tits per permit allowed
is1Buikioefermi itr- C,ge,a,0.7p +� /03 440- 46157(1 onatC0)4/91(:H
E0 /10 39Vd ENI1ti3H N093NO 9S 8- 169 -E05 Zb :91 800Z/t70/IT
-Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
l t
i `u W i!,µ uy E r l \ '2 Qti '{�" I £ �t�_;�� I �'� , ,'e 1 .1 � l y ,
' wi S ' i 1 4 Yi ��S L:. Ci:, z4v�c, � -n.�.rzrh2�u.i�at,b�:an'ITC�.`ll 7.�trrr."�.t �!x'� iiM i �_i6r.4 kc, h�1
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio Stereo Systems*
❑ Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
7 � �' }�� '� 1 t�'r y � F h F r .�,i� � �vl' ��y� � 4 u � . Pl }4- .1t��
1 t �i iP—..2 idd t.'4.,11mlam. �:al�i�.{wlLI, Airy :ii r. �di:ifTi`.C11 ti f� gili ty{cm.. { I H I E i t._ iV :�_
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ A udio and Stereo Systems
❑ B oiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
Fire Alarm Installation
HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls .
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
. ❑ Other
Total number of commercial systems:
"No licenses are required. Licenses are required
for all other installations
1: 1BoildiojtlPermita \FLC- PermitApo.doe 03/2)/06
Eg/Z0 39dd EJNI1d3H NO03a0 9SS8- 169 -Egg Z :91 8002/b0/It
CITYTIGARD
BUILDING DIVISION PERMIT #: ELR2008 -001.2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/5/1(1013
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 s&W °`'II
INSPECTION WORKSHEET FOR DATE: 1/7/2009 TIME: 7:01AM PAGE: 0
SITE ADDRESS: 08060 SW PFAFFLE ST 1.10 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: ACCOUNTAX
DESCRIPTION: Low voltage for thermostats.
OWNER: ACCOUNTAX, PHONE #: 503 - 619- i0'1()
CONTRACTOR: OREGON HEATING & AIR CONDITIONING PHONE #: 603 -538 -2953
•
Inspection Request Scheduled For: Date: 1/2/7009 Pour Time:
Code # Inspection Description .Confirm # Contact # Message
199 Electrical final 07934: 01 503-691 -9699 N
Corrections /Comments /Instructions: /
\ i .
•
\\
/1
c V
N ,
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G . N b 8 U Date: 1 ' vq Phone #: (503) 718 - tiiy6
CITYr,QF,TIGARD
BUILDING DIVISION PERMIT #: r� r -
t�LF22i1iJ8.13,1 � i 2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11 /L42tior
Phone: (503) .639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' -L.
INSPECTION WORKSHEET FOR DATE: 1'i/1 TIME: 7:02AM PAGE: 18
SITE ADDRESS: 08050 cw11J PFAFFLF ST 110 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: ACCOUNTAX
DESCRIPTION: Low voltage for thermostats.
•
OWNER: ACCOUNTAX, PHONE #: 503.618440
CONTRACTOR: OREGON HEATING & AIR CONDITIONING PHONE #: 50 .538.2953
Inspection Request Scheduled For: Date: 11/19/2003 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 078244 -01 503 -5313 -2953 N
Corrections /Comments / Instructions:
•
•
S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS •
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
`
Inspector: Date: J �'/ - '�1 Phone #: (503) 718-
P L ? )