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Permit
• C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT i DEVELOPMENT SERVICES PERMIT #: ELR2005 -00293 ..� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/20/2005 PARCEL: 1S134BC-00300 SITE ADDRESS: 12280 SW SCHOLLS FERRY RD ZONING: C -G SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG Project Description: Thermostat. 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: VINNACOMBE CONSULTING HVAC INC. 12790 SE BLUFF RD 5188 SE INTERNATIONAL WAY SANDY, OR 97055 MILWAUKIE, OR 97222 Phone: 503- 826 -1726 Phone: 503- 462 -4822 Reg #: LIC 50897 ELE 26 -571 CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 9/20/2005 $75.00 [TAX] 8% State Surchar€ 9/20/2005 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questio s to O U , NNC at 503 - 246 -6699. Issued By: Permittee Signature: Sl/ d WIO (44406" OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 'Electrical Permit Application p q FOR OFFICE USE ONLY City of Tigard RE CE � E , Date /B : —d - 0 `�. Permit No.: Z (� , A : �1L4 • 13125 SW Hall Blvd., Tigard, OR 9722 © Plan Review ether Permit: Phone: 503.639.4171 Fax: 503.598.1960 4 �''r i 1 ''� DateB Inspection Line: 503.639.4175 ■ a I Date Ready/By: IMI ®See Page 2 for Internet: www.ci.tigard.or.us SEP 0 �oo Notified/Method: Supplemental Information '- ,. - ._r „- ' T 1C/MP"ra :" , .'f,_`•,. ,: "? ,. - -. ".A ,t. • PLAN. ❑ New construction E- Afit$tipElTi'�I Sbement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., '!CATEGOR'2 OF CONSTRUCTION: • - of I- and 2- family dwellings 4 or more new residential ❑ 1 - and 2 - family dwelling (-Commerc Jindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure - El Multi family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more 2/ _ ; 1 " ; • ❑Occupant load over 99 persons [Manufactured structures or ' ' JOB ; SITE INFORMATION • A • NN ` ID LOCATION w , ['Egress/lighting plan RV park Job no.: Job site address: 1 'aa ' o sou Sr L 1\S fi r ❑Health care facility ['Other: 2 sets of plans with any of the above. City/State/ZIP: l l d (`p 6� The above are not applicable to temporary construction service. / 1 t '' Y - _r; _' :' " FE E * = SCHEDULE'i- a'.,' • Suite/bldg. /apt. no.: Projec ame fl U r, C �T a _ re A4 t71� Deserlptlon Qty” Fee. I Total I •• 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'( 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 r •,. . .,. : R DESCIPTION Off' •WORK? 4:' -'" -' Ai;:-_ ' ,-. ... . - �y '�'. , _ : y _ , Each manufactured or modular - dwelling, dwelling, service and /or feeder _ 90.90 2 r e-�L- °e, 'A- revitt-.t.4- `t kc,..Au_¢'% L Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 '.' ❑'c O,PERTY" OWNER ....4. , ' � "' ; A .:;)` 201 amps to 400 amps 106.85 2 {' PR " `. - . , TENANT 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 `''' ' :.'- _-„; - t'� - A. Fee for branch circuits with i- ''' �'.P,PI'I:IGvAN>; »"-t? ' � w' - , ❑ ; CON``CACi' �P�RSO :s =; r ; '.Y. .A Ti c ' , rb service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- . 'i' o:: -. .: :...;!,_•'.,,,, ener anel, alteration, or s =�.;_ f :��: •: .: "CONTRA IOR , ! � " - - '= �`s extension. Describe: P 4 T v extens l Page 2 2 Business name: � o wl J / Address: w , ' ^ Each additional inspection over allowable in any of the above S 1 �� S w Per inspection 62.50 City/State/ZIP: I V j C 1 L O ) 0 vco try- Investigation per hour (I hr min) 62.50 1 Phone: Industr plant per hour 73.75 c ) �(c2 —�K F ax :( y c�a -� ss5 �: " - : .,, " . �. ` ", ".ELECT'RiCAL :PERiVITT TEES*. , CCB Lic.: S o ' 7 Electrical Lic.a6 r r Suprv. Lic.: z bay Subtotal Suprv. Electrician signature, require Plan review (25% of permit fee) r --- State surcharge (8% of permit fee) Print name: ( Ow\ WV (,,-. Date: 9j �v / TOTAL PERMIT FEE . Authorized signature: � � } -. 4 -6--...,\ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: � %i°ilrrk 2obti4SU-v-\ Date: 4 1 2_0 /°S • Fee methodology set byTri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Building \Pemuts\ELC- PemitApp.doc 12/03 440- 461ST(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: n SS FT'" TTM' �..,707,7 Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COIVINTERUAt Wb +ONL,S . ' i �` = 71 Fee for each commercial system $75.00 (SEE OAR 918 - 260 - 260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\Building\Pamiu\ELC -Pc mitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005 -00293 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 P __ INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 65 SITE ADDRESS: 12280 CHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: GREENWA'• TOWN CENTER LOT #: TYPE OF USE: PROJECT NAME: OREGON CO , MUNI1'Y CREDIT UN DESCRIPTION: Thermostat. OWNER: VINNACOMBE CO `,ULTING, PHONE #: 503 -826 -1726 CONTRACTOR: HYAC INC PHONE #: 503 -462 -4822 Inspection Request Scheduled For: Date: 10/14/2005 Pour Time: Code # - = - ' - scription Confirm # Contact # Message 199 IMF Electrical final 1 8380 -02 503-462-4822 Y Corrections /Co - s: P PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS (FAIL ❑ C LL FOR INSPECT •N ❑ ADDITIONAL FEES ASSESSED Inspector: Date: k I „,--- Phone #: (503) 718- 1--14/ ti CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005 00293 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9120/2005 Phone: (503) 639 - 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 �+�- "'� �.. INSPECTION WORKSHEET FOR DATE: 9/30/2005 TIME: 7 :05AM PAGE: 79 SITE ADDRESS: 12280 SW SCROLLS FERRY RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: GREENWAY TOWN CENTER DESCRIPTION: OREGON COMMUNITY CREDIT UN Thermostat. OWNER: VINNACOMBE CONSULTING, PHONE # : 503-826-1726 CONTRACTOR: HVAC INC PHONE # : 503-462-4822 Inspection Request Scheduled For: Date: 9/30/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 13 Low voltage 017104 -01 503 -462 -4822 Y Corrections/Comments/Instructions: -- h N\ j PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 7----/- '. Date: 0 Phone #: (503) 718 -