Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00048
'I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/8/2006
PARCEL: 2S 101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 020 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: Energy Management System (located in basement). Job # 5161e.
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: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: ENERGY SYS X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TIGARD TRIANGLE I LLC STONER ELECTRIC
4650 SW MACADAM AVE STE 220 1904 SE OCHOCO STREET
PORTLAND, OR 97201 MILWAUKIE, OR 97222
Phone: Contact #: FAX 503 - 659 -2824
PRI 503- 462 -6500
FEES Reg #: LIC 44823
SUP 3496S
Description Date Amount ELE 26 -122C
[ELPRMT] ELR Permit 2/8/2006 $75.00
[TAX] 8% State Surcha 2/8/2006 $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: si_ Permittee Signature: �e, ,n
c
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:
CaII 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.
02/08/06 WED 15:28 FAX 5036594968 THE STONER GROUP 0 001
• Electrical Permit AppREREIVED FOR 0„ ICE USE ON'L1
,• City of Tigard • Received ,, _� JI' Permit --
13125 SW Hall Blvd l'la , Tigard, OR 97223 FEB 0 8 2006 Da �L O 74 t
R � nw
Phone: 503.639.4171 Fax 503.598.1960 r z l , ,:. Date/B:. Other Permit:
lnspcdion Line: 503.639.4175 -L�
Internet: www.ci.tigard.orms CITY OF TIGAR ` - °° e or thud lr l la �Plcmen
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ml rnrormatmn • fir
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❑ New construction ra Addition /allcration/replacement Please check all that apply_ ;
1:1 Demolition Other ❑Scrviee over 225 amps, comm'l ❑llamrdous location
-
- ... : :. : : :. Service over 320 amps - over 10,000 sq. ft,
: :.. CATE4OR. Y `OF' CO NSTIW Ci7
pN ?!.> •< ; ; : ; : ; ; . ' > ; ; ' ;� ;fir ; : r :
...:... .... .. .,. r . -. : •,: :. .::, of 1-and 2-family dwellings 4ormore new residential
❑ 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one stro *w
CI Multi- family 1:1 Master bolder Otlu�
['Building ng over three stories ['Feeders, 400 amps or more
..;::: . ;...... : :. : : : :.. :..- :.:.,. : .• : persons strnrsives or
: : : :. : : .- .,� : ;.JOB:SIT'E INFORMATION::.: ANI I'IACATIOPl: ;: :' : : : : ; :. > : : ; : :n
ClOccupaat DEgress/lighting � plan RV park
Job no.: 5161e Job site address: 13221 SW 68 PARKWAY [Wealth liroility ❑Other:
Submit 2 sets of plane with any of the above.
City/Statc/ZIP: TIGARD, OR The above are not applicable to temporary construction service.
8 ! j name: IHFJAI.T1fINbi T BUILDING `' ; AU E ~• % ;: :.., ;. ,^
Suitc/bld / no.: F
Project ._ ...,�.; :. :- : >•• :.. , . :
Deavfpa.n 1 Q I Fa. 1 '::.: Total I
Cross she d /directions to job site: I New re 1t1ea1iid single. or multi`famity dwefmg matt_
Includes attached garage_
1.000 sq. ft_ or tat, a _ 145.15 _ 4
Subdivision: f i.Ot no.: Ha add'1500 sq. II or portion 33.40 1
Tux map/parcel no.:
Limited energy, reaideanti 1 75,00 _ 2
:......::,;;.::.:..... 75.00 2
::. : :.: ... ,.. :., ;.: : :�' ..:: Each maaufacimcdormodular
ENERGY MANAGEMENT SYSTEM IN BASEMENT
dwelling, service and/or feeder 90.90 2
Services or feeders itallatioon, alteration, and/or relocation
200 amps or less - 8030 2
.. :.. . .. pF:l27 X:: OWNER" : : ; ; :. ; ` . :... l ampsto 400 :mops 106.85 2
401 =pa to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1.000 amps or volt% 454.6 2
City/State/ZIP:
Reconnect only 66.85 2
Temporary services or feeders installation, alteration, andior
—
( ) relocation
Phone:( ) Fax
200 amps or less T 66.85 1
Owner ilastallation: This installation is being made on pluperty that 1 own which is not 201 imps to 400 amps 100.30 2
intended for sale, least, rant, or exchange, according to ORS 447, 449, 670, and 701. 40! amps to 600 seeps 133.75 2
OW= signature: Date: Branch drafts —new, alteration, or eftensiou, per panel
:.:' CrkPPI:ICAIVT :; .: : : :.: .:, r:.` . i : :' ' , : - : : : [1 ;(`OI A,...3
.'ERSOhI � ... .. : ;. :. Ai'cc for branch c7rarits
:.. service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
titst blanch circuit 46.85 2
Address: .
Each add'1 branch circuit 6.65 2
City/State/7.1P: _ huseellaneoms (service or feeder am inducted) )
Phone. ( ) I Fax:: ( ) Pomp or irrigation circle 53.40 � 2
1 Sign or outline fighting 53.40 2
E - mail: Sigurd circuit(s) or limited-
..... • r
>C'01�1TAAGTO :
. . ea altc7ffiio or
. : ergy panel, n,
erd ma son D esctr lie ENER Page 2 2
Business name: STONER ELECTRIC MANAGEMENT SYSTEM
Address: 1904 SE OCk1OCO _Each additional hispect on over allowable in mry of the above
Per inspection 62.50
City /State/ZIP: MILWAUKIE OR 97222 investigation per hour (1 b* mm) 62.50
Phone: (503) 462.6500 — I Fax (503)659 _ Industrial plant pc r hour 73.75
ti : ;. ; " : :i SElrLECI'IRICAL1ERMl2;'i•FEE :i• i` : .' ;..
; .. ;:
CC13 Lic.: 44823 f Elee:trical Lic.`26 - 1220 1 Suprv. t.ic.: 3496S Subtotal --7 j • i :
Suprv, Electrician signatut+e, required: . . / Plan review (25% of permit fee)
� State surcharge (8% of permit fee) A
Print name: ryi July 4 Ev Ic,:f 4 C ® vest Hate: 2/8/06 ToTAL )PIIti4IIT r J
Authorized Signature This Permit erpNcpgoa espies bra permit is not obtp mo um
Print nttmc: Date: • Fcc au:rhod days otter it has been accepted as complyde
ulogy sue by Tn - county Building ledusuy Service Bond
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200&tr0O43
, EL •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. E 2005
Phone: (503) 639 -4171 anm-r ithiai ,
Inspection Requests (24 Hrs.): (503) 639 -4175 . , 11.. .
INSPECTION WORKSHEET FOR DATE: 2/14/2006 TIME: 2:22PM PAGE: 64
SITE ADDRESS: 13 SW 68T11 PKWY 021 CLASS OF WORK:
SUBDIVISION: TRIANGLE: CORPORATE RK LOT #: UO2 TYPE OF USE:
PROJECT NAME: HEALTH NET OF OREGON
DESCRIPTION: Energy Management System ocated in basement). Job # 5161e.
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 503-462-6 500
Inspection Request Scheduled For: Date 2114/2006 Pour Time:
Code # Inspection Description Confir # Contact # Message
a Low voltage 026B34- 1 103. 329.1971 Y
• orrections /Comments
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**PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
P
Ins ector: Date: 1 t Phone #: (503) 718- 20