Permit o CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2010 -00209
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/08/2010
Parcel: 2S101 AD00400
Jurisdiction: Tigard
Site address: 6655 SW HAMPTON ST 220
Subdivision: Lot: 0
Project: Data Motion Inc
Project Description: Data telecommunications system.
FEES
Owner:
HAMPTON OAKS LLC Description Date Amount
6665 SW HAMPTON, 2ND FLOOR Restricted Energy Permit 10/08/2010 $75.00
TIGARD, OR 97223 12% State Surcharge - Electrical 10/08/2010 $9.00
PHONE:
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: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $84.00
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
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 =•the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: .%—_4/ L./Et: _ �= Permittee Signature: • i / „Ai ,
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 603.639.4175 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 ADplicati %' O I.O I t o I I. I( 1. ,:s r. ()NI.,
City of Tigard mo
N.._ frig'' 11:5
13125 SW Hall Blvd., Tigard, OR 97223 1 VI \ Plan ate/B : w !
Phone: 503.639.4171 Fax 503.598.1' 4i; k.., Date/0 : Other Pte •
`
Inspection Lino: 503.639 - . pp �D Date Ready/By: l See Page 2 for
Internet www.tigard- or.gov Qti"
I 1 A is I , Y% 4 Nor a en ` , supplem ai inturwation
s. i.-4y
[] New construction Addition/alteration/replacement Flambe Milo; .k an that apply (submit 1 Data of piazza whim= Awaked below)!
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where We available fault current 0 Marinas :ad boatyards.
i1 (;4:1pMo *r o yc�T$ fkuCZCOn� . , : , , a . ;,:� exceeds 10.000 solos at 150 volts or ❑ Floating buildings.
.'...: r v. ` < ' less to ground. or exceeds 14,000 0 Commercial -use agricultural
❑ 1- and 2-family dwelling Commercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑Multi- family ❑ Master huilder 0 Other: 0 Fire pump. D Installation of75KVAa
'mug' atpaeately dcrivod ayawm.
' . • jOk ll O l � AM- O E A 7 1 0 N t': , , . ❑ Addition o£ saw motor load of ❑ "A ", "e ". "1.2 ", "1 -3 ",
Job no.: /0(4,0/ Job site address: �D �,�.r l oarlP TMC or more. dC occupancy.
`^' rn i _ p .. 1 t�LCIY M /CII dI181 I � RGCleat1011al vehicle
City/State /ZIP: 1 600 volts J 2�f D Haze b c facilities, ❑ voltage for nwto than
0 Hazardous locations. 600 volts nominal.
S uite/bldg /upL no.: Pr'oj na
cct me f- T d ❑ cervix or fen r 600 amps De mo.,
Cross street/directions to job site: /mam 1 Q. 1 F. 1 Total 1 •
_ • •• -. - .
_ - _.__.. . - ._ -. ..1� Mresident lP- oralldikfanlily dwdJling-unit• - -
. ... . .
_ -.._ . includes attached garage. -
Subdivision: Lot no.: 1,000 sq, ft or less 168.54 4
Ea. add'l 500 sq. ft or portion 33.92 1
Tax map/parcel no.: , Limited energy. residential 75.00 2
7 : T Y, : , _ : : iwith bove sq. it - `, �' ` � AI�iE".B1�PlOL�F�'OI? ;':GL!QRIC :: � ..� -� :..:: ; : :
.:- .:: � —' .
Limited energy, mina -family 75.00 2
1 J � 1(e J �y i� residential (with above a R.)
(/ I.G C�.Gt -�i Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
: •:'.::.:1: 1 ::::; ., . :iiROp'F+1tT>i;04 !IEB, . .. !.:>: . •',:: ,:.: " : •; -. —
201 amps w 400 ow:: 133.56
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
w Phone: ( ) l 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 -
antes 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or exteaaion, r panel
Owner signature: Date: _ — A. Foe for branch &Cults with
r fcc, 7 _
: : ::; ;'
-
... �I,IGANIf •`. ` ..,,.. :, .. 1�CID�PiACT'::>t�50 ''. -'
above service or feeder 42 �
., each branch circuit
Business name 7 S 4 t' A 49 / ) �/ B, Fee for branch circuits wrrhow
l-' ' service or feeder fee, fast 56 -18 2
branch oircuie
Contact name: /_ f / . / /. . / _'J Each add'1 branch circuit 1.42 2
A"'...:741- / ' 1f4 y� / J Miscellaneous (service or *titer not included) -"
Each mantlfacherli nr modular 61.8•t 2
City /State/ZIP: 1 , 4 /� �� `/� (� / - � ^ Q dwellgservice and/or feeder '
L � b $ 2 L q (OAS Q C7' 1 , Rcca pump te nna . only only nn circle 67 . 34 6
Phone: ( Fa x:: M 2
E -mail: • % / i t_ - e '' 1 s"' A 1 4 i• 111 4 Al 411 Sign or outline lighting 67.84 2
` _ >.r; 1r .,ti .':�"`r'a. `C0 . 'J 1 .'.r-. . . ...''r- ' .,c,. f, / 1.'. - Signajc ircuit(s)orhlmted- energy 2 �•
<:., < I
• " , panel. a rrratlnn. or rxleaaton. _ l Page - 7J. 00 ?
Business name: M A i r AR" Each additional inspection over allowable in any of the above ,
Address Additional inspection (1 hr min) 6625/ hr
: A " G , Additi gntl i n(1 coon° 6625/hr
City /state/ZIP: r f /� • • • �/ ! 0 lndustriai Pleat (I tar mm) 78,1 8/ hr
Phnne: (,5)g 1p0 �. (t a 5 Fax: 7 0 f Inspections for which no fee is
Q . meat listed (% br min 90.00/ hr
CCB Lie.: 7_38 7 2 _ E lectrical Lic �.101e( uprv. Lie. J21 � �. - • .. _ . =:ELE ICAVVEua r F!¢1tS; -' ': "
Subtotal: 75; aa
Suprv. t✓1ec11'iclan signaturc, rciiiiiicd: it 1 i % ; . • /}) Plait rcvicw (25% of pemrit foe): _
Print namc:� III' Date: /0 O State surcharge (129'a of permit fee): _ r 0 �
/ f TOTAL PERMIT FEE: ° if o a 4)
Authorized si 1 :. r:. 1 • This permit application capita it' a permit is not obtained witbia 180
_ 1� L f JL 1 days after it has been accepted as eemplete-
Print nano • • a grit 1 «, ,~ / , - Date: 1. . 10 a / , I 1 D • Number of inspections allowed per permit.
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