Permit •
rpg CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00447
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/12/2007
PARCEL: 2S 112AD -01100
SITE ADDRESS: 06650 SW BONITA RD ZONING: I -P
SUBDIVISION: PAUL SCHATZ FURNITURE LOT: 001 JURISDICTION: TIG
PROJECT: THOMASVILLE
Project Description: (1) low voltage system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES HASTINGS COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI 10015 SW STEEPLECHASE CIRCLE
PORTLAND, OR 97224 BEAVERTON, OR 97008
Phone: Contact #: FAX 503 -524 -5678
PRI 503- 789 -5852
Reg #: ELE 34- 602CLE
FEES LIC 131979
Description Date Amount
[ELPRMT] ELR Permit 12/12/2007 $75.00
[TAX] 8% State Surcha 12/12/2007 $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 • estions to OUNC at 503 • 6.6699 or 1.:00.332.2344.
Issu = V//� / A / � / 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.
1,_
' Elecfrical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/By: /2 IZ� SL Permit No.: /e -- ‘19447
1 1111
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
.
T 1 GARD Inspection Line: 503.639.4175 Date Ready /By: hris 6„. ® See Page 2 for
' Internet: www.tigard - or.gov Notitied/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW •
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 ®"Commercial /industrial ❑ 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 ", "1 -2 ", "1 -3 ",
//� EA) � I001IP or more. occupancy.
Job no.: Job site address:
to co lQ s B »- f 7'ct R d, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: "r'1 G 14z3) 0 R ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ) h o irvt u S V g , He 5+ e_ El Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I *
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'l 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.)
C
`' ` + Limited energy, multi - family 75.00 2
UO tI-0 V 0 1' & ,J ((( , .e. v 0 1 C. / a- +-6. residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
ROPERTY O R ❑TENANT 201 amps to 400 amps 106.85 2
•
Name: C� GG /L n ' 401 amps to 600 amps 160.60 2
G 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 ❑ CONTACT PERSON above service or feeder fee, . 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
• ' CONTRACTOR • Sign or outline lighting 53.40 2
Business name: ' y Tr ��" Signal circuit(s) or limited -
IA t 1 1 N F i S C O WI ✓vl V 10; C fit T I D /J S -+-1'1 C- . energy panel, alteration, or
Address: 1 0 0 l S SW S ?e.er )e L�,.t0.se_ CI r `t e i extension. Describe: / Page 2 ��Q� 2
City/State /ZIP: Se_o, V e-i I 0 1\ (% "7 00 8 Each additional inspection over allowable in any of the above
�) Per inspection 62.50
(
Phone: -7 8 Lj - S g 5 Z Fax: (g Y3 ) S z '1 - sl, 7 v Investigation per hour (1 hr min) 62.50
CCB Lie.: '31 q 7 t Electrical Lic.:3q• ( QZ CLE Suprv. Lie.: Le-A. ?Uso Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: FS• 66
Print name: Q D Plan review (25% of permit fee):
ATY I c ( (44571‘4, / 2 - /Z - 07 State surcharge (8% of permit fee):
(0. 00
Authorized signature: a
TOTAL PERMIT FEE:
^Q This permit application expires if a permit is not obtained within 180
104-7-g
Print name: ,L
/ C k /- - 'T s T t• '' JS 2 f Z .- 7 days after it has been accepted as complete. Date: / -
* Number of inspections allowed per permit.
I'\Building\ Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 1/05 /COM /WEB
■
Electrical Permit Application - City of Tigard
Page 2 Supplemental Information
LIMITED ENERGY PERMIT FEES:
.RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Fl Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ C lock Systems
-- $1 D ata Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
•
Total number of commercial systems:
*No licenses are required. Licenses are required
•
for all other installations
L 'Building\Permits\ELC- PermitApp doc 03/23/06
i
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: B" ,t?A01-4 004
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: )- 23 _ O $ TIME: PAGE:
SITE ADDRESS: 6150 %014.1 A 2D - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: v a "
I I p4tY �
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 1- 23" j% Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
XI PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL fl CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � Ntisb Date: - 23 ' 0 V Phone #: (503) 718 - i`1 ��
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00447
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
Phone: (503) 639-4171 :NM I il
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7:02AM PAGE: 6
N SITE ADDRESS: 06650 SW BONITA RD CLASS OF WORK:
SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: THOMASVILLE
DESCRIPTION: (1) low voltage erlem.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: HASTINGS COMMUNICATIONS INC k--- v 1\1 PHONE #: 503-789-5862
Inspection Request Scheduled For: Date: 1/1812008 Pour Time:
Code # Inspection Description C()__Ifir_ # Contact # Message
199 Elethical final 06354(1-01 503-789-58g N Y
..--
Corrections/Comments/Instructions:
• AO
- 61 ct?t n N
NG 5 iZ..• \OS et s'3 i
i I PASS PARTIAL APPROVAL CANCEL I i NO ACCESS
_ _
•\ FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: G ---, N 6q) L Date: if — 1 i ' 61 ' Phone #: (503) 7181-114
'. ' . •
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BUILDING DIVISION '
~~~~,~~~~..~~~ ~~"°"~~"~~"° PERMIT #: ELR2007'00447
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12M3/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ,4.131;
INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7\O2AM PAGE: 9
SITE ADDRESS: 06650 SW BONITA RD CLASS OF WORK:
SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 0Q1 TYPE OF USE:
PROJECT NAME: THOMASVILLE
DESCRIPTION: (1) low voltage system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: HASTINGS COMMUNICATIONS INC PHONE #: 503-789-5852
Inspection Request Scheduled For: Date: 1/18y2008 Pour Time:
Code # Inspection Description ant: m # Contact # Message
136 Low voltage 063838-0 503-789-6852 N
Corrections/Comments/Instructions:
8�f� rY�� � .�� �
—^~� �w� ^ �� ~ W)
0 PASS 0 PARTIAL APPROVAL KCANCE
� 0 NO ACCESS
=
��
FAIL CALL FOR INSPECTION ITIONAL FEES ASSESSED
_
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI-R2007- 00417
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12J I2/2007
Phone: (503) 639 -4171 4110 mall'
Inspection Requests (24 Hrs.): (503) 639 -4175 ■
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7 : 00AM PAGE: 1
SITE ADDRESS: 0660) SW BONITA RD CLASS OF WORK:
SUBDIVISION: PAUL SCIIATZ FURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: THOMA SVILLE
DESCRIPTION: (1) low voltage system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
• CONTRACTOR: HASTINGS COMMUNICATIONS INC PHONE #: 503-789-5852
Inspection Request Scheduled For: Dare: 1/17/2008 Pour Time:
Code # Inspection Description Genf Contact # Message
195 Misc. inspection - 063450.01 503 - 862 -7900 N
Corrections /Comments/ Instructions:
I I PASS El PARTIAL APPROVAL n CANCEL NO ACCESS
% FAIL CALL FOR INSPECTION Li ADDITIONAL FEES ASSESSED
Inspector: 6 66 L E � Date: I ) - �� Phone #: (503) 718 - 1 -1.14'0
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00447
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211217007
Phone: (503) 639-4171 tilliVitililt\
Inspection Requests (24 Hrs.): (503) 639-4175 .s.,,,-W■ '---.
INSPECTION WORKSHEET FOR DATE: 1/812008 TIME: 7:01Alvi PAGE: 19
SITE ADDRESS: 06650 SW BONITA RD CLASS OF WORK:
SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 001 TYPE OF USE: ■
PROJECT NAME: THOMASVILLE
DESCRIPTION: (1) low voitage system.
OWNER: PACIFIC RFALTY ASSOCIATES, PHONE #:
CONTRACTOR: HASTINGS COMMUNICATIONS IN ? e\ --- y PHONE #: 503-789-5852
W I
Inspection Request Scheduled For: Date: 1/6/2008 ' 2008 Pour Time:
Code # Inspection Description Confirm # Contact # jessage
135 Low voltage 062764-01 503-789-5852 y
Corrections/Comments/Instructions:
Cho Pg
.
c .„
X PASS 7 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
I FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 0 3"Th INIbtsc, Date: 1 -1. Phone #: (503) 718-