Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00151
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/14/2006
PARCEL: 2 S 113AB -01201
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505 -16535 ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Limited energy for HVAC.
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 GOHMAN MECHANICAL
15350 SW SEQUOIA PKWY #300 -WMI 412 S BEAVERCREEK RD #602
PORTLAND, OR 97224 OREGON CITY, OR 97045
Phone: 503- 624 -6300 Contact #: PRI 503- 650 -1588
FAX 503- 655 -0514
FEES Reg #: ELE 3- 495CLE
LIC 119952 •
Description Date Amount
[ELPRMT] ELR Permit 6/14/2006 $75.00
[TAX] 8% State Surcharl 6/14/2006 $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 • • R 95 1 o You ma obtain copies of these rules or direct c stions to OUN att5033 246-6699.
Issued = y: I" 1 % �r ' Permittee Signatu ✓�l���
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.
Electrical Permit Application 1.-(m O F r i C E 1l () I. V
City of Tigard nae ® Q � ,, Permit No.: E o — pv1SA
111141 13125 SW Hall Blvd., Tigard, OR 97223 R ECEI
Phone: 503.639.4171 Fax: 503.598.1960 " � :11171 { , t . P
Ot6e ermrt:
Inspection Line: 503.639.4175 4) ii • 1 Date Ready/By: ®Sce Page 2 for
Internet: www.ci.tigard.or.us JUN 1 4 2006 Notified/Method: Supplemental Information
TYPE OF � VL'QRK_ _ _ PLAN REVIEW
❑ New construction ❑ Addition i i Y � ]= TJ � r 1 Please check all that apply:
❑ Demolition ❑Other: �'�IFIUII4V ❑Service over 225 amps, comm'l ❑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
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories [Weeders, 400 amps or more
❑ Multi - family ❑Master builder 0 Other:
❑Occupant Toad over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
„�5 ❑Health -care facility ❑der
Job no.: Job site address:
/ U/ 7� /4de Submit 2 sets of plans with any of the above.
City/State/ZIP: R TL4l✓p I R 7 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: 5/ It r��,,t, Description I Q Fee' Tmal
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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
'- 5 — CI rS Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
'PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
�- 401 amps to 600 amps 160.60 2
Name: pf �L ` 601 amps to 1,000 amps 240.60 2
Address: /'S35-0 .5-1A, �7'd i1G-2
Over Reconnect amps or volts 454.65 2
CC Reconnect only 66.85 2
City/State/ZIP: c t '2j /, jP1 7A.... - °77aZ.2y Temporary services or feeders installation, alteration, and/or
�cr�) Fax: relocation
Phone: (
6•xy -� 3v� (5v3) � p - 7 T5� 200 amps or less 66.85 I
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 an 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: branch circuit
Contact name: _ B.
�� � � Fee for branch circuits
without service or feeder fee, 46.85 2
Address: ;9 first branch circuit
Each add'I branch circuit 6.65 • 2
City/State/ZIP: Miscellaneous (service or feeder not included) -,
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting ' 53.40 2
E -mail: Signal circuit(s) or limited- '
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 1 2'.
Business name: (' co b / itlie:/41 `NC . - - •
-
Each additional inspection over allowable in any of the above
Address:
• � 0 � S `: / .12,47 Per inspection 62.50
City/State/ZIP: t � � /' GJ7e9'Y Investigation per hour (I hr min) 62.50 -
Phone: (-T-03- ) C'.... y,-- � Fax: (,503)G55"-- b s -/ y Industrial plant per hour 73.75 *.
ELECTRICAL PERMIT FEES
CCB Lic.: //� .6 , Electrical Lic.: — yqd- Suprv. Lic.: Lio Lea Subtotal
Suprv. Electrician signature, required: ' 7 r f ' 411Pr - Plan review (25% of permit fee) .
Print name: l � Date: 6,—/ State surcharge (8% of permit fee
— ti-o4
TOTAL PERMIT FEE
Authorized signatw {� . This permit application expires if a permit is not obtained within 180
I , days after it has been accepted as complete
Print name: (�, -J�Z CA N 1 Date: t r -1 / — 0 1 • Fes methrvinlnov get by Tri- ('mmty Rniklino Industry Senrire. Rnanl
i
CITY OFTIGARD
BUILDING DIVISION PERMIT #: Et_R2006 00'i51
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .,'II�..
INSPECTION WORKSHEET FOR DATE: 10/20/2006 TIME: 7 :01AM PAGE: 67
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505 - 16535 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SAFECO
DESCRIPTION: Limited energy for HVAC.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: J03 -624 -6300
CONTRACTOR: GOHMAN MECHANICAL PHONE #: 503-650-1588
Inspection Request Scheduled For: Date: 1Q120/2006 Pour Time:
Code ' n Description Confirm # Contact # Message
199 Electrical final 038572 -04 503 -888 -0214 N
Corrections/Comments/Instructions:
INS i oN Sti c-Vaset. >• 61 gE"
D agaN 1 (D4 D c.-szvnlp(...46 v.., 174
sq st
...____
; NkL ale -A co-
� I
Ki t S i rsQct
It;
►!1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
0 5 1 :_!I XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: a-% L Date: ¶ Oli 1 60 Phone #: (503) 718 - ti 44tz
CITY OF TIGARD ft
BUILDING DIVISION PERMIT #: ELR200 &00151
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s' '! I..
INSPECTION WORKSHEET FOR DATE: 8/15/2006 TIME: 7 :05AM PAGE: 59
SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505 -16535 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SAFECO
DESCRIPTION: Limited energy for HVAC.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.624 -6300
CONTRACTOR: GOHMAN MECHANICAL PHONE #: 503 - 650 -1588
Inspection Request Scheduled For: Date: 8/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 034965.01 503.650 -1588 N
Corrections /Comments/ Instructions:
4'fCe T UV i f � !4
Po-0 V cia. , 2,,te cL i o : / /0, ti a i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �/l�' Date: T —is— o C Phone #: (503) 718-