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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT PERMIT #: ELR2006 -00255 Aertiva i � DEVELOPMENT SERVICES DATE ISSUED: 10/20/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 • PARCEL: 1S 136DD - 03400 SITE ADDRESS: 11740 SW 68TH PKWY ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG Project Description: SHELL Low voltage 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 NW PROPERTIES AMERICAN HEATING ATTN: PAUL GRAM 1339 SW GIDEON ST P.O. BOX 2206 PORTLAND, OR 97202 BEAVERTON, OR 97075 Phone: 503 - 626 -3500 Contact #: PRI 503- 239 -4600 FAX 503- 239 -7038 FEES Reg #: ELE 26- 993CRE LIC 33135 Description Date Amount [ELPRMT] ELR Permit 101201200E $75.00 [TAX] 8% State Surcha 101201200E $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. -7� Issued By: .c .l 0 Q .� /� Permittee Signature: // ? 5 --- / ga4C 15 / fl ICJ C�JI X .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: 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 Application FOR OFFICE USE ONLY City of Tigard _ �D Received Pemut `, __ DateB 1 / i � � - ow 13125 SW Hall Blvd., Tigard, OR 972 3 Plan Review Other Pe • Phone: 503.639.4171 Fax: 503.598.196Q © 2006 � % 'tr,• " D ateB : - if 1..le Inspection Line: 503.639.4175 L ∎• ` ! u ' I I .. Ready /By. Date Read /B . l n See Page 2 or Internet: www et ngard or us ra ®= TGc�A4R,1l' Nobfied/Method: Supplemental Information U Vl Y p� s� f. ,� � I, K f . , .717 n ! x i rrr.. t y„ ) ,. " '+( ,,- fir .7 ....'�'t7 aka r . ' + --r j �' v' a r i ,, 3w' A 7 .1' S cFt a i w k r . i i T � v ' y 5 ,, - '-� 'a i. �� d5 9 F q ''' ' .� '� 1 4 � ' i S N 1.r„ 5x� '1 - () ll G li� �' ifJG l � ...X'r i ::" K l "• ry ���hi;' � ,.Y �, .�� �r. , •� ,�F _ [Y� �� �_��.__ _L ��',. �� �} �c' te' A J... 7 ��.. �_ r_ �y � frf�. �5.' �� :1s., 3 i fr��:,;.'3'yi�7. ...u. �Y .���.d:�.s.,:._._, . .v�J �. a. New construction ❑ Addition/alteration/replacement Please check all that apply: ❑Service over 225 amps, comm'I ❑Hazardous location ❑ Demolition ❑Other: c -• f, �_ :�� - - ,I ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., s C _ .. te , , � " ; -`a f Z a tJ u Q ,C� r � (bj,�j;: { A t _ lr T 'ire a' of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling P'Comrnercial/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 r.; r f4 ° st t U 3 0 gp ' i`y t B ~ r lR. t P RV park � 3fg v. t...s;2, Grp`k _.3 z ,4%, iX. ; 1 � .- ,A �t� h. � il_R3•:� ilfr,l ❑Egress/ p Job no.: Job site address: I n 0 5� c 6lJ'i A ❑Health -care facility ❑Other. Submit Z sets of plans with any of the above. City/State/ZIP: t t • a a 4 I a,. The above are not applicable to temporary construction service. '1 ''? - ;j yyY aiV i' t i t : •`�y'_ ' . �' ,i n lr 5 . 1 {gin % „ ,x,:„ ,, •' • '' i r , Suite/bldg./apt. no.: Pro ect name: ` . � °,_r ' ` ' "` "' '- ,. •• • J Y I -. 1 i gam DauiptIon Qty. Pee. T Cross street/directions to job site: 5 , I/ 1 9 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 F . X ..3'5 ' T 1 Y '' rYi R t a l e a b r r i 6 �e:: r ^r - s..,r; .,...y. ... __�.� �4rs ., r n �.dii E: ns,fi (oi t i LL : f_` /stara � �,1� ;k _ Each manufactured or modular `� ` + r , t (� dwelling, service and/or feeder 90.90 2 �1 lam/ V 0. i� t 6 I. -f QY Services or feeders installation, alteration, and/or relocation l.i r "17"-' IP 200 amps or less 80.30 2 . `”7 � 7a_ 0 A F (gq 65i ,LL r ° S�� } ,7_ r; , . " �f 7 , liNK ;:f a ; 201 amps to 400 amps 106.85 2 ,_..__. :1. _ _� �. _ kf: ,7,:',LT�L.. ;^-1 E... . _ ✓1...1L W,' .2" 7 ,1 , 1 . {2 y '.c'r' i?, Y .�...��; 401 amps to 600 amps 160:60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 • Reconnect only 66.85 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 600 amps 133.75 2 Owner signature: • Date: Branch circuits - new, alteration, or extension, per panel r 1x t T: c , �� - c ,,, t'� r# t �;yv[� + ' y " y ; e t ''. A. Fee for branch circuits with .'a�, .4-,IY -ra. `12 , -, , d4l 16 _tz+ .3- ,„ r3' 5 °r.1u.'w %u.i:<< :55.r !!.d Tn�' r � . 0 - -tr, 1.21 service or feeder fee, each 6.65 2 itirTMENZIMINIIIMI branch circuit B. Fee for branch circuits Contact name: ) / • without service or feeder fee, 46.85 2 E � T each branch circuit Address: ►33� 3 L \ 1 ►_S), S , Each add'I branch circuit 6.65 2 City /State/ZIP: 1)0 Y i- I, 046 . 0 or) a 0-a. Miscellaneous (service or feeder not included) /,�, 1 a(� Pump or irrigation circle 53.40 2 Phone: • ) a3'" _ (�0 F () a J "1 Q3g Sign or outline lighting 53.40 - 2 • E - mail: �y . Signal circuit (s) s) or limited - G Y t , 1:F.7s y n , 0 } 6� U 1 jh .M. ": 4 ' i _ i P Y� `ii 4 G ✓fi i energy panel, alteration, or im' .,,2 �:..�.�:: '' ifi :-?�.. -4.. /..,._ . 7i :,; `..I,��z _;,... L.:z; extension. Describe: Page 2 2 X 11! M M Address: 1 33G se , t s# Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: 'TU y`t. ' 4 C E I ') aUa. Investigation per hour (1 hr min) 62.50 Phone: Q555) a- t- Goo Fax: (-lib) 1033 Industrial plant per hour 73.75 fV �0 Af r'. :l'�:,,� tit 8 +..' 4s ._:1�,fAMh� -tads �:� CCB Lic.: 33 ` 35 Electrical Lic.: , 6qcr3 cee Sup Lic.: DI 0 L Subtotal /6 , Suprv. Electrician signature, required: _ If • Plan review (25% of permit fee) h I State surcharge (8% of permit fee) 4 Pont name: 1 v Q _ �/ Date U_ U_OG TOTAL PERMIT FEE 01, t7 Authorized signature: �„ ` l1L / ,,� ; ` i This permit appllcatlon expires If a permit Is not obtained within I80 days after It has been accepted as complete M � I Date: 0 _ , I 0 G • Fee methodology set by :I'd Building Industry Service Board •• Number of inspections per permit allowed. i:\ BuitdinePemtiu \E1.GPennitApp.doe 11/03 44O- 46t5T(10 /02/COM/WEB • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006 -00255 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006 Phone: (503) 639 -4171 //�na 1 Inspection Requests (24 Hrs.): (503) 639 -4175 . �! — , 1 .. INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7:00AM PAGE: 6!3 1 1 SITE ADDRESS: 11740 SW 68TH PKWY CLASS OF WORK: SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: TIGARD TRIANGLE COMMONS DESCRIPTION: SHELL Low voltage for HVAC OWNER: IFIC NW PROPERTIES, PHONE #: 503.626.3500 CONTRACTOR: AMERICAN HEATING PHONE #: 503-239 -4600 Inspection Request Scheduled For: Date: 12/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 041386-0/ 503793.2240 N Corrections /Comments /Instructions: tk PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N d(3 LT; Date: 124-24106 Phone #: (503) 718 - 1.-44) CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006 -00255 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006 Phone: (503) 639 -4171 • tir"111 AIV1" Inspection Requests (24 Hrs.): (503) 639 -4175 J INSPECTION WORKSHEET FOR DATE: J2012007 TIME: 7 :09AM PAGE: 78 SITE ADDRESS: 11740 SW 68TH PKWY CLASS OF WORK: SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: TIGARD TRIANGLE COMMONS DESCRIPTION: SHELL Low voltage for HVAC OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626-3500 CONTRACTOR: AMERICAN HEATING PHONE #: 503 239 - 4600 Inspection Request Scheduled For: Date: 2/20/2007 Pour Time: Code # Inspection Description 'rm # Contact # Message 199 Electrical final 043564- 01''\ 503- 2030731 N ■ Corrections /Comments /Instructions: - -- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 ‘ 6 Lc Date: Z' 20 - 0 , Phone #: (503) 718- 2.1 741