Permit IN 4 y C ITY OF TIG
�� ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00157
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/23/2007
PARCEL: 1 S136DD -04100
SITE ADDRESS: 11850 SW 67TH AVE ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT: 007 JURISDICTION: TIG
PROJECT: TIGARD TRIANGLE COMMONS
Project Description: Connect and program HVAC controls. Job NO. 96777
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 NW PROPERTIES OREGON ELECTRIC GROUP
ATTN: PAUL GRAM 1010 SE 11TH AVE
P.O. BOX 2206 PORTLAND, OR 97214
BEAVERTON, OR 97075
Phone: 503- 626 -3500 Contact #: FAX 503 -535 -2763
PRI 503- 234 -9900
Reg #: ELE 26 -95C
FEES LIC 203
Description Date Amount SUP 4818S
[ELPRMT] ELR Permit 5/23/2007 $75.00
[TAX] 8% State Surcha 5/23/2007 $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 503.2.6.6699 or 1.800.332.2344.
Issued By: /j ,,L1 / Permittee Signature: Aj /0679
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.
Plliii 12:08PM FROM -OR ELECTRIC SVC 5035352763 T -622 P.002/002 F -969
f _ . � It: Kermit i ppllcanon , . l � O R Dale I 'N oNi
City -of Tigard i e i 7 % & ; Received
Dafu_B c 5 2 o S LlN) Permit No.. ) Q, rr -C7-
13125 SW Hall Blvd., Tigard, OR l' ll. - `
Phone: 503.639.4171 Fax: 503. 8. w ?i + � Pnlat /fReview
OtherPenni:. f 7/y(1 W _ it/r�
4
Inspection Line: 503.639.4175 '' J� ,,,,, 3le Date tt y eadylBy: iw �I la Sc Pa t
Internee www.ci tigard,or.us NAY 2 3 2007 ' NotiBed/Moth Supplemental Information
TYPE OF WORK PLAN REVIEW
121 New Construction ► AldditiOningefationimiltAttNT Please check all that apply:
❑ Demolition �p : :_ r Tr( 71r .r ❑Service ovcr225 amps. corm l ❑Hazadous location
�i I ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., ,i CATEGORY OF CONSTRUCTION of 1 - and 2- family dwellings 4 or more new residential
1 - and 2 family dwelling ® Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over throe stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons CI Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park
. Job no.: 96777 JJob site address: 11850 SW 67TH :Health - metre facility ['Other:
Submit 2 sets of plans with any of the above,
Ciry /State/ZJP: TICARD, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: TRIANGLE BUILDING FEE* SCHEDULE
Dcr,ripdon [Qty. 1 kra. I Told 1
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
indudee attached garage.
1,000 sq. ft. or Tess 145.15 4
SubdiVjSiOn: Lot no.: Ea. add'l 500 sq. [t. or portion 33.40 1
Tax map /parcel no.: Limitcd energy, residential 75.00 2
1
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
CONNECT AND PROGRAM HVAC CONTROLS dwelling. service and/or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 _ 2
El PROPERTY OWNER 0 TENANT . 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: TRIANGLE BUILDING 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/EP: Temporary services or feeders Installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or Iess 66.85 1
Owner installation: This installation is being made on property that 1 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
!' ❑ APPLICANT 1 0 CONTACT PERSON A. Fee for blanch circuits with
service or feeder fee, each
2
Business name: _ branch circuit 6.65
B. Fee for branch circuits
Contact name:
without service or feeder fee,
each branch circuit 46.85 2
Address: _ _
Each add'I branch circuit 6.65 2
City /State/ZiP: Miscollaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( ) - Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
I. CONTRACTOR energy panel, alteration. or C
extension. Describe: 1 Pagc 2 15, CC 2
Business name: Oregon Electric Group
Address: 1010 SE 11th Ave
Each additional inspection over allowable in any of the above —
Per inspection 62,50
Ciry /Statc/ZIP: Portland, OR 97214 investigation per hour (1 hr min) 62.50
Phone: (503) 234 -9900 Fax: (503) 535 -2763 industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
� :
CCB Lic.: 203 . ` e . rv: Li -, 4818 Subtotal 1 L . 00
Suprv. Electrician risen -4'Irq +ly . ..1 : , .I Plan review (25 %ofpermit fee)
State surcharge (8% of Permit fee) LP . (r.) D
Pri• ,.• ,e: vv1 r IL A,- A jI ' nd j Date: 5 ,)3 0 —
/ ' TOTAL PERMIT FEE T (,0O
l i �� �r Nf i Ibis permit application expires If a parade is not obtained Attila 180
days after I t has been atcrptcd of camplcte
Print name; 1,\A � n a v . i < 4 , l o -e.,1/1. Date; 57 / • Fee methodology set by Tri- County Building Industry Service Board
s• Number of inspcaions per permit allowed,
1:\ Budding ■Permin\E1,C- PeanicApp.doc 1?!03 41046IST(INOLCOM/WItu
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00167
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/23/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Connect and program HVAC controls. Job NO. 96777 .
OWNER: PACIFIC NW PROPERTIES, PHONE #: 501626.3500
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503
Inspection Request Scheduled For: Date: 8/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054606 -01 503 -234 -9900 Y
Corrections /Comments /Instructions: I , k \-
t ASS G �
'I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v �� Dater 7 -A i(f) Phone #: (503) 718- �"I f
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 0011h7
13125 SW Hall Blvd., Tigard, OR 97223 t DATE ISSUED: 5/23/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 4441154
s '''f L
INSPECTION WORKSHEET FOR DATE: 8/22/2007 TIME: 7:01AM PAGE: 42
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Connect and program HVAC controls. Job NO. 96777
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 -626 -3500
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503- 234 -9900
Inspection Request Scheduled For: Date: 8/22/2007 Pour Time: -
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054441 -01 503 -849 -7617 N
Corrections /Comments/ Instructions:
NO 6 N< 00 t 'M le cl.low woctie, bbNC,
n PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G . , Nte t Date: 1) 1 27 Phone #: (503) 718 - "Y V
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00167
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/23/2007
Phone: (503) 639 -4171
A I
Inspection Requests (24 Hrs.): (503) 639 -4175 . '
INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:02AM PAGE: 59
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE. COMMONS
DESCRIPTION: Connect and program HVAC controls. Job NO. 96777
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503- 626 -3500
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503
Inspection Request Scheduled For: Date: 7/25/2007 Pour Time:
Code # Inspection Description 1 Confirm # Contact # Message
135 Low voltage 052684 -01 503 -849 -7617 \ Y
Corrections /Comments /Instructions:
2 fbo2 cx t •:►NeI, f .
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ' 1" 0`6 Date:.. 2.5" d Phone #: (503) 718- 1.3010