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Permit II CIT Y OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2011 -00079 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2011 Parcel: 2S101DCO3800 Jurisdiction: Tigard Site address: 7190 SW SANDBURG ST 10 Project: Perlo McCormack Pacific Subdivision: Lot: 0 Project Description: Low voltage for data. Contractor: IES COMMERCIAL INC Owner: MCCORMACK PROPERTIES LP 16135 SW 74TH AVE 7190 SW SANDBURG ST TIGARD, OR 97224 TIGARD, OR 97223 PHONE: 503 - 648 -1900 PHONE: FAX: 503 - 670 -9572 FEES Description Date Amount Specifics: Restricted Energy Permit 03/30/2011 $75.00 12% State Surcharge - Electrical 03/30/2011 $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. ATTEN N: on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -001 through OARN952 -' • 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 2.1987 or 1.800.332.2344. ,� - h Issued • A / Permittee Signature: Y , 0 �O l(� 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. 03/29/2011 11:49 5036709572 NEW TECH ELECTRIC PAGE 01/03 Electrical Permit Application 1 City FOR orrice. _'st ONLY f Tigard r A '� : 4 . � � Received Q � /� /�,, / ���ry 7F ty ,.nr . 1 . � + eJ a . permitNn,; E /( "4:510 q \ Date/B : 111 I 13125 SW Ball Blvd., Tigard, OR 9 23 �� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 � � 60 , Date/By: OlherPcrmit; 1 I G r1 I. D Inspection Line: 503.639,4175 �� pr� . Date Reody/gy Jaria: 0 Sec Page 2 for � �'r Internet; www,tigard or,gov V NmaFled/Mothed: �jT p� ■ Supplemental Information `: i ✓ ±Y) , .ua ` ;, t ,;,,': , ' Piiv Oi'. Y. O , R PLAY RJ VIEW ^ ! , ,I .., .. � r: ❑ New construction ® Addition /alteration /replacement Please check all that apply (submit Z acts of plena w /items checked below): [) Service or fbeder 400 amps or more U Building over three stories. ❑ Demolition ❑ Other: where the available Omit currant ❑ Marinas and lxtatyan's, CATt COR' Orr CON `. exceeds 10,000 amps at 150 volts or ❑ Flouting buildings. less to ground, or exceeds 14,000 0 Commercial -use ngricultuml ❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building snips for all other installations, buildings, ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑installation of 75 KVA or • ■ t ' nS - (°JOB' SE Th 1N i ' ORRMt i , '1' IO It AN rI OCATEON l 9 : ❑ Emergency system, larger separately derived system, •e ©Additionof new motorloadof ❑ "A" "F" "1 -2" °t -3 ", Job no.: 592 43 7 Job site address: 7190 SW SANDBURG LN 10OHP or more. occupancy, ❑ Six or more residential units. El Recreational vehicle parks, City /State /ZIP: TIGARD OR 97223 0 Health -care fhcllitics. El Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: Project name: PERLO McCQRMACK PACIFIC 0 Service or feeder 600 amps or more. Cross street/directions to 0l) site: SC:1IEDU,) i^ `r 1, ; „: i J Dcuription I Qty. I Fee I Total I" New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 1 68,54 4 Ea, add'l 500 sq, ft. or portion 33.92 1 Tax map/parcel no.: Limited energy, residential 75.00 2 ,, DESCI1IPTION OF V4 0RJc ; (with above sq. fl.) Limited energy, multi- family INSTALL 6 DATA DROPS residential (with above sq. (t•) - 75.00 2 Services or feelers installation, alteration, and /or relocation 200 amps or less 1 00,70 2 "! o' ;'IRO'.rvtitY/ 0? Nita .' j :' >ToANT 201 amps to 400 amps 1.33.56 2 Name: 401 amps to G00 amps 200,34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552,26 l Temporary services or feeders installation, alteration, and /or City /State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps nr 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 pane! Owner signature: Date: A. Pee for branch circuits iiirh ❑ of above service Or feeder fee, Al3. ®CN TACT PI ItSOIY ,' 7,x12 2 • each branch circuit Business name: B. Fee for branch circuits withmn - - -- • - service nr feeder fcc, first 5G.18 2 Contact name: JORGE ALGECIRAS branch circuit - -- - Each add'] branch circuit 7.42 2 Address: Miscellaneous (service or Eccdcr not included) Each manufactured or modular City /State /ZIP: dwelling, service and /or feeder 67.84 2 Phone: (503) 648 - 1900 Fax: : ( ) Reconnect Only 67.84 2 - - Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 " ,CONT1iAC7[ OIt . Signal circuit(i) or limited-energy ' , . � Business name TES COMMERCIAL panel, alteration, or extension, Page 2 75,00 1 2 - - - Each additional inspection over allowabl i n any of the above Address: 16135 SW 74 AVE Additional inspection (1 hr min) 66,23/ hr City /State /ZIP: TIGARD, OR 97224 Investigation (1 hr min.) 66.25 / hr Industrial plant (1 hr min) 78.18/ hr Phone: (503) 648 -1900 Fax: (503) 670 -9572 Inspections for which no fcc is 90,00/ hr specifically listed (h hr min) CCB Lie.: 182452 Electrical Lie.: C448 Su rv, Lie.: 49115 P , ; �1„ r�'` )CAIt'A.Jt.':I'�R1 .. '' " ' 67 Subtotal: 75.00 Suprv, Electrician signature, required: /% Plan review (25% fee): Print name: COREY T3AYSiNGER ' Il Date: 03- 29 -1.1 State surcharge (12% of permit fee): 9.00 III - TOTAL PERMIT PEE: 84.00 Authorized signature: This permit application expires it a permit it not obtained within ISO days after It has been accepted as complete. Print name: Date: • Number of inspections allowed per permit. G•l building \Parmits\BLC•PonnitApp.doc 07/01/10 d40.4619T(11/09 /COM/WP_B 03/29/2011 11:49 5036709572 NEW TECH ELECTRIC PAGE 02/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information umrrED ENERGY PERMIT FEES: RBSTthNLOIcbNLY Fee for a residential systems combined $75.00 Check Type of Work Involved: 7 Audio and Stereo Systems* I: Burglar Alarm fl Garage Door Opener* 1 Heating, Ventilation and Conditioning System* n Vacuum Systems* ri Other: rrowmEicd.'fAt7voit1 co:NEY Fee for each commercial $75.00 system (SEE OAR 918-309-0000) Check Type of Work iovoved: El Audio and Stereo Systems El Boiler Controls El Clock Systems E Data. Telecommunication Installation El Fire Alarm Installation. El IIVAC 7 Instrumentation El Intercom and Paging Systems ri Landscape Irrigation Control* Medical Nurse Calls El Outdoor Landscape Lighting* 11 Protective Signaling El Other Total number of commercial systems; *No licenses are required. Licenses arc required for all other installations TAM! IldIng1PermItATLC-0 arm It A pr,d 07/01 /i