Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00473
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2007
PARCEL: 1 S 126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 ZONING: C -G
SUBDIVISION: ONE EMBASSY CENTER LOT: JURISDICTION: TIG
PROJECT: ARTIELLE
Project Description: 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:
PORTLAND OFFICE ASSOCIATES WILLAMETTE HVAC
BY TC PORTLAND, INC PO BOX 23334
8930 SW GEMINI DR TIGARD, OR 97281
BEAVERTON, OR 97008
Phone: Contact #: PRI 503- 628 -6841
FAX 503- 848 -2597
FEES Reg #: ELE 34- 346CRE
LIC 56951
Description Date Amount SUP 4025LEB
[ELPRMT] ELR Permit 12/19/2007 $75.00
[TAX] 8% State Surcha 12/19/2007 $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 ' ca io nt\r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rule or direct questions to it Iola at 503.246.6699 or 1.800.332.2344.
Is ued By: j/119/Leod 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.
Electricalkermit Application FoR 01:1- 1: t r. o\ 1.1
City of Tigard Received /2 ff p Permit No.: G�/ J7 -) 0 73
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' ® Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit.
T I G A R D Inspection Line: 503.639.4175 Date Ready/By Sets: ® See Page 2 for
Internet www.tigard -or.gov Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below).
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑Other
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ 1 and 2 family dwelling ® Commercial/industrial Accessory building
less • s ground, other or exceeds 14,000 ❑ commercial use agricultural
❑ rY g amps for all outer installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency
JOB SITE INFORMATION AND LOCATION of system. larger `rely derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 09020 Sw washingtoo square Rd 1aoxPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks
City/State/ZIP: tigard OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldgJapt no.: 450 I Project name: Bm /1- Art . ti e r— ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: ornriptian I Qtr. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. fL or portion 33.40 I
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. e.)
one thermostat 40
Limited energy, multi - family
75.00 2
Relocating — 1 �___ residential (with above sq. e.)
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
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) F :: ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRALTO Sign or outline lighting 53.40 2
Business name: willamette Hvac Signal circuit(s) or limited -
energy panel, alteration, or
Address: PO Box 23334 extension. Describe: 1 Page 2 2
City/State/ZIP: tigard OR 97281 Each additional inspection over allowable in an - of the above
Phone: (503) 628-6841 I Fax: (503) 848 -2597 Per inspection 62.50
Investigation per hour (1 to mm) 62.50
CCB Lic.: 56951 Electrical Lic.: 4025LE j ic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required. , Subtotal:
Print name: Mike Sicard / Date: 12/19/07 Plan review (25% of permit fee):
ii State surcharge (8% of permit fee):
Authorized signature TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: ,A J). t%' Date: days after it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007.0f0473
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/20:)7
Phone: (503) 639 -4171 i ll
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'_� °_.
INSPECTION WORKSHEET FOR DATE: 1/1&2008 TIME: 7:02AM PAGE: 7
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: ARi-IELLE
DESCRIPTION: („ voltage for HVAC.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: WILLAMETTE HVAC PHONE #: 503 - 628-6841
Inspection Request Scheduled For: Date: 1/i5l2008 Pour Time:
Code # Inspection Description Confirm #� Contact # Message
199 Electrical final 063256-01 503- 706-3211 Y
Corrections /Comments /Instructions: it
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A ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i Nb8 Le Date: 1 , 1'S O' Phone #: (503) 718 - 1-1411ki