Permit •
CITY F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00241
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2006
PARCEL: 2 S 115AB -01800
SITE ADDRESS: 11354 SW DURHAM RD WASH. MUTUAL BANK ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: JURISDICTION: TIG
Project Description: Washington Mutual Bank. 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:
BIT HOLDINGS LTD PARTNERSHIP MACDONALD- MILLER FACILITY SOLUTIONS
BY FORUM PROPERTIES INC 12801 NE AIRPORT WAY
FIVE CENTERPOINTE DR STE 290 PORTLAND, OR 97230
LAKE OSWEGO, OR 97035
Phone: Contact #: FAX 503- 244 -0902
PRI 503- 244 -0901
FEES Reg #: ELE 37 -1015C
LIC 154368
Description Date Amount
[ELPRMT] ELR Permit 10/4/2006 $75.00
[TAX] 8% State Surcha 10/4/2006 $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.
Permittee Signature: /.d /
Issued By: ./1 4�� g . _. •
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, .
: -. 5 --.1: i. ( s r f� ,i ' '1; :W ,t
Electrical Permit A '" ''' ri ' FOR OFFICE USE ONLY -
Clty of Tigard (; Received 1...."1"r****. permit No f /
4 2006 Date/By:, , + — Ill
13125 SW Hall Blvd., Tigard, OR 9722W 0 4; Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �") /i DateBv. Other Permit:
Inspection Line: 503.639.4175 : r .-.l�r- Date Ready/By: UM H See Page 2 for
Internet: www.ci.tigard.or.us �� -4 ` vi .1.e.ii :12,,1� Notified/Method: Supplemental Information
TYPE OF W O R K ' ' , ' . PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply:
Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition E Other:
['Service over 320 amps — rating ❑ Buildn 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 ['Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other:
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
❑Health -care facility ❑Other:
Job no.: 836 -6130 Job site address: 11354 SW Durham Rd
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard, OR. 97224 The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: Washinton Mutual #1169 FEE* SCHEDULE %*
Description Qty. Fee. Total
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
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Retrofit existing controllers and sensors for six vav boxes and one by -pass damper dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
install low voltage wiring for 1.5 ton mini split A/C unit 200 amps or less 80.30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Washington Mutual Bank Branch #1169 601 amps to 1,000 amps 240.60 2
Address: 11354 SW Durham Rd. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Tigard, Oregon 97224 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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ® CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: MacDonald - Miller Facility Solutions branch circuit
B. Fee for branch circuits
Contact name: Earl Salsbury without service or feeder fee,
first branch circuit 46.85 2
Address: 12801 NE Airport Way
Each add'1 branch circuit 6.65 2
City/State /ZIP: Portland, Oregon 97230 Miscellaneous (service or feeder not included)
Phone: (971) 244 -0904 Fax: : (971) 244 -0902 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: earl.salsbury @macmiller.com Signal circuit(s) or limited -
CONTRACTOR - energy panel, alteration, or
extension. Describe: Page 2 2
Business name: MacDonald - Miller Facility Solutions
Address: 12801 NE Airport Way Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Portland, Oregon 97230 Investigation per hour (1 hr min) 62.50
Phone: (971) 244 -0901 Fax: (971) 244 -0902 Industrial plant per hour 73.75
ELECTRICAL PERMIT "FEES*
CCB Lie.: 154368 Electrical Lie.: 37 -1015C Su rv. Lie.: /015—ALT Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name:
i'1/e AL L 6,-,://7 07 / Date: /e - `./ 6
t TOTAL PERMIT FEE
Authorized signature: e This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 5.4-L6 6(02i Date: 10/03/2006 * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\Building\Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200 &.00241
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2006
Phone: (503) 639 -4171 :mnuri t
Inspection Requests (24 Hrs.): (503) 639 -4175 ....„..111- .,f i
INSPECTION WORKSHEET FOR DATE: 12/1/2006 TIME: E : 56AM PAGE: ( 9
SITE ADDRESS: 11354 SW DURHAM RD WASH. MUTUAL BANK CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WASH. MUTUAL BANK
DESCRIPTION: Washington Mutual Bank. HVAC.
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: MACDONALD MILLER FACILITY SOLUTIONS PHONE #: 503-244-0901
Inspection Request Scheduled For: Date: 12/1/2006 Pour Time: .
Code # Inspection Description Confirm # Contact # Message
135 " v Itag - 040410 -02 503.572 -8797 N
Cor -ions /Comments /Instru'' ions:
•
■_
PAS - PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: �' NO8 Date: 12 4 -0 )0 Phone #: (503) 718 - 1-41TL