Permit ' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELR2010 -00163
Date issued: 08/18/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S113A600101
Jurisdiction: TIGARD
Site address: 16101 SW 72ND AVE 200
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Sunset Mortgage
Project Description: (1) audio /stereo system and (1) data telecommunications
FEES
Owner: Description Date Amount
PACTRUST
15350 SW SEQUOIA PKWY SUITE 300 Restricted Energy Permit 08/18/2010 $150.00
PORTLAND, OR 97224 12% State Surcharge - Electrical 08/18/2010 $18.00
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: Y Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $168.00
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 -00 -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: /L-l' Permittee Si g� /7 e-- / ���o" h .
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 AQDlication '-'‘'. -' - 1 , 1 c (,.; F. ()N1.1
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. . CCGIV /e r / , p...itNo.a 20/0 a/
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City of Tigard e ,‘ ,
„----' I S 13125 SW Hall Blvd., Tigard, OR tii3 \\'‘ : . ., . •'(\. Plan Review
I N
' . • Phone: 503.639.4171 Fax: 503.5 .1960` . . : - . Date/B : ler Penn rieti/oZ6V0 -- gel 7 -
loapeutiou Line. 501639.4175 . . : Dale Koatiy/l5y: RI Nee rage 2 Tor
• e i ..,, '
Internet www.tigard-or.gov ,,,. Notified/Method: NI ,10 Supplemental Information
' ..".'..,. -....'....!. : ...7'.;_ . .. '.: ..4 . ii i i ° CtietV•biliii,.. „, 4•1 , > 2 . ; ''''. I ' . : .1'..• : ... .II •::.,....' .......: I
ID New construction Addition/alteration/re a.c.eMent Please check all that apply (aubmit 2 sets of plans w/items checked below):
• 0 Service or feeder 400 amps or more 0 Building over direct stories.
El Demolition 0 Other: where the available fault current p Marinas and boatyards,
... . „ ' - : ,-: : I'4,'.■• I:: 7 . - '`'- ::!:: -I exceeds 10,000 amps at 150 volm or 0 Floating buildinga .
less to grouncl or exceeds 14,000 0 Commercial-use agricultural
01- and 2-family dwelling Commercial/industrial 0 Accessory building 321IPS (Or 411 other installations, buticlings.
0 Multi-family 0 Master builder li Other: 0 Fire pump. CI ['intonation of 75 KVA or
larger separately
408 1 derived $ystem,
' I • • .. ''. • ••'.• , :' - 7• I .' • •4TE M
' *::MIOLOCiiiTtOt :.' : .2 ...; . 0 Addon of new motor load or 0 .. K. "E" "1-2"
Job no.: dr 0 . Job eite address! ,, /0 _ . 7 ,fr .4 v 100HP or more. occupancy.
El Six or more msidential unite. 0 Recreational vehicle parks.
City/Statc/ZIP: ' jr Cy 0 Hoalthosare facilities, 0 Supply voltage for more than
i 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project narna;,S1..0.56/1.A0)41 4--Cie.) I=Servicc or Maier WU amps or more.
.••: .,:::."': ' - ::.: Seliceni.XEITV::: Ii.
Cross street/directions to job site: Description : 1 Qty. I Fee. I Total
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. h. or leas 168,54 4
--. En. WW1 500 sq. 11. or minion 33.92 I
Tax map/parcel no.:
,, Limited energy. residential
75.00 1
.., I '" „ : ,.;•'.1;..t. ,„ (with above 51 :1 , It
Limited energy, multi-fnmily
0 ice 4td a. adoib Air residential (with above sq 11.) 75.00 2
( Services or feeders installation, alteration, and/or relocation
200 amps or less , , 100.70 2
';`-' all . ! * . iikopiEjkttZ650j4W,::::' : ',:,.• '4 ::•...:.•:. : ::: .:(3:40Aitir.: :::..‘:;.i ::. 201 amps to 400 amps 133.56 2
, --
Name: , 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 501,04 ,., 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders insTellation, alteration, and/or
City/State/ZIP:
relocation
Phone! ( ) I Fax: ( ) ! 200 amps or loss 59.36 I
201 amps to 400 amps
125.08 2
Owner installation: This ingtallatinn is helms made on property that 1 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
15:1QNtrii „H.:::: ,: abOVe SelV1C0 Of metier tee.
742 2
each branch circuit
Business namErrbi g D/72 0...' B. Fee for branch circuits without
service or feeder fee. first
Contact name: 41.-
m it _- 4 of. I _- ../ brunch circuit
• Each add'l bunch circuit 7.42 2
Address: 71 v iiiiiiiiyaswgwavligw .,
Miscellaneous (service ur feeder nOt included)
Each manufactured or modular
City/State/ZIP: p , , v I , 0 ni off 1
dwelling, service and/cr feeder 67.84 2
PI1011C: (5C12 (5C12 6 A 2_ tii q,I 6. [!x:: . Cg teg,a- „9:70 j Reconnect only 67.84 -
Pump or irrigation circle 67.84 /
I .
E • .4.! JO .e. 41_ ' rIP 0 " 1 . s" . i 1 0 A' ILO A AA Sign or o - utline lighting 67.84 2
-
I AI!,':■tak C.' ,. ' • ' 0 : .. .: I .. ':', I : •:-.i,..,:.:•:;„6.!•:!'„,:'....:.L•':1'IIII:•;;,-,:‘.•/:„-: Signal o i roo go or li m i tec k norgy
Business name: 17c5Z 7 -- 1 ,1 a Panel, alteration. or extension. 2. Page 2 15O .co 2
Address: lei __
City/State/ZIP: k v,i. ip A 0)/ 91
/157z4.
y7$ f 1004247 /49„.12., i A hr
etio r allowabl of the abov
Investigation (1 hr min)
Industrial plant (1 hr min) 66.25/ hr
78.18/ hr
Phone: ( . 5 ) 2 4/S 2 , „ Li 4 5 ' I Fax: & a 6 s Y . 9 7 0 1 Inspections f o r which no fee is
woof hr
spccitically lists:di% hr min) ,
CCB Lic.:738 7 ,2, Electrical Lic,3,j,,..110 Lic0 &•061, s , -. .: :-..• .;.,,.::;:::,
Subtotal: 1 50, op
Suprv. Electrician signature, required: • / 3 .4 , 7 „, 7 _, r t k.k.A. )
Plan review (25% of permit fee):
)
Print natlleiV / I Date: le1 eliD state surcharge (12% uf permit fee); /
TOTAL PERMIT PEE; j t , 00 ---
Authorized Si : 14 c 5.4 44 4_ , ,,,, La4_ 1 o 0
,
, This permit applicadon expina• Ira permit is not obtained within 180
.-- - pOji. n . e4 ,,, I 6 f-
days alter it bas been accepted as complete,
Print mink _ ethe nat ...0 1 1 1 1 0
• Number of inspections allowed per panne.
1:ItuildingTermittaLC p400 07/01,10 440-4615T(11105/COMAWD
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY;
Fce for a residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
7(Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
V llata Telecommunication Installation
[l Fire Alarm Installation
❑ HVAC
0 Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 2
*No licenses are required. Licenses are required
for all other installations
I' Building \Pumits.ELC- prnuLApp.dac 07 /01 /IU