Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00016
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/21/2011
Parcel: 1 S 126DCO3300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 180
Project: Neopost USA Subdivision: Lot: 0
Project Description: Low voltage for voice & data.
Contractor: AF TECHNOLOGIES Owner: C/O CUSHMAN & WAKEFIELD OREGON
PO BOX 6551 200 SW MARKET ST #200
BEAVERTON, OR 97005 PORTLAND, OR 97201
PHONE: 503 - 466 -2900
PHONE: 503 - 279 -1700
FAX: 503 - 466 -2922
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/21/2011 $75.00
12% State Surcharge - Electrical 01/21/2011 $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 - ordance ' i 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. ' ENTION: Oregon - req ir- you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -1+1 -0010 through OAR 95 I+1 -00T. You may obtain a copy of the rules or direct questions to OUNC by callin• . 2.1987 or 1.800 332.2344. s. r
Is ued By: � ��_ Permittee Signa
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. ELEIi �� � Date:
LICENSE NO.
Call 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.
JAN. 21,2011 3:22PM 503 NO. 0868 P. 1
Elect I'erm 1, oR op 1. I( E t SF U ,
City of Tigard r _r 1\1E). .
..,),„,,,,,,,„ , ffirom71 permir...:, ,,
_ ,_,
I i i 4 13125 SW Hall Blvd., Tigard, AF72(.3, i,,, o V ' Plan Review
: Z Nom 503_718.2439 Fax: 359S.1960 DatelE : Other Permit:
' .
I R o.R.1) Inspection Line: 503.639.4175 i A N 2 1 2.011 Date Ready/ lois: lZi Sec Page 2 for
Internet: WWW.tigttni Notified/Method: Supplemental Information
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• • "•••• ' """'"' " ' • • • .
New construction 0 'a •••••-.11 ,ii I Please check all that apply (submit Z sets vf plans w/items checked Mow):
nlreplac -
0 Additionialttifiti ent
1..”-• I - • 9 Service or feeder 480 amps or more 0 Building over three stories.
D Demolition 0 Other: where the available limit gamut CI Marinas and boatyards.
; , : :- ' ''," ■' 0$11YOW :' 44 0 1,,,,,',:v.,,'Rv:=,q,,-, exceeds topeo amps at 150 volts or 0 Floating buildings.
. , less to ground, or exceeds 14,000 0 Commereial-use sarievlbunl
Ei 1- and 2-family dwelling • IS Commercial/industrial 0 Accessory building amps for all other instillabons. buildings.
0 Mulli-faMilY 0 Master builder 0 Other: 0 Pile pomp, 13 installation 0'75 KVA or
x-rmi „wi.; r„:. ,k ,,,,,,,' 0 Emergency system.
o larger separately derived system.
T iho:1?.400 qtkhg'tkk*tqg6kt*"iOdoiiit.*i-PF' 1.3 0 Addition of new motor load of 0
, ,,,• ' ,;,' ,'„ V; , „ ;, , „ „„. , „.„,, , , „.. ,, ,/ . ..,,, 4,„ ... 4,1 In. .1 1 05: :ti'' • 14 ' .A.'. i ,,
Job no.: 1 1002- Job site addreSS: MOO SW 6reen bur/ c• ' 1so 10011P or more.
D Six or more residential mita. D occupancy.
Recreational vehicle parks.
....---- 0 Health-care facilities. 0 Supply voltage for more than
City/State/ZIP: ilo o , I( 171-s-3 1:113avirdous locations. 600 volts nominal.
Suite/bldg./apt. no - Project name: N r_o '-r El Service or feeder 600 amps snore.
or More.
.
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■vi , .13.,',,',..t.F.rr,? „ A ;,
Cross street/directiOnS to job site: Diaerialloo I Qty. 1 kg. I ' Total .
New residential single- or multi-family dwelling unit
Includes attached garage.
SubdiviSi011: 1 Lot no.: 1,000 sq. fl. 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
, • ' ' • q l•.:' 't•''' ', ,' "::•'" O ' ,Hoido.,;:4,:tii.F (with above sq. It)
''' ' N '''' • •" •'''''.'' ''.1°'1 '''''''' ' J ' '''
Limited oh' Parril
t energy, m 1- t y
75.00 2
Y OICE i c' et 1 N residential (with above sq. ft.) -
• Services or feeders installation, alteration and/or relocation
200 amps or less 1111 100,70 2
201 amps to 400 amps IIIIII 133.56 2
,,',,,c,0,: .„.„, 7., .,‘. ,4'..:t4vipt, i0„/.' ,,,;,2i,:•:••if,A.,4 .;•. ,- .77A7.A-...' , AS: , ,; '..".■ 1 k.,A,,kr,,,; 401 amps to 600 amps I'll 200.34 2
Name: t
-. 0T0s 601 amps to 1,000 amps 11111 301.04 2
Address: ciquoav,) 6ref-N)c.iy-q -) • Ilia,D Over I,000 amps or voila =EEC' 2
— 'tempoay services or feeders installation, alteration, and/or
City/State/ZIP: - Mot co -61 rg sJ Cr72:23 relocation
Phone: t05) 31 - lc/ o s Fax: ( ) , 200 amps isr less
— 201 amps to 400 amps - 59,36 1
125.08
2
Owner installation: This installation is being made on property that I own which is not
intended for sale, bate, 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 pane!
Owner signature: . . Date: , A. Pee for branch circuits with
'el ';''
'r above service ot feeder fee,
7.42 2
, , ', , . ,,, - ...m. ,„ , , .?'"t'' '^-`- .' •‘',., "" ' " " '. ' '''''''' " '''• • .'"' ''''''''''''' each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first
56.18 2
branch circuit
COntact name:
-. addl brand] circuit 7.42 2
Address: — - Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: . dwelling, service and/or keder 67.84 2
Phone: ( ) Pax: : ( )
_Reconnect only 67 t4 2
— .
. Pump or irrigation circle 67,84 2
E -mail: . Sign or outline lighting 67.84 2
' , ,° , , , ',.`i, , :f.*A".t'AA.1 , ,' , "01.V,0: 7 X41:01 4 ,14iVgirW" . -4SY , :40%Wi'IPA; •‘ Signal circuit(s) Or liMited-011eFgy
1/4y. Business name: Av -1 N panel, ch alteration. or extension. Page 2
Ea additional inspection over allowable in an y of the ahoy 2
_,. Address: -PO -o ( \NeA Additional inspection (1 hr min)
e-'----' Ind Investigation (I hr In)
Phone: min) 66.25/ hr
66.25/1u
City/State/ZIP: -- 6E1:1\)6(Lipt..1 i _ pe,... Of -/Gv5
Phone: (505) 4101:7 - 1 n Fax: (505) 14-10i2-7.7_ .. ustrial [Arun (1 m
iispeetions for which nO fee is 78.18/hr
v _.. specificallisted CA hr min) 90.00/ hr
CC e Lic.: I ( Electrical Lie.: c ID Suprv. Lie.: "'. '32,21 Ve? )114','41$1,;, ','.•
-..,—...,— —
Solnota7 -75 —
&Try. Electrician signature, required:
Plan review (25% of permit fee): ----
Print name: id 0 L • ,I 'sio Aft e Date: I .- 2 - 1 1 State Surcharge (12% of penult fee): 9. 4°4
TOTAL PERMIT FEE: ..---
Authorized signamre: A iffil
'
a' This permit II koplicatinn aspires if a permit is not obtail vi ithic 80
r days after it has been accepted as complete. 3 do
Print name: . . Date: , Number of inspections allowed per permit •
6
. .
JAN. 21.2011 3:22PM 503 608 - 7198 NO. 0868 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for a residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating Ventilation and Aix Conditioning System*
❑ Vacuum Systems*
❑ Other:
FM', 'lq.711.76 y,wa `: w;r .. 01,.,, , ':!- 7nor,V'�kA, RA �,- r�� ,- -�'.r - ; .' a
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
0 Clock Systems
fp Data Telecommunication Installation
❑ Fire Alatm Installation
❑ HVAC
n I nstrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
F-1 Medical
❑ Nurse Calls
❑ O utdoor Landscape Lighting*
n Protective Signaling
El O ther
Total number of commercial systems: T
*No licenses are required. Licenses are required
for all other installations