Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1111111 tt • : :- COMMUNITY DEVELOPME t V./ Permit #: ELR2010 00251
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 — Date Issued: 11/18/2010
Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16150 SW UPPER BOONES FERRY RD
Project: Dow /Das Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Low voltage for data cabling. 3/11/11, reprinted to correct street name from 72nd Ave.
Contractor: OREGON ELECTRIC GROUP Owner: PACIFIC REALTY ASSOCIATES
1709 SE 3RD AVE 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97124 PORTLAND, OR 97224
PHONE: 503 - 234 -9900 PHONE: 503 - 624 -6300
FAX: 503 - 535 -2763
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/18/2010 $75.00
12% State Surcharge - Electrical 11/18/2010 $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. ATTENTI • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 rough OAR 952 -0. -.09r You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80Q.332.2344.
Issued : r.�. dl iIL -! / t Permittee Signature: ietqc
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.
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CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELR2010 -00251
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2010
TIARA Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16150 SW 72ND AVE
Project: Dow /Das Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Low voltage for data cabling.
Contractor: OREGON ELECTRIC GROUP Owner: PACIFIC REALTY ASSOCIATES
1709 SE 3RD AVE 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97124 PORTLAND, OR 97224
PHONE: 503 - 234 -9900 PHONE: 503 - 624 -6300
FAX: 503 - 535 -2763
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/18/2010 $75.00
12% State Surcharge - Electrical 11/18/2010 $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 acco da ce ' 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. ATTEN ON: Oregon w re. ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 through OAR 952- , -0090. u may obtain a copy of the rules or direct questions to OUNC by calling 503.232. 987 or 1.800.332.2344.
Issued y: L. ` a. 'A...IL /. Permittee Sign.ture: �-
OWNER INSTALLATION ONL
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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard ® r ) Date/By: # ( Q /D PermitNo.: ete at, cQf f
'1 13125 SW Hall Blvd:, Tigard, OR 97 2 C i R� ? fl Received Plan Review be
Phone: 503.639.4171 Fax: 503.598.1960 - : 0 Date/By; Other Permit:
Ti G111t U Inspection Line: 503.639 Date Ready /By: ri 6d See Page 2 for
Internet: www•tigard or.gov NOV tV V U 2 01(3 Notitled/Method: /L Supplemental Information
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❑ New construction ®Additi011/al t / `6 jacement , Please check all that apply (submit 2 sets of plans w/items checked below):
a, ■.. UI Y f .ft ys; i ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: u where the available fault current ❑ Marinas and boatyards.
p ` ` " a sue°l , "n ® e " t %A LA % " ° `'` 4# It amps at 150 volts or exceeds 10,000 a
? �r s ! r • is - , ❑Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial•use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. 0 Installation of 75 KVA or
t; }: rr ❑ Emergency system. Larger separately derived system.
' 177. - ; 6 0 e o r 9 I h �t ❑ Addition of new motor toad or ❑ "A" "H'• "1.2" , - 1 -3",
Job no.: 62294 Job site address: 16150 SW U 100HP or more. occupancy.
A 0 Six or more residential units. El Recreational vehicle parks.
i
t City/State/ZIP: A
/State /ZIP: PORTLAND OR 97224 7 '�°/ j t _ ❑ Health -care facilities. ❑ Supply voltage for more than
Q Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: DOW / DAS REMODEL fl Service or feeder 600 amps �� snore.
t Cross street/directions to Job site: Deacd lion ty. Fee. Total '�
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or Tess 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited ener gy, residential
v 67.84 2
u , � « r , ® o - (with above sq. a.)
Limited energy, multi- family 67.84 2
VOICE / DATA CABLING /-a2 a/ 0n L� ) e_/.14..11 / residential (with above sq. ft.) 2 Services or feeders installation, alteration, and/or relocation
e't-1 1 a t.. / dr-t t (..:7D / nJ a 200 amps or less 100.70 2
k; ® • e. i ti-c, « a��' : •;!s e ` _ .. _ at ' r 201 amps 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 amps or volts 552.26 2
City/State /ZIP' Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I 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 125.08 2
intended for sale, lease, 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 panel
Owner signature: Date: A. Fee for branch circuits with
.t�a e v R � y a 'te ' above service or feeder fee, 7.42 2
each branch circuit
Business name: OREGON ELECTRIC GROUP B. Fee for branch circuits
Contact name: JAMES FITZGERALD
without n crvice or feeder fee, 56.18 2
first branch circuit
Address: 1709 SE 3 AVE Bach add'l branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State /ZIP: PORTLAND, OR 97214 Each manufactured or modular 67.84 2 dg, Phone: (503) 234 -9900 I Fax: : (503) 234 -1001 Recon t only and/or feeder
Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
"° ` ' t ` , drill n 1z , t Sign or outline lighting 67.84 2
Business name: OREGON ELECTRIC GROUP Signal circuit(s) or limited -
energy panel, alteration, or c
Address: 1709 SE 3 AVE extension. Describe: 1 Page 2 /,k GCS ; 2
VOICE / DATA CABLING �✓
City/State /ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 234 -9900 I Fax: (503) 234 -1001 Investigation per hour (I hr min) 66.25 '
CCB Lic.: 203 Electrical Lic.: 26-• C Suprv. Lic.: 4818S Industrial plant per hour 78.18 1
,.
Suprv. Electrician e� �f/ t r
i?�'1 //� P/� - Subtotal: 7 5
�J/ / `� R,lPi � � Plan review (25% of permit fee):
Print name: MAKR AF: ; ` 1' Dat : 1 /9 /10 0
f State surcharge (12% of permit fee): 8ri'4 �
Authorized signah I • id J ./ _• . / TOTAL PERMIT FEE: 7SA%
''s A r - nP Qrr I V' This p ermit application expires if a permit is not obtained within 180 , w
Print name: MARK EINBEN • R . 19 days after It has been accepted as complete. /(V1/
• Number of inspections allowed per permit.
I:\ Building \PermitsU3LC- PcrmitApp.doc 10/01/09 440.4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 • Supplemental Information
LIMITED ENERGY PERMIT FEES:
' '`t '."-tw3tfuUi
Fee for all residential systems combined........ $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System'
Vacuum Systems'
❑ Other:
3
r v ;,,YA h zi. �n uar' L« nt i hi°f s c c a 74
Fee for each commercial $67.84
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
Rib i !ding \Permits CLGPermil App ,Aoc 10/01/09