Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00099
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/05/2011
Parcel: 25101 DCO3800
Jurisdiction: Tigard
Site address: 7190 SW SANDBURG ST 10
Project: Perlo McCormack Subdivision: SALEM FREEWAY SUBDIVISION Lot: PT 4, PL
Project Description: Install (6) data drops.
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 05/05/2011 $75.00
12% State Surcharge - Electrical 05/05/2011 $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. ATTENTIOi. ' ' - gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 t ough OA' 95 :. Os =' You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issued By: / I / Permittee Signature: =�
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.
0 5/0 4/2 011 07: 0 7 5 0 36 7 9 5 7 2 NEW TECH ELECTRIC PAGE 01/03
Electrical Permit Application RECEIVED
FOR OFFICE USE ONLY
City of Tigard MAY 4 2011 Received --
Dateja : 5 Altil.F1 Permit No.: , Ei..,e,aepa- - ee:40 • dr
•
*0 13125 SW I Blvd., Tigard, OR 97223
Plan Rew
Phone: 503718.2439 Fax: 503.598.1 9 e , ITY OF T vie Other Permit:
Date/J..3y ,
Inspection Line; 503,639.4175 IGARD
Date Remly/gy; ;IltriP: 6 see Page 2 for
FIGA RD
Internet; wwW.tigard-or. gov
BUILDING DIVISION Notified/Method; Supplemental Information
.': ' 7 . 1 '7' '",: : ,:..; ". .7 : . ; ..'• :: ; 7 ..".. : ';•:.: '''''.• '' •:. :: : :. ..:11 ::.::: . 08S
..... _
...: u New construction EI Addition/alteration/replacement Please cbcalc all that apply (submit:1 sets of plans w/items checked below);
, ..
0 Service or feeder 400 amps or more Li Building over three stories.
.._) Demolition ID Other: where the available fault current 12 madrins and boatyards.
Ekfk Or eb.i■iiittierief■iF::: ::, . • . ' ';'',:'',' exceeds 10,000 Limps at 150 volts or 0 Floating buildings.
— less to ground, or exceeds 14,000 0 Commercial-nso agricultural
1. and 2-family dwelling El Commercial/industrial ID Accessory building amps for all other installra ions, buildings.
Multi-family 0 Master builder El Other:
:i ''•,.. ;,. ., ::::'',:.:.' ; ''' '':,:j' : . . :. ..
Job no.: 60624 Job site address: 7190 SW Sandberg St. EE Fire pump. ‘ own
': . : ' 0 Addition o me' larger se
tor load of
100T-TP or more, El Installation of 75 KVA or
parately derived system.
occupancy,
......,
El Six or ttinrd residential units. LI neereatienal vehicle parks.
.....-.
c. % City/State/ZIP: Tigard OR 97223 ID I-teeth-cam facilities, 0 Simply voltage for more than
01.4ncerdous locations. 600 volts nominal.
Su ite/bldg./apt. no.: Project name: Perla McCormack Cl Service or feeder 600 amps or more,
'::"' 7 H; ''', ' ..•, '....at:$C.R.t*ir:;t:::...::::.:;.:,:•',;:!'T.:77
Cross street/directions to job site:
Demi tiol i.
o,t . F m.
kl•-) New residential single- or multi-family dwelling unit.
Includes attached garage.
m . .. ____
L--J Subdivision: Lot no.: 1,000 sq, ft, or less 168,54 4
.._
— - Ea, acld'I 500 sq. R. or portion 33,92 I
Tax map/parcel no.:
Limited energy, residential
75,00 2
qfp 1..!..;;;,,,771 ;;Itig ..,;: ,,, ' ; '. : ; :,•:,::, .,,,. Li (w above sq. ft)
d energy, multi I
75.00 2
0. Install 6 data drops residential (with above sq, ft
—
- Services or feeders installation, altera ion, and/or relocation
200 amps or less 100.70 2
:: nbotkoi*jiii.o *ow ,:.-; :.:: ,,, ::::'::.,:: ., 0: TENANT ,. ,,: ; ' . , 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or volts 552,26 2
Temporary services or feeders installation, alteration, and/or
---)
City/State/ZIP:
relocation
Phone: (
) Fax: ( )
Owner installation: This installation is being made on property that T own which is not 401 amps t
168
s 599 am
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Owner signature: Date:
A0ii,iek,if : ,‘ • ,:,'' '.'' ': ::i : :;.,',i':.:'::::•:21-01■4ACT.rtitgoi■r bove service or feeder fee
" ;', • . ..;
, •
Business name: 200 amps or less 59.36
201 amps to 400 amps
o
125.08
,511
i p
Branch circu ts - new, alteration, or extension, per panel
A. Fez for branch circuits with
a ,
_ each branch circuit
B. Foe for branch circuits without 7A2 1
2
2
2
— " ' service or Feeder fee, first
56.18 2
(.) Contact name: Jorge Algeciras branch circuit
Each add'l branch circuit 7.42 2
. j Address:
Miscellaneous (service or feeder not included) ...
.. ...
• City/State/ZIP: dwelling, service and/or
....1
Phone: (503) 648-1900
E Fax: : ( ) Each manufactured or modular
feeder
Reconnect only 67,84 2
Pump Or irrigation circle 67,84 2
67,84
2
Sign or outline lighting 67.84 2
• - .;;.'!.,,:.;' ',, , : ,(; ..,,, 7 ' : ., , ' ' ' ; - Signal circuit(s) or limited-energy T
75.00
Business name: ins Commercial panel, alteration, or extension, Page 2 2
Each additional inspection over allowable In any of the abov
3 Address: 16135 SW 74 Are Additional inspection (1 hr min) 66,25/ hr
investigation (I hr min) 66.25/ hr
City/State/ZIP: Tigard OR 97224
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 648-1900
Fax: (503) 670.9572
Inspections for which no fee is 0/
CCB Lie.: 182452 ,. ...1 Electrical Lie,: C448 _ _ — Suprv. tic,: 4911S
— specifically listed ( hr nun) 90,0 lir
' ' , ' ' . • rtitertAtem; kkitiiiT , FEES, ' .,, • ;' . :.,,....:•.*
T. Subtotal: 75.00
s- Suprv. Electrician signature, required:
Plan review (25% of permit. fee):
.---------- Print name: Corey 13aysinger . ate: 05-04-11 State surcharge (12% of penult foe): 9.00
..
TOTAL PERMIT FEE: 84.00
"--------..- Authorized signature:
‘.11 This permit Application expires If a permit is not °Maned witt11n1
__ 81)
days after it has been accepted as complete.
Print name: Dale:
. ' N of inspections allowed per permit,
l'AlliildingTermIPAP.1-C-1 07/01/10 440-41515T( I 1/05/COM/W ER
05/04/2011 07:07 5036709572 NEW TECH ELECTRIC PAGE 02/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Informatiion
LIMITED ENERGY PERMIT FEES:
k'cc for a 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:
e0 lv ": r g ala P1S10-
F'cc 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.
❑ IIVAC
❑ Instr7umenta.ti.on
❑ Intercom and. Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑
Other
Total number of commercial systems:
*No licenses arc required. Licenses are required
for all other installations
r;lRult <1;itmrermit: nc.NrmltApq.Aoc 07/0!/10