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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00141 , i DEVELOPMENT SERVICES DATE ISSUED: 2/21/2006 �J I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DC -04500 SITE ADDRESS: 07555 SW TECH CENTER DR A ZONING: I -P SUBDIVISION: TECH CENTER BUSINESS PARK LOT : 001 JURISDICTION: TIG Project Description: Reconnect gas pack on roof. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SUMMIT PROPERTIES INC PRO CIRCUIT ELECTRIC LLC 4444 NW YEON PO BOX 3948 PORTLAND, OR 97210 WILSONVILLE, OR 97070 Phone: Contact #: PRI 971 - 563 -8211 FEES Description Date Amount Reg #: ELE 3 [ELPRMT] ELC Permit 2/21/2006 $46.85 LIC 161382 [TAX] 8% State Surcharge 2/21/2006 $3.75 SUP 51075 Total $50.60 REQUIRED ITEMS AND REPORTS 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 Utili otification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rule ec questio to OU t 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: `T 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. E Permit Application FOR OFFICE USE ONLY • 'City of Tigard Received _ 2 e` Permit No — Q'0 Date/B . • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re 'w Phone: 503.639.4171 Fax: 503.598.1960 AA , , o. f I Date/B . Other Permit: Line: 503.639.4175 — 1J_, Date Ready/By.. ISM 65 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction R Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['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 ja Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ Multi - family 0 Master builder 0 Other: ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: 5S ,W 1V C T c,, - Q ^ ❑ Health -care facility ❑der: Submit 2 sets of plan with any of the above. City / State/ZIP: 1,-,./..444., c cit.-7 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE Description I Qty. I 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'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 (L t� ,1 G �•r *` P u a r (Z Q- dwelling, service and/or feeder 90.90 2 [ ��,�11 �.�.� J ` V!V \��1 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 ` 'E �� 401 amps to 600 amps 160.60 2 ��t Name: 1i 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: ( ) I 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 I ❑ 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, I G 46.85 q 2 Address: 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: ( ) I Fax: ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or P �� J' r7 extension. Describe: Page 2 2 Business name: '/v � [_,,, Address: 17. o • 6 39 .4 5 Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: i, t SDA J d i l � ©2 CI"7 Investigation per hour (1 hr min) 62.50 Phone: J 1 (9 11 1( j 1 SZ l ( I Fax: ( . a) zh ( b b k( Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 1613 gZ Electrical Lic.: ..( E t;r Suprv. Lic.: 5(07-5 Subtotal 1 Suprv. Electrician signature, required: ` — Plan review (25 % of permit fee) Print name: Date: — State surcharge (8% of permit fee) 15" •° � TOTAL PERMIT FEE - C Authorized signature: This permit application expires if a permit is not obta within days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. .5-"Vs. 6 0 i.\ Building\Permits\ELC- PamitApp.doc 12/03 410.4615T(INO2/COM/WEB V r CITY OF TIGARD BUILDING DIVISION ► PERMIT #: 0 t.:�llllti (low 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: :42-10(10k Phone: (503) 639 -4171 �w� 1 A\ ' Inspection Requests (24 Hrs.): (503) 639 -4175 ``� INSPECTION WORKSHEET FOR DATE: 2/2//2005 TIME: 1 01AM PAGE: i02 SITE ADDRESS: plrcrr I3W EP4 i DR A CLASS OF WORK: SUBDIVISION: (E CH CENTER B SIhJC:;; PARK LOT #: 001 TYPE OF USE: PROJECT NAME: L.(11 1311-2r) TRAN�, •SCR DESCRIPTION: Fteconner3 ga.$ pack n rout. OWNER: .;l IMMfI PROPi flr NC!, PHONE #: CONTRACTOR: PR CIRCUIT F;LECT Rl L Lt� PHONE #: �171_r�6'i ti:, i i Inspection Request Scheduled For: Date: 2 /e ll 0w Pour Time: Code # Inspection Description • • # Contact # Message . ' or heating unit c . .uit 0 578 01 9/ 1- V,: .8211 N lam — Corrections /Com ts/ • 6,,. bons: 1 S PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector:`v , e) " ` 6 � Date: Z 0 Phone #: (503) 718 - A4V