Permit •
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
l DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00162
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/7/2006
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 410 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
Project Description: Low voltage to re - hook up stats.
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: 503- 624 -6300 Contact #: PRI 503- 233 -6911
FAX 503- 238 -9767
FEES Reg #: ELE 26- 1063CRE
LIC 38868
Description Date Amount
[ELPRMT] ELR Permit 7/7/2006 $75.00
[TAX] 8% State Surcha 7/7/2006 $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 - 246 -6699.
Issued By: '.4„f Permittee Signature: 7
////"'' 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.
ect Permit Applica ' � CEI Y FOR OFFICE USE ONLY
City of Tigard Receive permitNo ���pQfj- oO /�1.
Date/B : Ol _ _
13125 SW Hall Blvd., Tigard, OR 97223 JUL 0 7 Plan Review
u
Phone: 503.639.4171 Fax: 503.598.1960 1,( Date/By: Other Permit:
®
Inspection Line: 503.639.4175
BUILDING DIVI _
ka " Date Ready /By: See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TI ' j Notified/Method: , V Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® 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.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I - and 2- family dwelling ® Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
Job no.: 8936 I Job site address: 12909 sw 68th ❑Health - care facility ['Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: tigard Oregon 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.:.I`L I Project name: National Title FEE* SCHEDULE
Description I Qty. I Fee. I Total I **
Cross street/directions to 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. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Rtele$ete - tw ct d na , 2 �� dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
S' p -' 200 amps or less 1 1 80.30 12
201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER I ❑ TENANT 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address:
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
® APPLICANT ' 1 ® CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Protemp Associates branch circuit
B. Fee for branch circuits
Contact name: Bruce Butner without service or feeder fee, 46.85 2
first branch circuit
Address: 9788 SE 17 Ave Each add'I branch circuit 6.65 2
City /State /ZIP: portland Oregon 97222 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
• extension. Describe:
Business name: Same as above THERMOSTATS i Page 2 2
Address: Each additional inspection over allowable in any of the above
City /State /ZIP: Per inspection 62.50
Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
CCB Lic.: 28868 Electrical Lic.: 241063cre Suprv. Lic.: 2613 te,e ELECTRICAL PERMIT FEES*
s Subtotal 7�
Suprv. Electrician signature, re Plan review (25% of permit fee)
Print name: MoN� sej L &, C surcharge (8% of permit fee)
Y Date: 7 /7/06 Stat surc�
Authorized signature: T PERMIT FEE D
This permit application expires if a permit is not obtained within 180
Print name: n 2 d L 13 � <� Date: 7/7/06 • days after it has been accepted as complete
U Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \ELC- PermitApp.doc 12103 440- 4615T( I0 /02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00162
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/7/2006
Phone: (503) 639 -4171
Alliii,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/31/2006 TIME: 7 : 06AM PAGE: 71
SITE ADDRESS: 12909 SW 68TH PKWY 410 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL TITLE
DESCRIPTION: Low voltage to re -hook up stats.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 543.624 -6300
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 233.6911
Inspection Request Scheduled For: Date: 7/31/2006 Pour Time:
C. • - • Inspection Description Confirm # Contact # Message
199 Electrical final 034009 -02 503- 519-6199 N
Corrections/ Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G IQ 06 Date: ' I 311 0 'O Phone #: (503) 718- 1-IW0
CITY OF TIGARD . ,--
BUILDING DIVISION PERMIT #: ELR2006 001G2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/7/2006
Phone: (503) 639 -4171 ittl �Inspection Requests (24 Hrs.): (503) 639 - 4175 _
INSPECTION WORKSHEET FOR DATE: 7/31/7006 TIME: 7 :06AM PAGE: 72
SITE ADDRESS: 12909 SW 68TH PKWY 410 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL TITLE
DESCRIPTION: Low voltage to re -hook up stats.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-624-6300
CONTRACTOR: PROTEMP ASSOCIATES INC 2 R ve,E , PHONE #: 503-233-6911
Inspection Request Scheduled For: Date: 7/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 034009.01 503-519 -6199 Y
1q F1 NI-
Corrections/Comments/Instructions:
PP 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G - 1 N be) W. Date: d it 0 Phone #: (503) 718- *ft)