Permit 7N/,vim ?.v Cd22EaT Szf7 ;3 5�/' -44
` ' CITY OF F T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00302
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/30/2007
PARCEL: 2S113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 100 ZONING: I -
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: OREGON STATE BAR
Project Description: HVAC Controls, sensors.
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:
OPUS NORTHWEST LLC HVAC INC
1500 SW FIRST AVE SUITE 1100 5188 SE INTERNATIONAL WAY
PORTLAND, OR 97201 MILWAUKIE, OR 97222
Phone: 503 -916 -8963 Contact #: PRI 503- 462 -4822
FEES Reg #: ELE 26- 571CLE
LIC 50897
Description Date Amount
[ELPRMT] ELR Permit 7/30/2007 $75.00
[TAX] 8% State Surcha 7/30/2007 $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 v' questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: �/�i ?�Y( �L
/, Permittee Signature: tr f� . 'e "5-770/\./ `� 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 F(llt ( i wi-: i si -: ()NIA
City' of Ti gard "ed 't : .�.o D ' ` r3 ' Permit'}, e t 4 1DO 7_'30
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revue
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Phone: 503.639.4171 Fax: 503.598.1960 II� Daa
Inspection Line: 503.639.4175 _t ' � Other Permit.
' 1 Date Read yBy 3ua• ® See Page 2 for
Internet: www.citigard.or.us Notified/Method: Supplemental Information
-` := ':£x'.' r. :•'� _, ': TYPE OF. ,_;-•.• ' -• -;'.- ;-'�,,;M1= :.;:: <= : :.,, : :.? .::.:.:;7,:.PLANeREVIE_ W-: =- : i t ,t'i =s
❑ New construction 4P alteratio placement Please check all that apply: .
1:1 Demolition El Other: ❑Service over 225 amps, comm'I ❑Hazardous location
Service over 320 amps rating Buildn over 10 000 s
p - ling ❑ g . ft q
-- :-. `<CATEGORY CONSTRUCTION - _ • . of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling mmercia t dustrial 0 Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ['Building over three stories 0 Feeders, 400 amps or more
- .: - - ' 'JOB SITE - INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑RV utactured structures or
❑Egress/lighting plan park
Job no.: 356 3 Job site address: I (0 03 caw U 0 Health-care facility ❑der.
r1 ��'� i T6� a Submit 2 sets of plans with any of the above.
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City/State/ZIP: • b' 01,63 Lr'1 S The above are not applicable to temporary construction service.
I
QrP� J,...-L:44',,.......:, 'FEE! SCHEDULE :, 2- .? . .-
SuitSuite/bldg./apt. no.: / I A Project name: J on S
Description I Qty. I Fee. I Total I . •
Cross street/directions to ob site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. It 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
1) C Ceyr' S dwelling, service and/or feeder 90.90 - 2
t'TD S e4'I SIPS Services or feeders installation, alteration, and/or relocation
/ 200 amps or less 80.30 2
.. ❑ PROPERTY:OWNER • - :I . -: '. ❑ TENANT 2. _ :-
201 amps to 400 amps 106.85 2
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
- • =• - ❑ APPLICANT I . ❑ CONTACT PERSON - - - -. A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name:
without service or feeder fee,
Address: each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax::( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
- - •• :•,:-. ' CONTRACTOR - - :.- --- • -, - , . energy panel, alteration, or
extension. Describe: / Page 2 2
Business name: 1VAC _
Address: Si �� SE / _.,. ' �,(� �y Each additional inspection over allowable in any of the above
I Per inspection 62.50
City/State/Z�: ` �i 0 Y , e �\ Investigation per hour (I hr min) 62.50
Phone: (b 4 ,2_ y" gam / Fax :3) e�a _oss S Industrial plant per hour 73.75
CCB Lic.: =t - ELECTRICALSPERMIT;FEEStif
S0 7 El ectrical Lic ..5 7,Ct. & Su L ic.: 6 o S L EA Subtotal
Suprv. Electrician signature, required: F Plan review (25% of permit fee)
A
Print name: AA e SCOIo eitZ Date: 7 q o7 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: 4 00111 This permit application expires if • permit is not obtained within 180 t days after it has been accepted as complete
Print name: S let e — rp b Liins Date: 7 H / • Fee methodology set by Tri County Building Industry Servia Board
•• Number of inspections per permit allowed
i\ Dui idingWemirta∎ELC- PamitAppdoe 12/03 440-46isT(10/02/COM/WEB
V
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00302
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2007
Phone: (503) 639- 4171 '' 0^ 11 #
Inspection Requests (24 Hrs.): (503) 639 -4175 ..— ti
INSPECTION WORKSHEET FOR DATE: 10111/2007 TIME: 7 PAGE: Q5
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 100 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: OREGON STATE BAR
DESCRIPTION: HVAC Controls, sensors.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503. 916.8963
CONTRACTOR: HVAC INC PHONE #: 503-462-4822
Inspection Request Scheduled For: Date: 10/11/2007 Pour Time:
Code # Inspection Description / Confirm # Contact # Message
1 35 Low voltage 0574113 -02 971-9984440 N
Corrections /Comments /Instructions: - �9
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 01 61 01 Phone '#: (503) 718 - viLito
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2007 -00302
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2007
Phone: (503) 639 -4171 :alit
Inspection Requests (24 Hrs.): (503) 639 -4175 _�._ IL.
INSPECTION WORKSHEET FOR DATE: 9/4/2007 TIME: 7 :01AM PAGE: 35
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD� CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: OREGON STATE BAR
DESCRIPTION: Controls, sensors low voltage.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503 - 916.8963
CONTRACTOR: HVAC INC PHONE #: 503 - 4822
Inspection Request Scheduled For: Date: 9f4l2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 055049-02 503-462-4822 N
Corrections /Comments/ Instructions:
%1 I — I~.
❑ PARTIAL APPROVAL XCANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION / ' • • • ' ' FEES ASSESSED
Inspector: 1----.
Date: !iii 0 Phone #: (503) 718 - VI%
•
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2007-00302
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/3Q/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �'II�
INSPECTION WORKSHEET FOR DATE: 1/9/2008 TIME: 7 :01AM PAGE: 24
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 100 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: ORE :GON STATE BAR
DESCRIPTION: HVAC Controls, sensors.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503 - 916 -9963
CONTRACTOR: HVAC INC PHONE #: 503462 -4822
Inspection Request Scheduled For: Date: 1/9/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 062845-02 503-459 -9226 Y
\
Corrections /Comments /Instructions: J 1 11/\ 1 O M�f'N S
1
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� �
.,• Aiii/
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 00 0 tW) t Date: 1 -9. Phone #: (503) 718- %