Permit r
, r _ 1 _ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
0 COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00315
i'
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/13/2008
PARCEL: 2 S 112 DA - 00800
SITE ADDRESS: 15055 SW SEQUOIA PKWY 140 ZONING: I - P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: GEO ENGINEERS
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:
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
Reg #: ELE 26- 1063CRE
FEES LIC 38868
Description Date Amount SUP 2613LEB
[ELPRMT] ELR Permit 11/13/200E $75.00
[TAX] 12% State Surch 11/13/200€ $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
Utilit ''cation = ter. Those rules are set forth in OAR 952 -001 -0010 through OAR 952- 001 -0100. You may obtain copies of these
ru s or direct question . : • at 503.246.6699 or 1.800.332.2344.
I sued By: 1 1 4 i L,; Permittee Signature: Itrtz
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.
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Electrical `" Application 1 FOR OFFICE USE ONLY
City of Tigard `' Recei Date /B ved
4/17M) �� `�� Permit No.: ,,
q 13125 SW Hall Blvd., Tigard, OR Z` Plan Review
C Phone: 503.639.4171 Fax: 50 Date /By: '.,------7 Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready /By: , Juris: ® See Page 2 for
Internet: www.tigard - or.gov !�V O ! � •
nQD 1"V/
Notified /Method: /C /y /r (� 77'6 Supplemental Information
TYPE OF WORK 11V ((''���'I ,o 1' - w \ r� Q+�ffc-t PLAN REVIEW
❑ New construction ® Addition /alt rlpl'I �t O��S` ®,`t Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other: (��` �`s where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CORSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ". "1 -2 ", "1 -3 ",
Job no.: 9477 Job site address: 15055 SW SEQUOIA PKWY Six 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: GEO ENGINEERS ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtv. 1 Fee. 1 Total 1 ;
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
THERMOSTAT &WIRE Limited energy, multi- family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or Tess 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal panel, or limited -
Business name: PROTEMP ASSOCIATES
energy panel, alteration, or
Address: 9788 SE 17 AVE extension. Describe: 1 Page 2 �j 2
STAT & EIRE
City/State /ZIP: PORTLAND OR 97222 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 519 -6199 Fax: (503) 238 -9767 Investigation per hour (1 hr min) 62.50
CCB Lic.: 38868 Electrical Lic.: 26 -1063 Suprv. Lic.: 2613 LE Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES ,
Suprv. Electrician signature, required: Subtotal: 750-
Print name: MONTY SCHROEDER Date: 11/7/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): /` a6`
Authori zed signature: �, �
TOTAL PERMIT FEE: 3 it.
Print name: BRUCE BUTNER Date: 11/7/08 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(t I /05 /COM /WEB
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: A.R10013-00315
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2008
Phone: (503) 639-4171 AA,
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1.17/2009 TIME: 7 PAGE: 2
SITE ADDRESS: ig)66 ',EM SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: GEO ENGINEERS
DESCRIPTION: LOW voltage for thermostats.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503.2334i91
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 079477-02 503-M6-6199 N y
Corrections/Comments/Instructions:
•
kn/A,
\J
•
PASS 0 PARTIAL APPROVAL 0 CANCEL LIJ NO ACCESS
7 FAIL 111 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: CrTh N 68 Lq Date: 11 - 11 Phone #: (503) 718- 7-114)