Permit il CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
6 y u Permit #: ELR2010 00265
: ;s- COMMUNITY DEVELOPMENT
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2010
Parcel: 2S 113 BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 300
Project: Optum Health Subdivision: Lot: 0
Project Description: Data telecommunication system.
Contractor: E C COMPANY Owner: BEHRINGER HARVARD WESTERN
PO BOX 10286 PORTFOLIO LP
PORTLAND, OR 97296 BY EASLEY MCCALEB & ASSOCIATES I
PO BOX 190700
SAN FRANCISCO, CA 94119
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/02/2010 $75.00
12% State Surcharge - Electrical 12/02/2010 $9.00
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
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
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 -101 -0090. You ma of the direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. -'
Issued By:G� / 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.
CaII 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Dec. 1. 2010 3:34PM No, 8208 P. 1
Electrical Permit Applications g tl E ID ft ( }
. . lot- 11(}, 1. Si.: {')\1. a . ' :
tl
City of Tigard Received
'• ' .--,- ° 13125 SW Hall Blvd., Tigard, OR 97223 1 n NI s. ill 1I r :te n'
. 2 Phone: 503.639.4171 Fax 503.598.19 r 1 ? Q Other Permit: t1 r i iIo 1i
T t c; A'ID Inspection Line: 5 03.63 9.41 75 i p p Date Ready/By: See Page 2 for
Internet: www.tigard- or,gov CITY OFTIGARD Notified/Method: Ligni Supplemental Information
TYPE oF.ilIakDING DIVISION PLAN REVIEW
0 New construction E Addition /alteration/replacement P1e4&e check all that apply (submit sets of plans w%items checked bclow):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other: where the available fault current ID Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ l'loatieg buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
0 1 - and 2 - family dwelling ® CommerciaYindustrial 0 Accessory building amps foray other installations. buildings.
0 Multi family 0 Master builder 0 Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE IrIFO D LOCATION ID Emagmcy system. larger separately derived system.
❑ Addition of new motor load of ❑ "A", ,.E, "1-2 .•1 -3",
Job no 74032 Job site address ❑ six or $W Durham rd Iixo or more. oec
more residential units. ❑ Recreational vehicle parks.
City /Stare/ZIP: Tigard, OR 97224 0 Health -care facilities. ❑ Supply voltage for more than
['Hazardous locations. 600 volts nomiml.
Suite/bldg. /apt. no.: - 1 .Project name: Uni Health Group ❑ Service or feeder 600 amps or more.
street/directions to job site: L�, FEE SCHEDULE
Cross street/directions
J G t " 1 , Description 1 qty. j" erg root {, •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: + Lot no.: 1.000 sq. ft or less 168.54 4
Ea aeld'l 500 sq, ft, or portion 33,92 !
Tax map/parcel no.: energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
• - . . Limited energy, multi - family 75.00 2
Install Cat5e cables for Data Network residential (with above sq. ft)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
tO PROPERTY OWNER 0 TENANT 201 amps to 400 snips 133,56 2
Name:
401 amps to 600 aicp 200.34 2
601 amps to 1,000 mops 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/o
relocation
Phone: ( ) ! Fax: ( ) _ 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.05 2
intended for sale, lease, rent, or exchange, according to ()RS 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. Fec for branch circuits with
® APPLICANT 1 ❑ CONTACT PERSON above service or feede fee 7.42 2
each branch circuit _
Business name: EC Company B. Fee for branch Circuits without
service or feeder fee, first 56,18 2
ontact na
Cme: Kathy Kelley branch circuit
- Each add'I branch circuit 7.42 2
Address: PO Box 10286 Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular .
tY Port land OR 9 7 2 9 6 dweninn service and/or feede 67.84 2
Phone:(503) 224 -3511 I Fax: : (503) 295 -3012
Reconnect only 67.84 2
E -mail: kathyk @e -o - co . Coto Pump or irrigation circle 67.84 2
. Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or linnitcd- cnergy 1
panel. alteration, or e xtension 75
Business .name: EC Company e 2 2
Each additional inspection over allowable in any of the abov
Address: PO Box 10286 Additional inspection (1 hr min) 66,25/ hr
City/State /ZIP: Portland, OR 97296
Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (5 0 3) 224-3511 Fax: (O3) 295-3012 Inspections for which no fee is
•
7rr specifically listed CA hr min) 90.00/ hr
CCB Lic.: 49737 ,Electrica ' .. 7.6-45C Su is • Y tLECTRICAL PERMIT FEES —
/ / J Subtotal: 75 .0 0
Suprv. E1 _, _, elute, require : �/ +� , PIan review (25% of px fait fee):
Print Dam (', , .... . : 12/01/2010 State surchar (12° %0 of permit fee): 9.0 0
Authorized signature:
TOTAL PERMIT FEE, 84 . 00
This permit application expires if a permit h notobtalned within 180 .
days after it has lien accepted as complete.
Print name: Arjdr'ea Stinger Data 12/01/2010 • Number of inspections allowed per permit
I: lBuildingTermitsTLC- PefmitApp.doc 07/01/10 440-4610T(11/05 /COM/WEB
Dec. 1. 2010 3 :34PVI No. 8208 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: '
Fee for all 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*
Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: .
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
gi Data Telecommunication Installation
❑ Fire Alarm Installation
} l HVAC •
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are requited. Licenses are required
for all other installations
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