Permit „ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 00017
T I CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/25/2011
Parcel: 1S135BC00700
Jurisdiction: Tigard
Site address: 10831 SW CASCADE AVE
Project: Comcast Subdivision: Lot: 0
Project Description: Data telecommunication system.
Contractor: AIRWAVE LLC Owner: CH REALTY III /PORTLAND INDUSTRIA
9865 NW 307TH AVE. BY THOMSON PROFESSIONAL &
NORTH PLAINS, OR 97133 REGULATOR
CONTROLLING OWNER OF
EPROPERTYTA
PO BOX 4900
PHONE: 503 -647 -5999 SCOTTSDALE, AZ 85261
FAX: 503 - 647 -7443 PHONE:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/25/2011 $75.00
12% State Surcharge - Electrical 01/25/2011 $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 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 -0090. You may a cop of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800,332.2344
Issued B . - Permittee Signature: �•% == tir
''� 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 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.
01/23/2011 23:37 503- 647 -7443 AIRWAVE LLC PAGE 01
Electrical Permit Application RECrit
Aecetvea
FIJI:. oFFi( : :k' !.:till: ON IN
Ili Cary of Tigard Date, : ; i ® i / enn N o. : (l - a i 7
w 13125 SW Wall Blvd., Tigard, OR 97223 s A Matt Review
Al Phone: 503.718.2 Fax: 5 03.598.1960 JAN 6 4 2011 Date/By: OtherPennit: 4ZC.y011-6g)37
T 1 c- h Inspection Line: 503.639.4175 pato Roady/By: lurk: la Sc! Page 2 for
Internet: www.tigard- or.gov _ CITY OF TIGAt?D NotiiiedAleStod: 7j L Supplemental
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r �- Vi���7i? l�rii '.•jf�iil�� ',!� '�Pl[i r. t{il� �� y r , rlr�.4i:.oU rrNll i(iitG..l.'7.•. { .t I'� � u ..if+>,!ill�'1 � lll�l�hf.ur�ia.�i��� �ts� 1�:��, ' �.�..l,b l. i, 6�1 [�i+ilt'ir rill
❑ New construction ®Addztion /alteration /replacetrlent Please check all that apply (submit 1 sets of plans w /items checked below):
❑ Service or feeder 400
• amps ar more 0 Building over three stories.
p Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
r rpl u ' ,u,: r If ; .i . . i 4' ',..1,1E9 l +!(rnur 1 , i . `I l l ! p y : )i ; 'r t l mps at 150 volts of ❑ Floating bt14ie
6 . ; 1.. { ?; ++1 : lI ,:,,,,,,l;(;,l:i.,.� f, it, ' f ub/ ri Seltil t it - • f i T , ✓� � i' 11,Itit. 11(1'/_• X '4 exceeds 10,000 a & i.
■ , .4 ,t::' 4�.,., f 1 l L '
�f nealltli .� wn� l ess t o ground, or excee 1 0 agricultural
❑ 1- and 2 - family d.wciling ® Commercial /industrial 0 Accessory building amps for all other installations buildings.
0 Multi- ftitnily ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or
t +'l: i ::: $ y'i:, (,�;li 1FFii `' r : r'1< t al r � ; fg ti 5 r g �',I , :." , . + f L' ! ; ;.'; '„ i' , y ii:ilr! P i l I t ID Emergency system. larger separately derived system.
1 iii 'i+1E�illi6.f .L:',<<,,:I.'i2li�iliai `bffA'i1'a!' .15 iiTtiri,'I 4411 a' s' i�. ji�l:; ldllii:; ❑Additionofnewmotocloadof 0 •, ..Err.1- 2 -3•'
loOHP or more. occupancy.
Job no.: Job site address: 10831 SW Cascade Ave
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health-care facilities. 0 Supply voltage for more than
• ❑ Hazardous locations 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Comcast ❑ Service or feeder 600 amps or more.
. i ', . i ,, , ili :ir' ::.! w:ri; ia.li ,,,,
Cross street/directions to job site: West side of Cascade pprox across D ti 1 on `i I "" �°"" . v Yoe s;.I +in o a, ,,,,.r�,
j AVE, , Description 1 20. roe TomI
New residential single- or multi- family dwelling unit.
from Harley Davidson. _ includes attached garage.
Subdivision: L n 1,000 sq. ft. or less 168.54 4
Ea. add 500 sq. ft. orponion 33.92 1
Tax map/parcel no.. Limited energy, residential
ins I"q `n. r ;`'4'fli i +, e , ; r : �:riri + � =� , r r;�pyyrpla� j 75.00 2
r 1 lEfy I ! ?yl;j l , f, i ii l . J ,I (1 I . ' s h ty,� E I O with above ft.
i+l+i;N�: ■ il:i ., ll ' Il 1 l l l', i. ; r , y L �i(I� 1c;,;i;vl +I {I il��ir�f . 'ul OP s4 )
mac c ,, , '' lul'�i rhl,a,t,as Limited energy, multi - family
75 00 2
CAT 5)v Cabling • residential (with above sq_ 1.)
• "^ Services or feeders iatstapationn, alteration, anntor relocation
' 200 amps or less 100.70 2
iic ;1 :0 ; i ll '[ :f s ' rtTEs rl 1 j ∎ : li i r • i imnl' ljia f' r e, yl ii 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Comcast -- . _ 601 amps to 1,000 amps 301.04 2
Address: 10831 SW Cascade Ave Over 1,000 amps or volts 552.26 2
- "' Temporary services or feeders installation, alteration, and /or
City /State/ZIP: `Tigard, OR 97273 relocation
Phone: (503)596.3766 Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 • 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 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 extension , er , and
Owner signature: Date: A. Fee for branch circuits with
w i ' ++ i +'t'� i'iltliL;.; t mat a , x t+;r+w i. + C 9r ,.., .,,._.; w er above Servi Or feede fee,
e i!. t n 1 '' P I . ar a s+ =;:in it ! 7.42 2
i j �� ,,.. �., I i s, . fi e.'[ ;.i!, 7 iii j l I ' ... �,, l(l l i, 1 ,
t,„,. ..Mtl ' u ucuaf:h � s , 'iiJ a ;i11i11,�1�; , wrlti�� w. '(! each branch circuit - �
Business name: Airwave LLC B. Fee for branch circbiu , vtthout
service or feeder fee first 56.18 2
Contact name: Sue Marshall branch circuit
Each add'l branch circuit 7.42 2
Address: 9865 NW 307 Ave Miscellaneous (service or feeder not includedL_
City/State /ZIP: North Plalos, OR 97133 dwel l i Manufactured e service and/or feed 67.85 2
Phone: (503) 647 - 5999 IFax: : (503) 647 - 7443 RccnnneCt Only . 67.8 __� ��
Pump or irrigation circle 67.84 2
E - mail: sue@airwavellc.cotn Sign or outline lighting 67,84 2
.' M l ' li i l' I t ', 'ti • "'x" r',,,; '' ; FFFFI '! I (ajliiiiailflillill M •IIh In ( cfc
si i tits) or hmitrtd- enereY
tI'll!' fir: ` �;i. Hf il!i lh�iil h1 I��:��,�,edPti. �.� ;�r6li l l i,, U, � { ��_; -
Business name: Airwave LLC _panel. alteration, or extension. ( _.,.,,-
Page 2 75 " 2
Each additional inspection over allowable In any of the abov
Address: 9865'NW 307 Ave Additional inspection (1 hr min) 66,25/ hr
City/State/ZIP: North Plains, OR 97133 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 647 - 5999 -1 Fax: (503) 647 - 7443 . Inspections for which no fee is 90.00 / hr
s•7ecif cal listed %a hr min)
CCR1.1c.: 160178 Electrical Lic.: 34688CLE Suprv- Lic.:542LEA gili;1,1ailllil4tiiir 11 1 '= *11ii +r,�i + •
Suprv. Electrician `; attire. reytrir Subtotal; " 75.00
/� :, Plan review (25% permit fee):
Print name: Bob She o ... t t Date: 1/21/11 State surcharge (12% of permit foo): 9.00
`-` TOTAL PERMIT FEE: 84.00
Authorized signature � / p e pp PI permit This trait a trca6oa ex rYa if a Mrit is not obtained within 180
Print name: Sue T hall Date: 1 /Zl /l 1 days after it baa been atceptexl as complete.
* Number of inspections allowed per permit.
t'\ Baiisiogfermirotatt- ramit.ADD.dec o7101/f0 440- +615-14tir05fCOM/wEe
01/23/2011 23:37 503 - 647 -7443 AIRWAVE LLC PAGE 02
Electrical Permit Application - City of Tigard .
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
rl ,....... r . s "' fl. r ; l.1•d �� �� , l �� �� �� ,,ryry tll , .. 14 r �� ° � t �)� � {�li;t;' " aGI'l 1• I
lr'.,,� H n ���„.tL�a- Atd�ihHicd r 17ICJm �.'e!lrilwr�tt a 1 Vo �'�. � , "' '`th`�`y
.pee for all residential systems combined......., $75.00 •
Check Typc of Work Involved:
❑ Audz"o and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
n: ...., ., .. _,... , •: - ! ! � �f' 'fit Y � f I L'
f li If i ll r a� I/ 4 r' 1 id •; i �! ;�: i ,l d - ,' ;j a 1i IG't 1 ' IN t �'� INI
.0 m na b (.dr nvrrt nrn ilpV
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
® Data Telecommunication Installation
❑ Fire .Alarm Installation
(� HVAc
•
❑ Instrumentation
•
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Si
n Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I. 13wldiapPermas\ELC- PiamitApp.dec 07!01110