Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I : COMMUNITY DEVELOPMENT Permit #: ELR2011 -00057
- TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2011
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 200
Project: Angelvision Subdivision: Lot: 0
Project Description: Low voltage for voice and data.
Contractor: AF TECHNOLOGIES Owner: HILLTOP BUSINESS CENTER LLC &
PO BOX 6551 HUNZIKER LLC
BEAVERTON, OR 97005 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 466 -2900 PHONE:
FAX: 503 - 466 -2922
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/09/2011 $75.00
12% State Surcharge - Electrical 03/09/2011 $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 - 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. A NTION: Oregon - 'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 0010 through OAR 952 -0 r r . ou may obtain a copy of the rules or direct questions to OUNC by : .,.! . 11987 or 1.800.332. 44.
I
Is- ed By: 1 �— -� - / .Latin l Permittee Si. 4111W
r . 4.. . ■
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.
Mar. 9. 2011 12:22PM Trilogy Custom Homes No. 1334 P. 5
Electrical Permit Application G FOR OPr l(F r_si O\L
City of Tigard (%C.N 1. °" eceived / Permit / p
13125 SW Hal] Blvd., Tigard. OR '" DamaB , ` . , r" a
�l �_��57
g 4 ma Plan Review
Phone: 503.718.2439 Fax 503.598,1960 % 1 rFermit:
'1:1 c; A R r7 Inspection Line; 503.639.4175 MP� Date Ready/By: iuri : H See Page 2 for
Internet wWw,tigard or :gov 0tilN � Notified/Method; Sepplemental Information
New construction d ition/alf r , ' W"' t all that ap ply (subim 1 plans
® ■ Addition/alt Please check ! t meta of la w / items checke b
D Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current 0 Marinas and boatyards.
exceeda 10,000 amps at 150 volts or lLI Floating buildings.
,.. , . _ `. '' less to und. or exceeds 14,000
® Commercial/industrial ❑ Accessory building amps file all other irlst,illations. ❑ buil�g�s ial -use agricultural
❑ 1- and 2- family dwelling
❑ Multi - family Q Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
1 ^ " , r ' ❑ SmergeoCy Sysfam. larger separately derived system,
,,....,. ,. ❑ Addidcu of new motor load of ❑ „ „E„ "1 -2 1.3"
Job no.: 11039 Job site address: 7330 SW Hunziker #200 100I1Pormorc. Recres Cy,
❑ Six or more R.
residential units. ❑ ecreational vehicle parks.
City / State/ZIP: Tigard, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
Cl Hazardous locations. 600 volts nominal,
Suite/bldg. /apt. no.: Project name: Cubicle Add • V{ • ❑ Service or feeder 600 amps or more
Cross sfrcet/directions to job site: - „4'.4',4,„_
� Deccrfptloa Oh- Fes. Tool •
New residential single- or mule - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq, fr, or less 168.54 4
Tax map /parcel no.: Fe. add'1500 sq. ft. or portion 33.92 I
Limited energy, residential T
I kt (with above 9G. ft.) 75.00 2
Emote! eat rgy, mule - family
Voice & Data Installation residentia with above . f2. 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or lass _ 100.70 2
1 rc `r; 201 maps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200,34 2
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 turps or volts 552.26 2
City /Slate /71P; Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being mad on property
201 amps to 400 amps 125.08 2
m$ p petty that I own which is not 401 amps to 599 amps 168.54 2
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new a, lteration, or extension, er pane
r
Date: A. Fee for branch circuits with
Iy 4
Owner signature:
e ach branch Clre1llt
i . � 5 �ir„ r, rC''1:'''',..-,',” �' , + ' � , l , v� _� ahnVe sG.rnce Or e f ire,
.,. , . ..,..;� .... .,, .. >y....r. :. ,5 . •: < z „,.., , + .,.ua 7.42 2
Business name: 4 T , B. Fee fbr branch circuits without
service or feeder fee, first 56. 2
Contact name: / - j fir ' branch circuit
Each add'1 branch circuit 7,42 2
Address: Misedlancous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 _
I 2
E-mail: Pump or irrigation circle 67,84 2
i . r 4 , x , t Sign or outline lighting 67,84 2
. ,,.. - ,.....,. w ,l,:' . reu.e^' ..n".,.., ........u..a.:..4. ,..,,..; . �.`.' Signal ctrcuit(s) or limited-energy
Business name: AF Technologies, Inc. panel, alteration, or extension. Page 2 _ 2
Each additional ins I ection over allowable in an of the above
Address: PO Box 6551 Additional inspection (1 hr ruin) 66.25/ hr
City/State/ZIP: Beaverton, OR 97007 Investigatlon(1 hr min) 66.25/h
industrial plant (1 hr min) 78.18/ hr
Phone: (503) 466 -2900 Fax: (503) 466 - 2922 Inspections for which no fee is 90.00/hr
s iiicall listed 14 hr man)
CCB Lic.: 167061 l Electrical Lie.: CL 10 I Suprv. Lic.: 2903LEA r - .. , . "r r ,.
Suprv. Electrician signature, required: -__ Subtotal: 75.00
Plan review (25% of permit fee):
Print name: Matt Niswonger 1 l Date: 03/08/2011 State surcharge (12% of permit fee): 9.00
Authorized signature: symr
TOTAL PElj1 T FEE: Y 84,00
T his permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: toy on Date: • •• 1 j • Number of inspections allowed per permit
IaRuildi na\Permite/ELC- PetmitApp.duc 07/01/10 440- 4615T(11 /05 /COM/WER
Mar. 9. 2011 12:22PM Trilogy Custom Homes No.1334 P. 6
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
R
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:
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
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:%BuildinggPFRnit91ELC•Pemt tApp.doc 07/01/10