Permit W ' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
c COMMUNITY DEVELOPMENT Permit #: ELR2010 00040
T 1GARL? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/04/2010
Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15875 SW 72ND AVE
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: Calypte
Project Description: (2) low voltage systems, data & access control.
• FEES
Owner:
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 03/04/2010 $135.68
PORTLAND, OR 97224 12% State Surcharge - Electrical 03/04/2010 $16.28
PHONE: 503 - 624 -6300
Contractor:
TECHNOCOM INC
7929 SW BURNS WAY STE. F
WILSONVILLE, OR 97070
PHONE: 503 - 682 -4195
FAX: 503- 682 -2781
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $151.96
Intercom /Paging: N Landscape /Irrigation: N
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: Y
Other Desc:
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 ac - . ith 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. ATT TION: Oregon la • ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001- 10 through OAR 95 / 001 -01 . may obtain a copy of the rules or direct questions to OUNC b lirre"5tj3346.6699 or 1.800.332.2344. ■
1 ,
Issue y: Permittee Signatur-. a _ ' , ..�Tft- t•
i J 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 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 Aanlie RF CE r 2_tI011 t , ? 3ei 1 , . ,,,,2 f)I�I�I( 1:'115 �j L1 .., ,. A:
City of Tigard Q Permit N6.: f�Qo?WU OGt��fp
q 13125 SW Hall Blvd., Tigard, OR 97223 MAR 0 3
PlaceiB : es+ 3 /o
Phonc: 503.639.4171 Fax: 503.598.1960 flan Review
See Page 2 for
)'d'F; n i IASpcctinn tine 603.639.4175 175 r Date/Bv: —
Other Permit:
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Internet www.tigard- ur,gov CITY Y C r 1 IG R otiiiod/Motl>oeL • 4.1,11.M411.' r-. t ni I0 ,� Supplemental Information
''r l'1 .�Nl r A 74 � �7 9f i �� � 1 �11'1rm }�.lt � y tl t `i � t ] {d7 ty���iS•,hy � Ll ,l( tl ;y� .
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❑ New construction Q<ddition/altcradon/rcplacement Please cheek all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more El Building over three stories.
❑ Demolition ! J Other:
�� ( 19f :( t�(�p / y t where the available fault current ❑ INA:Anna atui boatyards.
l , i t ' Yt;iE'1ftr1ML :li KN a � v o C' . .1e6e 7 tr u l i,,(� 111N } �f 7, 1 e xceeds 10,000 amps at 150 volts or ❑ Floating buildings.
� ,��'. a -,N i -� , � + �(, i it �• p 8 s. g
1- and 2- family dwelling Commercial /industrial 0 Accesso{ building less tO ground, or exceeds 14,000 ❑ Commercial - use agricultural
y g amps for all other installations. buildings.
❑ Multi family 0 Master Q Addition of now motor toad of builder
f s^rt t ice ,f ild ❑ Other: ❑ Fite pump. U bisl:illahan of 75 KVA or
yy i^' 7,0t.. ... •� _ r' . b1 ❑ Emergencysystem. lar ,ri<, er
� r:� 1R t ttili 1�tr� D _ ,p t 1.'rtl s
.�, 1 N �t rx "l . . l r � ) 8 4,/ ' , !h 7.T v ) " D Q 4 tl i' " , ti larger separately "1 -2", °!.3",
derived system.
❑ "A ", "E ", "1 -3 ",
Job no.: Job site address: ) ' de �� { O or m crr ncrupmcy.
!3 ❑ Si IO HP x or more residential units ❑ R4:creational vehicle parks.
City /State /Zip: / ❑ H Health-care facilities.
/, / , / ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Piujecl mime; _ e , ❑ Service of feeder 600 amps or more.
—
Cross street/directions to job Site: ,l i act d ,�r�i i,, i 1E 5';,iuw '. '�yl,; i i l r .,, ,669k?.:s:
Um cr:ptiuo Qt F. 'fowl •
New rcnidcutiul stogie- or multi - family aw'elling unit.
Includes attached garage,
Subdivision: Lot no.: 1,000 sq. ft. or less 168,54 ! 4
lax map/parcel no . Ea. aC4'I 500 sq. tt, or ponlon 33,92 t
! ,, std ifct6il� "p "1 a + t0r n t x I c ; q�rp 3p1 l _ (with above sq, Limlt2d
i t a:r f d , s r a I - ..1 el i, ' r; ; ai .� AIM' tlpi j114 ft)
67.84 �� / Limited cnotgy, multi - family
/L /tln,�/ �j residential (with above sal. tt.) 67,84 2
/ , Services or fccders installation. alteration, and/or relocation
LIt , A" / �_ t m
zoo aw or less 100.70 '
t.l a •;' •.>? ' $ 1 Y ''? '91 -4,!~"l e lil \ iIn l stiv t ! 1 a,. 7.,+ r , a` r'V' : 201 amps to 400 amps 133.56 2
Name: • C' l k e A- LT`( 401 amps to 600 snips 200.34 2
_ GO l amps w 1.000 amps _ 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /Z1P; Temporary services or feeders installation, alteration, and /or
relocation ��rr --
Phonc: ( ) Fax: ( ) 200 amps or less 59.36 I ,
Owner installation: This installation is being made on property that I or'yn which is not 201 amps to 400 amps 125.08 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
CA) y { Ki G'• ur t' }, r A. Fee for branch circuits with
1)1 A) 114 t, _ '� 't ••i'"1 i r �t 1 I '111 15 v11.' � C l e" 1 , `7°�:Y'�ry "1S i t r „ '', above t vice or realer tee,
Pi' 1�' . ,. , al ; } act
brunch circuit 742 2
—
Business name: ' ' ' ` / '� B. Fee for branch circuits without
i�� service or teeder t,' , firvt
Contact name: �g,1�i /lLr�a branch circuit 56.18 2
,1 //�� Each addI brunch erratic 7 42 1
Address: 79„,.. " I `/2S /'/ 'CM E ' I 2
M iscellaneous (service or feeder not included)
'LIP; J, Each manufactured or modular
City /State /
r� i ,.• , IC q t! dwelling, service and/or feeder 67.84 2
Phone: ( tt.),3 . .0 x"7'-/ 1'ax:: LD,4 /_ g �1 _ rt / Reconnect only 67.84 2
Email: t0 • D ec4 . I c y r o ! Pump r irrigation
tl ine f i g circle 67.84
1 t ; il,1'v'k :"Jf':��c;t ,Slv^a, v'�•fi �'a ,. , i g Sign or outline lighting 2
�'
, .. t r . r, p 1 s A ` ' , 6 F " . ,T; y D( . W. 4t, 4111. , �! r ;,i, � . V, f iS9 �' -0,1 Witt itt B 67.84
I M!U Signal circuit(s) or limited -entry
Business name: --- 1/: ' ` a _ , --- CJ panel, alteration, or oxtension. 2, Page 2 , 27.8 2
Each additional inspection over allowable in any of the above
Address: / A dditional inspection 1 hr min
, n i Ai _ P ( ) � 66,25/ h,•
i City /State /ZIP: , CA�'� ��'" Investigation (I hr min) 6625/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) 1 Fax: ( ) Inspections for which nn fee i5
CCI3 Lie.: I Electrical Licj 'uprv. Lic_i /�/ i s csticall listed (%hrmin)
90.00/ hr
� '[ it � /S r v ' ': ` k� ' s m i(' d ! M iCti a x .�' a d t''t ,l il►Oyi
Suprv. Electrician signature, required: . 6 fi t e r ' f it fee);
Subtotal: 1��� �
�^ /� Plan review (25% perm
` T permit fee)
Print natne: �,D S` ,d.„ Date: 0, 13,3 /D State surcharge (12% of permit fee): , ft - 2 1, Authorized signs re: _ TOTAL PERMIT , " f FE 5 / , d7 ta /
� This permit application expires if u permit is not obtained within 80
�Z�, Date: )22 days after it has been accepted us complete.
1_ � / ' Number or luspcctions allowed per pane.
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