Permit `` CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I : ' COMMUNITY DEVELOPMENT Permit #: ELR2011 -00084
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/07/2011
Parcel: 2S112AC01700
Jurisdiction: Tigard
Site address: 15065 SW 74TH AVE
Project: Interstate Roofing Subdivision: FANNO CREEK ACRE TRACTS Lot: 16
Project Description: Low voltage for voice & data.
Contractor: TECHNOCOM INC Owner: INTERSTATE DEVELOPMENT LLC
7929 SW BURNS WAY STE. F 15065 SW 74TH AVE
WILSONVILLE, OR 97070 PORTLAND, OR 97224
PHONE: 503 - 682 -4195 PHONE:
FAX: 503 - 682 -2781
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/07/2011 $75.00
12% State Surcharge - Electrical 04/07/2011 $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. AT N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 010 through OAR 952- 1- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 - .1987 or 1.800.332.2344. .
Issu y: $ a___vyLtu1/t Permittee Si., ature: . / Of �CL��
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.
Electrical Permit Application I oR oFFIcE usu., oN LI
City of Tigard . Received ,...,
/ peii.i.a. No.. EA(4,90(7- 60 e5
. -
4 13125 SW hall Blvd„ Tigard, OR 97223 .
Ph Date/B : 7 Ce //
Plan Review ,
1 I , Phone: 503.7182439 Fax: 503.598.1960 Other Permit:
Date/B :
-CIGAR') Inspection Line: 503.639.4175 nate Ready/By: shiriii. 0 Sae Poge:2 for
Internet: www,ligard-or.gov Notified/Method; — -770. Supplemental Information
.,.
4 :'..Y: ;. ::i: : :::::;::::: ; i:.:!; ;:: ::!:-:::::.:::: ::' ::::::: ::::::' : ' ' ' - : ' .0ENAEVTOr'E!'":;•;':!''''.::',..::::':::;'!'::::':
0 New construction El Addition/alteration/replacomem Please chock all that apply (submit 2 sets of plans w/items hasked below):
CIService or feeder 400 amps or more CI Building over three stories.
CI Demolition 0 Other: where the available Built caveat CI Marinas and boatyards.
:: :. • . ,..::: ::':,.: .:!'!..Z. .:: 0 :"c9N3T10,040,4;H :'.:,.., :'..:.. .!!. , !:; , :, . H . ::: exooecla 10,000 oinpr ot 150 volts or El nomio boilt1i1163,
less to gantmd. or exceeds 14,000 0 Commercial-use agricultural
El 1- and 2-family dwelling EE Commercial/industrial b Accessory building amps for all other installations. buildings.
0 Multi-family Ti Master builder 0 Other D Fire pump, ID Installation of 7510/A or
- - .... - . . • ! :., v,7 , , .., , , 0 EmergencY sYekill- liu separately derived system,
4 :IN.ORIk7A,119N: AND i i:'JJ] !!;' ''' , ,,, , ': ..
0 Addition of new motor load of 0 "A", "E", "1-2", "1
Job no.: 114024 riob site address: 15065 SW 74 AVE 100HP or more. occupancy.
_ El alo ea mute zcoiactilial undo, ID ROOlOotiOuol vehicle poi kb.
City/Slate/ZIP: TIGARD, OR 97224 1:11Iealth-oare facilities. D Supply voltage for morn than
0 Hazardous locarions, 600 volts noMinal.
St/ ire/bldg. /apt. no.: Project mune: INTERSTATE ROOPINC 1:1Aervier nr feeder 5f)(1 si milt nr mom
...
Ftg:
Cross street/directions to job site: Detcriptioo Qty. Per Total I •
_____
New residential single- or multi-family dwelling uuit.
Includes attached garage.
Subdivision: Lot no.: , 1,000 sq, ft. or less 168,54 4
-. Ea. add'l 500 sq. ft. or portion il cp. ' I
lax map/parcel no ,
Limited anew, residential
75.00 2
,';'HH::!,;!'!!'•,: ::::::::. ' •.:...'': Ll!. pgcglrilloNE: OE WORK .. ..H::::,:''' :''''"i'''::'":;;:: ::::::',•::„ :: (with above sq. ft.) ,
. . , ..,
Limited energy, multi-family
VOICE/DATA CABLING residential (with above scot) 7s,00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100,70 2
1 .* 0 •t -017 0* 4 .E 11: Hi:: :,!,: ' ,E 1 :l. ':'.',",!'': CI TENANT 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to i amps 301.04 2
Address: Over 1,000 amps or volts _ 552.26 : 2
Temporary services or feeders installation, alterittion, and/or
City/State/ZIP:
relocation _.
Phone: ( ) I Fax: ( ) :. 200 amps or less 59.36 1
201 400 amps
Owner installation: This installation is being made on property that I own which is not amps - to 125.08 2
40i to 599 s 168,S4 ' 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
amps
Branch circui amp ts new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
. iiiiii,N . i . H.,:,. 'i!::.i:,. ! !t!:L:' rg!etiNiX6'':iii,4iii,iiF:1:.,..',!;,.:' above service or feeder fe 7
e,
,42 ' 2
, ., . , .. , ,. , . , ,
each branch circuit
___________
Business name: TECENOCOM., INC B. Fee for branch circuits without
service or feeder fee, fust
56,18 , 2
Contact name: LESLIE PARSONS blanch uncoil.
Each add'l branch circuit 7.42 2
Address: '7929 SW BURNS WAY, STE F Miscellaneous (service or feeder not included) .
rooh martufucturcd or mediator
City/Slate/ZIP: WILSONVILLE, OR 97070 dwelling. service and/or feeder 67.84 2
_ — --; —
Phone: (503) 682-4195 Fax: : (503) 682-2781 Reconnect only 67.84 2
___.. ._. . .. . Pump or irrigation oirele 67.84 2
E-mail: l.parsons@gOtechnOcom.com
67.84 2
. :";;;:;,!; H ;. ; ;,';; : .. ; ' :CONTRA.0,(00: !:,; ::- ..:";:: :;,:,:, ; , ;;1. :: ,;•:, ; :: :: ';: ' Signal circuit(s) or limited-energy i
75
panel, alteration, or extension, Page 2 2
61,1$1rIen name: TECHNOCUM, INC
Each additional inspection over allowable in any of the above
Address: 7929 SW BURNS WAY, STE F Additional inspection (1 hr mm) 66.25/ hr
—
Invossisation (1 hr min) 66.251 hr
City/State/ZIP: WILSONVILLE, OR 97070
Industrial plant (1 hr mm) 78.18/hr
Phone: (503) 682-4195 [ Fax: (503) 682 Inspections for which no tee is 90.00/ hr
specifically listed (Si hr min)
CCB Lie.: 73872 Electrical Lic.: 34 Suprv. Lie.: 2281LEA ::::::..:!'•:i::::::';:, ELECTRICA11...P1414171T EEO '!. l:'
- Subtotal: 75.00
Suprv. Electrician signature, required: „4 : 1 "te;" . _,11"...„,...Z-- Plan rcvicw (25% of permit reer. -
Print name: JEFF SANDNER Date: 04/06/11 State surcharge (12% of pcnnit fee): 9.00
' TOTAI, PER.MIT FEE: 84.00
Authorized signature: ... a.,.. .... This permit app lication expires if a permit is not obtained within 180
days after it Ws been accepted as complete.
Print name: JEFF SANDNER Date: 04/06/11 . * Number of inspections allowed per permit,
1
lArtiti1tling1PormitskELC•ParMitAPP.d0C 07/01/10 440.4615T(11/05/COMME8 i
1
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
IESIDENTXAL NVOI ' ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
CQmm RCJ L! WQRK �T:
Fee for each commercial $75.00
system
(SEE OAR. 918- 309 -0000)
Check Type of Work Involved;
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
® Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape irrigation Control*
n Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number : ,of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
118uildiny1Permns1ELC •Penti[ADP.do0 07/01/10