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Permit r CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT IN COMMUNITY DEVELOPMENT Permit #: ELR2010 -00127 TIGARD: 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2010 Parcel: 1S 1260000300 Jurisdiction: TIGARD Site address: 9771 SW WASHINGTON SQUARE DR D08 Subdivision: Lot: 0 Project: CCS Project Description: Limited energy structured cabling. Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount 2235 FARADAY AVE STE #O Restricted Energy Permit 07/21/2010 $75.00 CARLSBAD, CA 92008 12% State Surcharge - Electrical 07/21/2010 $9.00 PHONE: Contractor: CACHE VALLEY ELECTRIC COMPANY 6200 SW ARCTIC DR. BEAVERTON, OR 97005 PHONE: 503 -431 -6600 FAX: 503 - 624 -1436 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: N Fire Alarm: N HVAC: N Instrumentation: N Total $84.00 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 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ( / % _ Permittee Signature: "le, L f e�! ld e^' / 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. 07/16/2010 15:28 FAX 425 424 9966 _ - CACHE VALLEY ELECTRIC Zi001 Electrical Permit Application . 1 l. N rok Ori F'usr ONLY, � . City of Tigard � � �`� eves „ , 3 ' 9i- No L X0 /0 D�J /.? LWOW l 13125 SW Hall Blvd., Tigard, OR 97 Other Permit /. t/ ' 2Q/© Q/ g , , 11 Phone:' 503.539.4171 Pax: 503.598.[44960 � � i �r hl gj SeoPngebtw• ' ` I ion Line: 503.639 ��� ' �P' �` y y' or Sea Page fnf umber t a ., t - Internet www.tigard- or. 11 �� UiledlMetboch -.. o nstntction In A Addition/alteration/ ' t Please check all that app (: - ',nit a sets of plans Odom checked below) u New e v Service or feeder 400 amps or more ❑ Building over three stoics. Other • .• • n I where the available fault courant © Marinas and boatyards. © Demolition ex � "�* exceeds 10,000 awpa at 150 volts or 13 Floating buildings, ar il . 'era < ^a _'W.' 9 : , ,4�" r ^ , .l. u ! b - .. lass to ground, or exceeds 14,000 O Comtaerofal -use agicultural o 1 - and 2-family dwelling 13 Commercial/Industrial ❑ Accessary building amps for all caberinstanauons. Qba ��SKVAar M builder ❑ Other' D Fire poop. E] Multi-flintily ; ❑ Emergtacy systmn. larger separately ern danvtd system. ' I j'' t t ei t l i � "c t ^' ;7 ❑ ❑ "A ". "E". "l_2 €+� - - r �� �.. , . � � �� � 100HP or MM. Job no.: 431 Job site address. • �rl� - r El Sixar more residential [mils. D Recreational vehicle parka a i. Q Walk -care facilities. D Supply voltage for more tbao City /State/ZIP: ( , r• m: el ❑tiarardouslaoMaons 6a0 volts nommlal Project name �AA » qrs or mom Suite bldg lapt. no.: j l �'.� ❑ Service or feeder 600 o g - �.,,.�,` V Cross street/directions to job site, ° o,strliton Otv. Fee Total • New residential single- or multi - family dwelling trait. Includes attached garage. 1 Lot no.: 1,000 st fl. or kss 168.54 4 Subdivision: Ea. add'I 500 sq. tt or portion 33.92 1 Tax map /parcel no Limited clergy, residential 75.00 2 � 1 ' i k tr i `.,s -.,. x :` .. . , m , N (with above sq. ft.) r �, .- : ' Limited energy, multi-kmily 75.00 2 ` J, .. / .. 4. MIA � � `' - 0 . 1 residential (with above so. ft.) ��) . -..(� , Services or feeders installatIon and /or relocation I 200 amps or less 100.70 2 4 i. p -� 1 j a a fiF t- ) - - Gr rYxr 201 a to 4110 atnpa 133.56 2 401 mulatto 600 amps 200.34 2 Name: - 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 snipe or volts 552.26 , 2 Temporary services or feeders Installation, alteration, and/or City /State/ZIP; refutation 200 amps or less 1 59.36 1 Phone: ( ) ,Fax ( ) 201 amps to 400 amps 1 t 125.08 2 Owner installation; This installation is being made on property that I own which is not 401 amps to 599aps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. [[ranch circuits new, alteration, or exteatd0n, r Panel Owner signature: Date: A. Fee for branclt circuits with s e v r F s ,e,,...--- ;, . , above service or feeder fed. 7.42 2 r r`". - F ±:.t t 2L. ` 1,. each branch circuit II. Fee for branch circuits Wflh0ut Business name: service orfe vier fee, first 56.18 2 •� breach circuit Contact name:\fa i E a c h add'IBchc11 t 1 7.42 _ 2 s Addreses: V l� Mlseellancoas (service or feeder not included) Each manunexurvd or modular ' 67.84 2 CitylBtate/ZIP: dwelling, service and/or feeder Reconnect only 67.84 2 Phone; ( ) `Fes' : ( Reconnect Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67,84 2 3 * ..-" r= ` 'E' , ' Signal diem)(() or limited energy ?r s ' t :..°. e it ' s i ..�mca5s�t' acr ig 15 pR 2 a t aa2F.. a � A ':y - - '� - , pnnel,atteratlon,orec1ensiou, 1 , Page2 � Business name: 1 et p,, t . ' Each additional inspection over allowable in any of the above �^ I - f 1;V s '- T f r ) e Additional lnspecUai (1 hr ,viii[) 6625/ br hweatigation Address: �(„ 66,251 hr City/State/ZIP: • 4. l [ ICS y T zpe p, o ] Industrial plant (1 hr min) 78.18! hr P e: ( 101 , , S. Fax Inspections ibr which no fee is 90.007 hr {� �s 3 ' t`i�7[ tJ�'r � � s, 'Gall listed 141ami i , rv. L[a: MOAN ----,7-1- a T ' E� !y�31,' .1 a :�s ; r • CCB Liu.: ssag Electrical Lie.. ' P � Subtotal: k Suprv. Electrician signature, requir � // �; / Fran review (25 %of ptntnft ice): r State surcharge (12% of permit ice): q, .,---- PrintnameDy �� I -' Date — A ..10 TOTAL PERMIT FEB: Auth01'IZed Signature; This permit application expires eta permit Is not obtained Itldn 180 days after It has barn accepted as complete. Print name: 1 Date: • Number of inspections Allowed pat permit. 15Buildlimwermitonc duo orrouao 440.4615T(11f0SlCOMIVE8 •