Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
-! 'a, COMMUNITY DEVELOPMENT Permit#: ELR2013-00268
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2013
Parcel: 1 S126DC03300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 130
Project: TIAA-CREF Subdivision: LEHMANN ACRE TRACT Lot: 4-5
Project Description: Low voltage for HVAC
Contractor: OREGON HEATING&AIR CONDITIONING Owner: ATHERTON REALTY PARTNERSHIP
19300 SW 118TH AVE 2100 S WOLF
TUALATIN,OR 97062 DES PLAINES, IL 60018
PHONE: 503-691-9699 PHONE:
FAX: 503-691-8556
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 10/28/2013 $75.00
12%State Surcharge-Electrical 10/28/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503/. 32^1987 or 1.800.332.2344.
Issued By: ``� �P Permittee Signature: „_��.r
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
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.
Oct. 24. 2013 12: 36PM No. 1187 P. 2
Electrical Permit Applicat IT' I CE!VED FoR oFI•'IC.E USE ONLY
City of Tigard Dale/Bea �',e��o/3-x'2 '6)
O�� Pem,it No.:
-'t 13125 SW Hall Blvd.,Tigard,OR 97,2 2 Plan Review Other Penrrit; ,6N I9 t.,/3-QQ,2 7
Phone: 503.639.4171 Fax: 503.59 b 4 2013 DaretBy;
t'1GAllll Inspection Line: 503.639.4175 Dale Ready/By: NMI GI See Pagez(or
Internet: www.trgard•or.gov CITY OF TIGARII Notified/Method; Supplemental Information
TYPERIZDEC DWI SIG l PLAN REVIEW
at d
❑New Construction ®'Addition/alteration/replacement Please oheek arat apply(snbmil 2 sets of plans wfitems checked below):
0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boalyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or []Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling LiCommercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A"."E"."1-2","I-d--,
/ D I OOHP or more. occupancy.
Job no.: j1 Q "d d�`- Job site address: yOO 511/ G�e1 6�< ❑Six or more residential unite. ❑Rrcreatio„al vehicle parks.
City/State/ZIP: p0/"f(c p 0 9 7)-�7 ❑Hazardoare facilities, ['Supply voltage for more than
R 1 ❑Hazardous locations. 600 volts nominal,
Suitc/bldg./apt.no.: l30 Project name: `--r44 "I ❑Service or feeder 600ampsormore.
FEE SCHEDULE
Cross street/directions to job site: oescrtpilon -r-Qty. I' Pee. I Total I -
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: + Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.R.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
with abovo s.,ft.)
75,00 2
DESCRIPTION OF WORK ( ww.
Limited energy,multi-family
It) 75.00 2
t) T Lc r l f' resideslialSwith above sq.ft.)
Services or feeders Installation,alteration,and/or relocation
200 amps or less 100.70 ' I 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 .
401 amps to 600 amps 200,34 2
Name:
60!amps 10 1,000 amps 301.04 2
Address:. Over 1,000 amps or volts 552.26 2
• Temporary services or feeders Installation,alteration,and/or
City/State/ZIP: relocation
Phone:( ) pax:( ) 200 amps or less 59.36 f I
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125,08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 4111 amps l0 599 amps 168.54 2
Branch circuits—new,alteration,or extension, er panel
Owner signature: Date: A.Pea for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
nosiness name: 3 z C 6,e(0 UI B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name: 0Sk Fairer branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous(service or feeder not included)
City/State/ZIP:
Each manufactured Or modular - 67 84 2
ty dwelling,service and/or feeder
Phone;( ) I Fax::( ) Reconnect only 67.84 2 .
Pump or irrigation circle 67.84 2
E-mail: 'CC; r'( dn &Qct,PA.7-' 60\ Sign or outline lighting 67.84 2
CONTRACTOR Signal cirouil(s)or limited-energy
„Business name: 0 re_fei !+e�,�-: D A C panel,alteratioa�orextension. I Page 2 "Sr 2
Each additional Inspection over allowable in any of the above
Address: l C 3 00 5 fu j I S 4-L, k i,� Additional inspection(1 hr min) 66.25/hr
p Investigation(I hr min) 66.25/hr
ity/State/ZIP: Tk„.A.t� ;n( 0 1\ cy 70
Industrial plant(1 hr min) 78.18/hr
Phone:(.0) t 01 /— /CM Fax:(.CO S) ,(9/- 5 " Inspections for which no fee is 90.00/hr
specificalYlisted('r4 hr min)
CCB Lie.: `l�' Electrical Lic.:L• �` yQ Suprv,Lie.:) U 1.�o ELECTRICAL PERMIT FEES
Suprv,Electrician signature,required: -- ._ - _ Subtotal: `r5.��
Plan review(25%of permit fee): '----r _
Print name: 'r as Date: 1041,..! 3 Stale surcharge(12%of permit fee): q-00
I(� TOTAt.,PERMIT FEE; %K'C9U
Authorized signature: - -- This permit application expires ifa permit is not obtained within ISO
r days after it has been accepted as complete.
Print name; J eists, Fes'I-e( Date: (,04.1-143 • Number of inspections allowed•per pencil.
I.''Building\P arm itstELC-PermitApp.doc 07/01/10 440-4615T(11/OS/CO.w1VEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9900 SW GREENBURG RD 130, TIGARD, OR, 2013 -12 -02 00:00:00
97223
Record Type: Record ID:
Commercial - Electricial Limited Energy ELR2013 - 00268
Inspection Type: Result:
199 Electrical final PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor