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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 114 ` COMMUNITY DEVELOPMENT Permit #: ELR2011 -00106 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2011 Parcel: 2S112DD00200 Jurisdiction: Tigard Site address: 15500 SW 72ND AVE 200 Project: JP Morgan Chase Subdivision: PACIFIC CORPORATE CENTER Lot: Project Description: Low voltage for voice and data. Contractor: XTREME COMMUNICATIONS, INC. Owner: PACIFIC REALTY ASSOCIATES LP 24023 NE SHEA LANE, #215 ATTN: N PIVEN WOOD VILLAGE, OR 97060 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 618 -8816 PHONE: 503 - 624 -6300 FAX: 503 - 618 -9985 FEES Description Date Amount Specifics: Restricted Energy Permit 05/13/2011 $75.00 12% State Surcharge - Electrical 05/13/2011 $9.00 Type of Use: SF 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. ATT • ION: Ore.= law r- •uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -s.10 through OAR 95 0% -00.0. ou may obtain a copy of the rules or direct questions to OUNC • - " 3 .1987 or 1.800.332.2344. % / / Issue. =y: P ermittee Sign. _ . _ !� � � %i 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 Applica. ' rOI�t OFFICE' .USE ONLY City of Tr `Y I iu��lYnd C , � nn-- �p�q II rr and g Date /rd : � LM Permit No.' � /00 M ill 13125 SW Hull Blvd., Tigard. OR 9722 Plan Review —" 1' � Phone: 503,639.4171 Pax: 503.591s t b01 3 2011 pate : Other hermit: TIGARD Inspection Line: 503.639,4175 mac Readydy /13y: rail,: m Sou rage 2 rur . ..- Internet; www,tigat'd- or,gov Ty OF TIGARD Notified/Mothod; Supplemental Information ,., : ,.: 7•;i' VY #Igs ....; . _ ::... � �`'�IV, .. . . PLAN I�VIL; a .. ❑ New construction Addition /alteration /replacement — Pima,: check all that apply (submit a aela uC plant; w /hears eheciced Wow): ❑ Suttee ur fouler 400 amps or morn ❑ 130 ildiug over ihiee stories ❑ Demolition Other: where ilio available 1'dlllt OW=11 ID Muiaas and boatyards. `.::•';:'w •;' ,` `! CA'I`,JE4OIOy::P1?',CRvi pN: : : ... „...4$ 10,000 aurps tit 150 volts or ❑ Floating buildings. loss to 13rounci, or nxaneds 14,00(1 ❑ Commercial -use agriaulturel ❑ I - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family Master builder ❑ Other: 0 Pint pump 0 Installation 01'75 KVA or 4 4,;' hlkl ,RMATI 1 'D'• ,C QR ' A ' dition alum mu tiger separately d syslc • .:.•..,, ., 1 rta derived m. ❑ Addition of nut Motor load of ❑ '•A ", "P, "1-2", 13 Job no.: 760 5 Job site address: 15500 $ W 72. rive 1001 -1P oe n>oru, occupancy. Q $ix tic iu0r'e Ivsidnutial units, I] !recreational vehicle parks, City /State /LIP: PO n o1.'. q12 L� 1 ID Health-care facilities. ❑ Supply voltage for more than �+ ~•+ ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: T. p orusc, , ❑ Service or feeder 000 amps or luau. : I ' E'.SCII'ED ULE Cross street/directions to job site: V �.� y� � • ' Dvticril�tiun J Qly. I Fur. I Tutu' I '" • +J New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or 15 168.54 4 Lea, add'! 500 sq, ft. or portion 33,92 I Tad. reap /parcel no.: 1 — 1ev d� • ] .'d r „ ,a. ' s QF : •* ;' '77'.77.7. above sq. 11.) n Ua , ,r' � ,f✓' �' Qltlfi .:. , r... ... _:. ,�, �. �� " ,:;,.; ' " (with :tb .. T._ ---.. �..., O n v . Limited energy, multi- LAmily 75,00 2 pi c,�, 1 y�A residential (with shots sq. lt.) �w Services or feeders installation, alteration, and /or relocation 200 umpa or less 100, 76 2 E1 ;1'ROi, ?11",utry RWN tat, , 1' , ©~ �I"1Mhi4z.o. 201 amps to 400 amps 133.56 _ -.__- ._.. 2 Name; 401 amps to 600 amps 200,34 2 601 amps to 100 mops 301.04 2 Address: Over 1,000 amps or volts 552,26 _ _ — 2_ City /Stale /'LIP: Temporary services or feeders installation, alteration, and /or _ _ relocation _ Phone: ( ) F ax; ( ) 200 amps or loss 59 36 1 201 amps to 400 amps 125.08 2 — Owner installations •1 "his installation is being made on property that 1 own which is not 401 amps w 599 amps 1 6ss4 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. E' 1' Brunel: circuits - new, aheratiun, or extension, per panel Oevnor signature: Date: A, Foe for branch circuits with - above service ur feeder lac, ' each branch circuit __ --_.___ Business name: 13. Fee for brunch circuits without service or feeder fee, fear Contact name: branch circuit se , ,, Each add'I branch circuit 7.42 2 Address: Miscellaneous (service nr feeder not iucludcd) City/State/ZIP Each manufactured Of modular 67,80 dwelling, service and /or feeder _ — Phone: ( ) Fax: : ( ) Reconnect only 6 7.84 , „y. 2 — --- Pump or irrigation ciecle 67,84 2 E - mail: - Sign or outline lighting 67 84 g htin g 2 Liusinc5s nurrt ,,,,; ,I,;,.... ` t, !la C±G1IYTEll'IAeOXI..h2 :r.� Signal circuit(s) or Limited- energy _.. _ _ T e: ' c.... c.... m on r- �,.r p ane,, alteration, or extension. l Pi 7�. l :tell additional inspection over allowable in any a of the above Address: . 0 , X72 Additions! inspection (1 hr min) 66.25/ hr ______E LI investigation (I ht thin) 66,25/ hr City /State /LIP: .61 t ,_ r _ 6/70l Industt'ialplant (1hrmin) - •`�•� -- �' 78,18/ hr Phone: 603 6 . `6 l I I .1 h s /_ r �C g insp.:bons for Which no No is 90.00/ hr r 4 51 =ifm4111Jtiled (A hr min) CCI3 Lie.: a.4 7'2,6 .. L „ , Electrical Lie,: 'uprv. Lie.: , $"j . . - . ELIaC'rilic*Li.,:PERM 1'l'. FEES T Subtotal; -- q Suprv. Electrician signature, required: %'/!' / ^�— -- � _ Plan review (25% ol'permit fee)' Print name: // m1'/ ln re/ r Date /� f / State surcharge' (I2u/u of permit foe); ! TOTAL PERNI1T FEE; �` `'' Authorized signature: Ms permit application expires if a permit is sot obtained within 150 days after it has been accepted as complete. Print name: Date' . Number ol'inspeetious allowatl par pnraut, 1: 111uiiding \Punnital6LC- ParmitApp.doo 07/01/10 440 4515 I /0= /CUM /W12I! Ee /1e 3E S866819E09 EI1:z1 TIF%/E1 /5e Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDEwTTIAI : w _'4.,N :Y: Fee for all residential systems combined....... $75.00 Check Type of Work Involved: [,] Audio and Stereo Systems* Burglar Alarm ❑ Garage Door Opener* U heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems *. ❑ Other: __ COMIN4ERCI '' 'WO.MON.LY '.. . Fee fot tad), commercial $75.00 system . (SLi2 OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls . ❑ Clock Systems Data Telecommunication Installation ❑ Fire Alarm Ins tallation ❑ 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 iA liuilding1PermitsZLC- PurhiliApp.doc 07/01/10 CO/Z0 39dd 9866819E0S Ee:ZT I- CH /ET /SO