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HomeMy WebLinkAboutPermit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 1S i COMMUNITY DEVELOPMENT Permit #: ELR2010 -00104 T I ARL?; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/08/2010 Parcel: 1S135BA01802 Jurisdiction: Tigard Site address: 10101 SW WASHINGTON SQUARE RD Subdivision: WASHINGTON SQUARE TOO Lot: 0 Project: Bank of America Project Description: Low voltage for voice /data. Owner: FEES PPR SQUARE TOO LLC Description Date Amount BY BANK OF AMERICA, NC1- 001- 03 -81, 101 N Restricted Energy Permit 06/08/2010 $67.84 TRYON ST 12% State Surcharge - Electrical 06/08/2010 $8.14 PHONE: Contractor: NETVERSANT SOLUTIONS III LLC 9740 SW NIMBUS AVE BEAVERTON, OR 97008 PHONE: 503 - 646 -0533 FAX: 503 - 641 -6613 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: Y Fire Alarm: N HVAC: N Instrumentation: N Total $75.98 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: N Other Desc: This r it is issued su• - to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be •one in accordance with approve. • . . This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 d. ys. ATTENTION: Oregon law quires yo o follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR • .2-001-0010 thr•ugh OAR 952 -Or -0 00. Y ay'obtain a copy of the rules or direct questions to OUNC by calling.5o3 9na �a 9 or 1.800.332.2344. ssued By: 00. � Permittee Signature: ( 0 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 Application r , '0 ` °' .a i -' 4`� O FIC E�oNLKY� N -7 8.t =� "4...,1;','-4 ;� ,' .1' `" ';,' Cl Of Tl and Received p , Plan / ` g Date/By: Rev p /D j/ /eT l 13125 SW Hall Blvd., Tigard, OR 97223 iew tr:' - - t': Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit � eve ti ,, , +1 GAR Inspection Line: 503.639.4175 Date Ready /By: El See Page 2 for sac+^ a wvt«s? 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. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling Ylf Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "t- 2 ", "1 -3 ", Job no.. 7q /� - Job site address: /O /off y, kt (� '^ - Six or or more. occupancy. � ,�� L 7 ° �� }I �' S , ✓ 1 141?-.. K ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: — n Q / ❑ Health -care facilities. El Supply voltage for more than / 1 q,, j , t ( / 7z 2-...; 0 Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: 2h� tr p P ro j ect name: Z4 Fi°0/ Q , j .' ❑ Service or feeder 600 amps or more. '` FEE SCHEDULE , Cross street/directions to job site: ' / 4 0 f l 0 A f / [ d e- Description Qty. Fee, i Total [ • .\ � ' 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. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family residential (with above sq. ft.) 67.84 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 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: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Ci City/State/ZIP: Each manufactured or modular tY dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax :: ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy , r Business name: //� y� � .tp p alteration, or extension. / Page 2 67 ' 1 8 / 2 /t/� / ��/i S �N 1 S = l u-t \Iin5 Each additional inspection over allowable in anv of the above Address: 7 p Si) A /0 r✓1 L as d v c , Additional inspection (1 hr min) 66.25/' Q } J L,� 0 Investigation (1 hr min) 66.25/ hr City/State/ZIP: A e a t/�ei y 11 04 / ? c' ' t-' Industrial plant (1 hr min) 78.18 / hr Phone: (1, ) 6 if 6._ ©3 33 Fax: (.51,3) 6 y/ - 6 lv /3 Inspections for which no fee is 90.00 / hr ` specifically listed ('A hr min) CCB Lic.: ! g b, 22... Electrical Lic.: CLE / I1 Suprv. Lic.: 7 / 0 L A E ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: j� ' Subtotal: ] 7 / L�'j Plan review (25% of permit fee): Print name: � r,:+iZ 1 ' �� Date: 6, 7 / 0 State surcharge (12% of permit fee): g i d I / 7 , TOTAL PERMIT FEE: 75 78 Authorized signature: This permit application expires if a permit is not obtained within 180 • Print name: Date: days after it has been accepted as complete. 'D �� {/ �J v 4, `7 - /i) N umber of inspections allowed per permit. I: \Building \Permits \ELC- PermitApp.doc 10 440- 4615T( t I /05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: • Fee for all residential systems combined $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems" ❑ Burglar Alarm ❑ Garage Door Opener" ❑ Heating, Ventilation and Air Conditioning System" ❑ Vacuum Systems" ❑ Other: COMMERCIAL WORK ONLY Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control" ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting" ❑ Protective Signaling ❑ Other Total number of commercial systems: "No licenses ai7e required. Licenses are required for all other.in llations I:1 Building \Perm its \ELC- PennitApp.doc 10,01 /09