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Permit C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT , DEVELOPMENT SERVICES PERMIT #: ELR2006 -00257 ,.� �° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/20/2006 PARCEL: 1S136DD-03400 SITE ADDRESS: 11740 SW 68TH PKWY 250 ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG Project Description: Low voltage for HVAC wiring. 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: PNWP LLC AMERICAN HEATING 6600 SW 105TH AVE. STE.175 1339 SW GIDEON ST BEAVERTON, OR 97005 PORTLAND, OR 97202 Phone: Contact #: PRI 503 239 - 4600 FAX 503- 239 -7038 FEES Reg #: ELE 26- 993CRE LIC 33135 Description Date Amount [ELPRMT] ELR Permit 10/20/200E $75.00 [TAX] 8% State Surchar€ 10/20/200E $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 folio s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 - 0010 through R 952 0 - You may obtain copies of these rules or direct queq % cgs to O NC / A03 -24 6699 Issued Permittee Signature: / ✓'C l` /lid- /7(S � ��-- 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. r .. Electrical Permit Application FOR OFFICE USE ONLY • City of Tigard ge e (p ©� , ied'60o? 13125 SW Hall Blvd., Tigard, OR 97223 ,, ,, , , _ ,, Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 . D ate Ready/By: NI H See Page 2 for Y /B Y Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information _ ..a j17F•.,.6 •r- to a -. �- �r�'r.r p ��� tl�1" 8 � � ° 7 � : � .?, �7, S ^r` . J �U . ' r`� � . ` H r {' �, a r 7 lr + �T 7 t i. C `4;:fi'+�'#.. 7: F ' u 51 .+,�, A ,'..- l liE.� , 4 r 1 Ilr;r;^ - *. + -..r t . r ''�" r . G�f°.asl. f R (J a�. a b.i� : }r' n -t r . _ .rr� - 7 k!. - ad %.: Sx i's.'' 3i32.xr �..:, : __,_ ._t. .�- } _..._..._-ti,_'ri, ~ ?: ❑ New construction !_!I Addition/alteration/replacement Please check all that apply: Demolition ❑Other: ❑Service over 225 amps, comm'i ❑Hazardous location ❑ # ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., ... r. 7 ro r � r e tilt r=- _^_ . -- � ----.- -- Y S y-. Z"✓ i 4' 01110- S' �(01 rtir"�tpit < e d r r , -4 of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 - family dwelling p'Commercial/industriai ❑ Accessory building ['System over 600 volts nominal units in one structure ❑Building over three stones ❑Feeders. 400amps or more ❑ Multi family ❑ Master builder ❑ Other ❑Occupant load over 99 persons ['Manufactured structures or - 5 : y - .' id∎_: 4 x k't ti� l �� "1 ✓ti )s`+�'t�; , c) .,40,P t + � t1 � r 7:-.,:-.7.7.3,'"7,71:4171,7157/;7'.1 , i t t, i ' c � � i _ t ❑Egress/lighting plan RV park �! z: i Job no.: Job site address: 1 �?3W�� ••:��., __.l: .,t..�s..___.._.z._....� � _ _ :_i;.._N�. <... , .�..��.�.� ❑Other: 1 " 1 0 taw 1 ( s 0, ❑Health -care facility [t -- - Submit 2 sets of plans with any of the above. City/State/ZIP: t t • * d e f. Q...,3 The above are not applicable to temporary construction service. Suite/bldg. /apt no. Project name: ` C s '_ - "` ' 8 a • Description Qty. Fee. Total Cross street/directions t. 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. add'l 500 sq. R. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 ' + 7 .0 of .. �; r. r3+ ' n , i a m >` + �, + )y3 ,; i �l ? L l ¢`i( +b ? ?. , l d, tr '-;').:1 : -. /% :: ; J : Each manufactured or modular . �.,._ _._._. :4• , : , _..... �; " �: . I �� r.. J- ..+ ?i:.. ..,.1s s _..._ ,: .._ s Up t i (� dwelling, service and /or feeder 90.90 2 — V0. �• I r{ n Services or feeders Installation, alteration, and/or relocation C ,E/ � IP 200 amps or less 80.30 2 Y " y �, r r 4 �ti' ! et ` I-r-', ` : r 'st ' t., 201 amps to 400 amts 106.85 2 S r n ...f_.i -7t �� �,t1 '. 1i , wb, a� f`.z_ i ' A/'..iat t..:v�_,., W._:r_ . L. r'11 7i/ '�' ?? i t k j „_... ._ i 401 amps to 600 amps 160:60 2 Natite: 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. 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 �r -r srf'1 )I.jif ✓v40 "' J �jiCf } ..I ;' 4 D •lta,� i )Sy `t�vc tf s 54:i,i4 `�wFut i 1z A. Fee for branch circuits with r , J x f F'r k�ld� .� 1 + s s.s:, a , t:� r "; service or feeder fee, each 6.65 2 '- Ili f i - • 1 branch circuit B. Fee for branch circuits Contact name: : I • i without service or feeder fee, 46.85 2 each branch circuit Address: 1 . - - SE t t , .)1 Each add'l branch circuit 6.65 2 City/State/ZIP: l U Y'4 1 0,4 d . 0 12 qi DO-a. Miscellaneous (service or feeder not included) a - Pump or irrigation circle 53.40 2 • Phone: ) a3C _ ,00 Fa ' • )a � J 6 o% Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - i {,.sX ( 3 rwt : W( , f j g ; ;' WiiiLlt t ' etW iT : } f . °a.4 , l ' j j i is F t T F `; ,;.try energy panel, alteration, or a W.. e _ <__� _� .. . . ,:..r..�3z <. ._ . ti i:a extension. Describe: Paget 2 . 1 � �, • • p Each additional inspection over allowable in any of the above Ad dress: �. t Pe r. inspection 62.50 City/State/ZIP: . , 0 e_ 40—)-30 Investigation per hour (I hr min) 62.50 J' Phone: Fax: 73.75 --, og' Industrial plant per hour ( ) 1' (p � ) '� S, ° ha Rig ' ,ifa uf'` 07iif+it7K4i iZ Ite' 1 v n L .. ... .v se" Z IEIERIENO Electrical Lic.: , 6gcf3 CLt Sup Lic.: a.( f" Subtotal Suprv. Electrician signature, required: _ ' it p, Plan review (25% of permit fee) • 1 State surcharge (8% of permit fee) Print name: • ' \( , _A 0 a Date: b_ . 0_ (o Vt TOTAL PERMIT FEE ,, Authorized signature: ,/ / . ,� ; ` +� This permit application expires if a permit Is not obtained within 180 days after It has been accepted as complete � � Date: , DG • Fee methodology set by Tri- County Building Industry Service Board _ •• Number of inspections per permit allowed. . _ .._ tin tc. Crt. nmo+rnvnvcw CITY OF TIGARD BUILDING DIVISION l PERMIT #: ELR2006 -00757 - 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10120/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639- 4175 INSPECTION WORKSHEET FOR DATE: 2/21/2007 TIME: 7:00AM PAGE: 25 SITE ADDRESS: 11740 SW 68TH PKWY 250 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 009 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: Low voltage for HVAC wiring. OWNER: PNWP LLC, PHONE #: CONTRACTOR: AMERICAN HEATING PHONE #: 503- 239-4600 Inspection Request Scheduled For: Date: 2/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final ' 043658 -0? 503. 793 -4001 N Corrections/Comments/Instructions: —.- K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cr " 1V 0. LS*" Date: LI O ri Phone #: (503) 718- 2J1 Ei ' CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR200&00257 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006 Phone: (503) 639 -4171 / µ j Inspection Requests (24 Hrs.): (503) 639 -4175 __.. INSPECTION WORKSHEET FOR DATE: /2/21/2006 TIME: 7 :QQAM PAGE: FQ • SITE ADDRESS: 11740 SW 68TH PKWY 250 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 0Q8 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: Low voltage for HVAC wiring. fai rommomwmorsiffs OWNER: PNWI•' LLC, PHONE #: CONTRACTOR: AMERICAN HEATING PHONE #: 503-239-4600 Inspection Request Scheduled For: Date: 12/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 041385.01 503- 793 -2240 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` N L Date: IL( 'Ll 4Io Phone #: (503) 718 itAki b •