Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
44 DEVELOPMENT SERVICES PERMIT #: ELR2003 -00093
13125 SW Hall Blvd., Tigard. OR 97223 (503) 63 -4171 DATE ISSUED: 4/7/03
SITE ADDRESS: 11308 SW 68TH PKWY PARCEL: 1S136DA -00100
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Limited energy for fire alarm alteration.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BENSON CAPITAL OREGON ELECTRIC CONST /GROUP
1708 3RD AVENUE 1010 SE 11 TH AVE
NEW YORK, NY 10017 PORTLAND, OR 97214
Phone: Phone: 503 234 - 9900
Reg #: UO3 53520578
SEIE5 2344143111S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 3/28/03 $75.00 Elect'I Final
[TAX] 8% State Tax 3/28/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
I ued by � 4 J � . Permittee Signature �pF ` e� ' �1/�
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'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
J
`• 1. Electrical Permit Application
OFFICE USE ONLY •
City of Tigard D ate received: ,q2 03 Permit no.:14 jV5-75
13125 SW Hall Blvd Project/appl. no.: date:
, ' j ) Phone: (503) 639 -4171, FAX: t 1, 5 t961?1003 Date issued: By: j Receipt no.:
Internet address: www.ci.tig. • u J [ Case file no.: _ ayment type:
24- Hour Ins .ection R - c :,F ,: ,i , .;
TYPE OF PERMIT
❑ 182 family dwelling or accessory ::11 I I 111 : rC : ?j 'T/ r: (a ? ' ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ addition/alteration /re•lacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job Address: 11308 SW 68th Parkway Bldg. No.: Suite no.: 125 Tax map /tax lot/account no.:
Lot: Block: Subdivision
Project Name:Tigard Data Center suite
125 Phs 1&2 Description and location of work on premises: Alteration of existing fire alarm
Estimated Date of completion/inspection:
Will ou call for ins . ection within 24 hours? Yes No x .
CONTRACTOR APPLICATION FEE SCHEDULE
, ,no.
Job No.: 68319 Description Qty Fee (ea.) Total insp
New resrdentraT- stngte or - -
multi- family per dwelling unit.
Business name: Oregon Electric Group Includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. 1000 sq. ft. or less $ 145.00 $ - 4
City: PortlandlState: OR Zip: 97214 Ea Addl 500 SF or Portion $ 33.40 $ -
, Phone: (503) 234 -9900 Fax: (503) 234 -1001 1E-mail: Limited Energy, 1 8 2 Family $ 75.00 $ - 2
CCB no.: 203 Elec. bus. lic. no.: 26 -95C Limited Energy. Multi- Family $ 75.00 $ - 2
■
Ct mea rOic. No.:
Each manufactured home or
� modular dwelling. Service
s, � u/ 1 1 g e norz, Q„ 'r > y V and/or feeder. $ 90.90 $ - 2
Service or Feeders -
S• .. Elect. Na : • ri • :Mark Kenne ■ Al License no: 4460S Installation, Alteration or
Relocation:
PROPEP. , Y OWNER �p 200am.sorless $ 80.30 $ - 2
Name (print): - C ,O, Tjy r - i [.A L v 7 t Tt ti 2olamps- 400amps $ 106.85 $ - 2
Mailin 7 ' TL ' rD Addrreess:Li 7G !s)ec e.', � ak to , 4olamps- 600amps $ 160.60 $ - 2
Cit State:G•IQ n
.IZip: '71 „a/ 6olamps- 1000amps $ 240.60 $ - 2
Phone: Fax: I E - mail Over 1000A or volts $ 454.65 $ - 2
Owner Installation: The installation is being made on preperty I own which is Reconnect Onl $ 66.85 $ -
a according to ORS 447, 455,
Temporary
• or
not intended for sale, lease, rent, or exchan I Services
g 9 Feeders • Installation, ,
479, 670, 701. Alteration or Relocation:
Owner's si nature: Date: 200 amps or less $ 66.85 $ - 2
201amps - 400amps $ 100.30 $ 2
Name: Over 401amps - 600amps $ 133.75 $ - 2
Branch Circuits - New,
Address: Alteration or Extension Per
Panel: A. Fee for branch
City: State: Zip: circuits with purchase of service
or feeder fee, each branch
Phone: Fax: E - mail: circuit $ 6.65 $ 2
B. Fee for branch circuits W /Out
Purchase of Service or Feeder.
PLAN REVIEW 1 st Branch Ckt $ 46.85 $ - 2
❑ Service over 225 amps - comm. ❑ Health - care facility Each additional branch circuit $ 6.65 $ -
❑ Service over 320 amps - rating of ❑ Hazardous location Miscellaneous - (service or
feeder not Included)
182 family dwellings ❑ Building over 10,000 square feet four or Each pump or irrigation circle $ 53.40 $ - 2
❑ System over 600 volts nominal more residential units in one structure Each Sign or Outline Lighting $ 53.40 $ - 2
❑ Building over three stories ❑ Feeders, 400 amps or more Signal Circuit(s) or Limited Energy
Panel Alteration or Extension'
D Occupant load over 99 persons ❑ Manufactured structures or RV park 8 - 2
❑ Egress/lighting plan ❑ Other: 'Description: ' 0. 4. •
Each Additional Inspection over
the Allowable In any of the
Above. Per inspection
$ 62.50 $ -
Submit 2 sets of plans with any of the above. Investigation fee: _
The above are not applicable to temporary construction service. Other /
Notice: This permit application Permit Fee $75 ,, ,/ I
expires Ifa permit is not Plan review 25%
obtained within 180 days after it State Surcharge 8% $6_00 �/
has been accepted as
complete. Total T iq