Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELR2010 -00223
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/20/2010
Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY
Subdivision: FARMERS INSURANCE Lot: 0
Project: Triangle Pointe
Project Description: Security system.
FEES
Owner:
TRIANGLE POINTE LLC Description Date Amount
901 NE GLISAN ST #100 Restricted Energy Permit 10/20/2010 $75.00
PORTLAND, OR 97232 12% State Surcharge - Electrical 10/20/2010 $9.00
PHONE:
Contractor:
COCHRAN INC
7550 SW TECH CENTER DR. #220
TIGARD, OR 97223
PHONE: 503 - 234 -6564
FAX: 503 - 238 -2098
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: Y 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 cset forth in OAR
952- 001 -0010 throu R 952- 001 -0100. You may obtain = •py of the les or direct questions to OUNC by calling 503.246669 �� — .� i ce
or 1.800.332.2344.
` � or
Issued B Permittee Signature:
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.
00T/20/2010/WED 09:44 AM COCHRAN TECHNOLOGIES FAX No.971 205 4268 P. 002
Electrical Permit AppIicaR • im mi=zionmium
City SW Hall Blvd Tigard Tigard, OR 9 rzz. - • - • ICT 0 2010 • Air
pcn
_._._._ _......40. .. ... : -____Fteccived , ' • Lie .4.0
Date/Br
., ,s Plait Review
1 - -: • " 13125 Phone: 503.639.4171 Fax: 933.52=6.0
UPUOF TIGARD Dateft3y: Other Permit:
• i 1 Ci A R 0 •
Inspection Line 503.639.4175 Date Ready/Br - rari= m see Page 2 for
Internet: wwW.liprd-Or.gov BUILDING DIVISION __ Notified/Method: Supplcrecntal information
- - .. t7:-tt.i. t . 'l . !• t::. 0 :0 51F - 0 , *? 7:. ... ;: ::: . L. . ':
[1] New construction tia4kdditirmialteration/replacement Please ebeek MI that apply (submit 1 sets of Mans wiltems checked below);
0 Service or feeder 400 amps or more 13 Buildin over three aterie5
D Demolition 0 Other: where the available fault current 0 Marian and boatyards.
j•;,.ckrit060 ,:,: :.:'-..:‘,:',...);.; excreds 10,000 amps et 150 volts or 0 Floating buildings_
less lo ground, or exceeds 14,000 , 1:71 Commercial-use agricultural
El i- and 2-family dwelling ■ Commercial/industrial 0 Accessory building amps for MI other installations. buildings.
o Multi.family 0 MaSter builder 0 Other: - 0 Fire pump. 0 Installation of 75 KVA or
tamer separately derived system,
..: .. • : ': : . ,, , ' : . ::: ,:: 4. # SR: PIC10,070 0 Addition or new moior load of 0A", E", 12". 13",
• A , 100HP or more. occupancy.
j 13
no.:1I3G Job site address! ;3336E 6915 1 if...t....46 tic 0 Six or ;nom rexidential units. 0 Recreational vehtc& parks
•
City/State/ZIP: . "1 - Z,x - c5L. OR. ci712_3 0 Health-care &citifies. 0 Supply voltage for more than
0 Hazsrdous locations. 600 volts nominal.
Suite/bldg./apt. no.: c- I Project name:kc$ --nr-1 ( f t. 46 16 lib or feeder 600 . amps or mom.
•
Cross street/directions to job site:
Demiption ,
......
- , Nev residential single- or multi-family dwelling unit.
_____ Includes attached garage.
;
Subdivision: Lot no.: 1,000 sq. R. or less 168.54 4
•
- En. add', 500 sq, 11. or ponion 33.92 I
Tax map/parcel no.: .
Limited energy. residential
,: l .',1". : :', ..... :..-'s1 ; j :: ::: :: ::• .: 1 ;'. ; : l. " ::: ::'.....: 1 .0tOrf - )00.:cOco40.:'::: : ';:: - : - g:::!.;::::.:: .. . i : ,. : : ::.... - : : ::: : ..::: • ::',:l . i : ::: : , (with ab° $ 53 . 75.00 2
Limited encrgy, multi-family
75.00
q(_3 5eZAkri-1 •
residential (with above sq: R.) . 2
Services or fteders installation, alteration, and/or remotion
200 amPs or less 100.70 ;--- fp 2
'. :'•000 . f . : ',%',.',: . : ' . .,*;: ... 3 ; M:1:40iiptill,;:', - •: : : ::;:::7;K,l;,1 ! •,•Zt 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
City/State/ZIP: , Temporary services or feeders nstallatIon, alteration, and/o
- relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
o
intended for salc, lease, rent. or exchange according toORS 447, 449, 670, and 701. 401 amps t599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
a -clr f i ced i er fee 7.42 2
,
Business name: a Cbrstlies.-c*-tzt< - B. Fee for branch circuiis withoui
-.--_, service or feeder fee, first
.'- 56.18 2
Contact name: pc\ i vL A , - branch circuit
Each aeld'I branch circuit .7.42 2
Address: Miscellaneous (service or feeder not induded)
- Each manufactured or modular
City/State/ZIP:
dwelling. service and/or feeder 6724 2
Phone: (563 ) 1107... qgoo J j Fax: : C6 3 ) „p3 6 - a l j cif3" Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E c_la 6 Le) Red ce)c.-\ \ 3- ct ra-n c.. ,_ co 01-1 Sign or outline lighting 67.84 2
(_;•:::.• • i.'-' 1 .',.. : ::1 :': :,'..:'....: !.',‘! .:.:',.:.0:01 V.,144 ;:. ::;, :.:.!.:: : ',...;,... ''. :::',..i. :",:;:::: Signal circuit(s) or limited-energy
B iness name: panel, alteration. or extension. 1 Page 2 7.2 2 - us C_Ct V\Z
Each additional inspection over allowable in any of the above
Address: 1 5 50 5 T ece l c . N...,...q (_ ra k e , , r , , *2„
Additional inspection (1 hr min) 66.25/ hr
r
- ig 66.
City/State/ZIP: , a.A.-t 0 (2., 72_ a Investalkm (1 hr min) 25/ h r
industrial plant (1 hr min/ 78.1V hr
on
Phone: e?o3 2. c4.„... j ( Fax; (*..3 )2_38 2_091r Inspctions e for wh (y,, ic hr h no fee is 90.00/hr
, specificalklisted , mio
CCS Lie.: 72 Electrical Lic.: - gi e,.. Suprv_ Lie.: 34/473
Subtotalt . 75 -
Suprv, Electrician signature, required: Wille ,
. . . . Plan review 0.5% of permit fee): , .
. _
. .. .
A atc.
• " . KA 5 - State surcharge (12 of permit fee): q
TOTAL, PERA4E
Authorized signature:
This permit munition expires if a penidt Is not obtained within 180
• dais after it has been accepted as complete.
Print name: Date:
• Number of inspections allowed per penult.
0Builc6n0crenits•ELC-PennitApp,doc 01 440-4015T(110:.: CO+WEB
L.