Permit C ITY OF TIGARD • ELECTRICAL RESTRICTED ENERGY PERMIT
Ia.; COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00017
TIGARD 13125 SS all Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/29/2008
PARCEL: 2S 112DC - 00701
SITE ADDRESS: W 72ND AVE BLDG - ZONING: I - P
SUBDIVISION: OREGON BUSINESS PARK III LOT: 038 JURISDICTION: TIG
PROJECT: CASCADE COMPUTER
Project Description: Thermostats and 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:
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
[ELPRMT] ELR Permit 1/29/2008 $75.00
[TAX] 12% State Surch 1/29/2008 $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
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 ■erect qu- ion o OUNC at 503.246.6699 or 1.800.332.2344.
•
Issued By. / • 1 � ' Permittee Signature:
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.
Electrical Permit ApplicatioA FOR OFFICE USE ONLY
City of Tigard EcElvED Received 1.11
Permit No ...___
- 0001
Date/B : / , D ;I �_I __/ , •
° 13125 SW Hall Blvd., Tigard, OR 97223 f n Plan Revie •
' C Phone: 5 03 .639.4171 Fax: 503.598.1960' N 2 3 L U U Date/B : Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: 110i 111,4_, ® See Page 2 for
Internet: www.tigard - or.gov CITY v � F 1 «ARD Notified/Method: 1 9 �l Supplemental Information
TYPE OF WOl2R_ PLAN REVIEW
11 New construction ® Addition/alteration/replacement 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: where the available fault current ❑ Marinas and boatyards.
. CATEGORY OF CONSTRUCTION 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 ® CommerciaUindustrial ❑ 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 ", "I -2 ", "I -3 ",
Job no.: 9332 Job site address: 15951 SW 72 AVE IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD OREGON ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: CASCADE COMPUTERS ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 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'I 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.)
THERMOSTATS & WIRING Limited energy, multi- family 75.00 2
residential (with above sq. 0.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
g A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: PROTEMP ASSOCIATES 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
Miscellaneous (service or feeder not included)
City/State /ZIP: PORTLAND OREGON 97222 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503 —) 519 -6199 Fax: : (503) 238 -9767 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: SAME AS ABOVE
energy panel, alteration, or
Address: extension. Describe: 1 Page 2 2
THERMOSTAT &WIRING
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: 38868 Electrical Lic.: 261063 C Suprv. Lic.: 2613LEB Industrial plant per hour _ 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, requiredt-,r 1 /- Subtotal: OO
Print name: MONTY SCHROEDER Date: 1/23/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 9 -
Authorized signature TOTAL PERMIT FEE: %V
This permit application expires if a permit is not obtained within 180
Print name: BRUCE BUTNER Date: 1/23/08 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(ll /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2.00R -00017
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/200f
Phone: (503) 639 -4171 �°w
Inspection Requests (24 Hrs.): (503) 639 -4175 '_
INSPECTION WORKSHEET FOR DATE: 1/30/2008 TIME: 7 PAGE: 59
SITE ADDRESS: 72ND LASS OF WORK:
1596:i' 72N{7 AVE AVC BLDG
SUBDIVISION: OREGON BUSINESS PARK 111 LOT #: 038 TYPE OF USE:
PROJECT NAME: CASCADE COMPUTER
DESCRIPTION: Thermostats and wiring.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-233-6911
Inspection Request Scheduled For: Date: 1/30/2008 Pour Time:
Code # Inspection Description onfirm • Contact # Message
199 Electncal final 064162 -03 503519.6199 N
Corrections/Comments/Instructions:
J\l
r \
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' Ov be Date: I ' 3 0 011 Phone #: (503) 718- _ F