The URL can be used to link to this page

Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2011 -00127 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2011 TIGARD , 9 Parcel: 1 S126DCO3300 Jurisdiction: Tigard Site address: 9900 SW GREENBURG RD 240 Project: Advantage Dental Subdivision: LEHMANN ACRE TRACT Lot: 4 -5 Project Description: Data /telecommunications Contractor: LAN TEL SERVICES INC Owner: ATHERTON REALTY PARTNERSHIP 204 -A JEFFERSON ST 2100 S WOLF EUGENE, OR 97402 DES PLAINES, IL 60018 PHONE: 541 - 688 -1427 PHONE: FAX: 541 - 688 -4642 FEES Description Date Amount Specifics: Restricted Energy Permit 06/07/2011 $75.00 12% State Surcharge - Electrical 06/07/2011 $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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503,232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ON (7 ° ,6 /69770A/ 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 603.639.4175 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. JUN -0E -2011 15 08 LAN TEL SUCS EUGENE 15416884642 P.01 72/R 7 Electrical Permit Application FOl OFFICE- LSLONLY ' °': City of Tigard Received / 7 VED Plan Review bare /13y: W/7/' f //• Penit r4U,: E Q/ .. t /�' 0 I3125 SW Hall Blvd., 'Tigard, OR 972' 3 ' N Phone: 503,718,2439 Pax: 503.598,1960 Date/13 : Other Permit 7f 'GAI' D inspection Line: 503,639.4!75 JUN 6 201 Date Ready /By; Juris: 0 See Pale 2 for " Internet' www,tigtrd- or.gov Notified/Method: f` SuppIcnteutalInformation : { �I i "51;1 3;; �::;y,,. ,. +, ,., ,,,'+ ':1 °ri1j1" !' • ° ' t a, ply, e i ' •t' y ., r: . r, �`; I ,'t ..� 1. '' i J'� 6.. ,13/ 11 1; P a � .. , 15' i •,'. a.; ,,. , , ,„ � .: , ,.� ' ,� ,t,l ,u l,t,a r '• }It ;i1r419�r?ii,ia�i��S�l�fG , t � �:, .i _,,. l,. k, ��; 4� t a s:, t�P;'!< .,:,:,, {, ?; ,., ;i ; � , ❑ New construction r t ,,�,rt>, =r tr Ple ase check all that apply ❑ Addition /a tet'atton /r�eplalcbr� Pr Y (submit? sets of plans w /items checked below): ❑ Demolition ❑ Other: tr.pt.t,� f fj � _kl f ❑ where the available fault current © Mann and boatyards. yeS ? Cpiffid " € , +1,. 5.,,, , , "'r, rs' llk?q 2 : '4 1� • '1� exceeds 10000 'i ees , a Floating ©' y dwC p =. .+' amps 150 volts or ❑ eating buildings, 1 •and 2 . , ... . .. ................. ..„,.1,3.,,„,..,,,„.• ; , . t..,., „', �;ax. �t.,,t , ��t„i4�1?`,�s��!��il: r less to ground, or exceeds 14,000 [] G buildings. cia! -use agriculttusl flin I Commercial /industrial E1 Accessory building amps for all otter installations. buildings. ❑ Multi - family ❑ Master builder j J Other: El pump. ❑ Installation of KVA or ,, ",.�e 2 i,, : „. ,., ..,,,, t m 1`, 4 ,',, ,.t,,.: ,ir: {;;. ❑ Emerrnc y s y stem . larger m, yrr, �r,�� erivcd system, '' I'.Yn '.' ” ∎. i:' ,. ' . A? 4,:7ET'4, ; ,, � + b 1 �.�,4 , Y•'i I lf y .':.�...,,, , 4 � x .;1,9... .' ��,,,t;r ?�,;il:;.1 ' � • • ❑ Addition of new motor load of © •'p" "E" "1-2", "1-3", Job no.: Job site address: qa 6 100HP or more. occupancy. Qa �� ❑ Six or mute residential mots. ❑ keereationa1 vehicle parks. City /State /ZIP: • �(,,� / \ 6 e ❑ Hcaltlt care facilities. (] Supply voltage for more than � Hazardous locations, 600 volt, nominal, ,/ uitc /bldg. /apt. no.: I Project name: w I © ��{ Se e rvice or feeder 600 am s or more. , CroSS5trCCl /diCECtt w 1 i ..:Lr.( \' � - -LIL, 1 , N,, „ ,,; ; ,, ;;, ors to job site: 1 II(i. 1 . tC1 i ,,ro��y; i . .Y4Ni' , i.Cs;1;4:, ?..il: ”' Descrtptfen Qty. I F. J Teblt •'. i " New residential single- or multi - family dwelling unit. Includes attached garage. • Subdivision: l Lot no,: 1,000 sq. ft, or less 168.54 III ..._ Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33,92 c i' y Limited energy, residential Cf Yi .. }lsii.,. " „ .',s1s ?,,ic': "; "i'; f �'a'r, °`l;!4.' y', ,, r , 7 i ! i .4', gitSC,1Zi1COlT,:: tJYC , 1 . 2' t , L. A� ,Ih,:�1'�k;. 4 . "', with above s.. ft. 5.04 ` :.. Limited energy, multi- family MEM — ID y, AI _ , Z g 0 a _ residential with above s.- ft. Services or feeders installation, alteration, and/or relocation 200 amps or Eett Mill 100.70 mum :;1° O IM `I 0 0 . ..:,:,.i,,:Bii'•�l:�lij i v7.'F;k�n' d itn'l i;3? ":al4y.....1ft.. �i.'1 ?�.L ii!'a�` q',.�, p!i. � ,. . �1'''�j, ,ER , � � : y ! ; . �'1H9 �.��,�,1;r %r�l' f,�';,?'w'��,� ?>,�; 201 amps to 400 amps MI 133,56 El Name: 401 amps to 600 amps IIII 200.34 fl - 601 amps to 1,000 amps il 301 04 Address: Over 1,000 amps or volts 552,26' City /State /GIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) 200 amps or less 1111 59.36 0 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. Fcc for branch circuits with , Hi !^ 'i,. "CA' : M r ;ii'i,i, iii `i: `^ ii k Mi ' ; iiii;, 1 : ', ; ; -- .,. °" apt' 'YGu"!r ., { ; above service or feeder � p . . ,•, T '.' -' :'.` rdq '; ,'''.. , rA ". 5' '`'.' ° " ; fee, 7 42 2 each branch circuit Business name: La,yt 1-4( ( SAtf` V 1C.,t 13, Fee for branch circuits without Contact name; @ �� • branch or feeder Fee, first 1 �/�f� bran circuit SG, l8 2 Y ' vu'S( Each add'l branch circuit Address: 7.42 mmHg f' r • A • r Miscellaneous service or feeder not included City /State/ZIP: "E. kt4,0 r A � 411462_ Each manufactured or modular El dwellin • , service and /or feeder 67.84 � Phone: -1/ ) . L+ . � ( Z Fax:: ( / g 2_ Reconnect only 67.84 mori i 1 e ,a `c a h l • ` � Pump o •irrigation cite! - v a r , (' i`I•,,,,:;, . tA' ' . {.g , ys n, � Si ., 1 ,,. Sign or outline lighting 67,84 Buss l See ,. �''', � f 1t Qrr) p� '' �'f '.'�i. it � t ,ea S'z ,; , +1. I l., . � ',,. ., 1.. ':: "I j,.:. E,1, .. ,, :.. e!; .,,,. `' " "' '' „1 - Signal cireuit(s) or r energy / mess name: L � C' � panel, alteration, or extension, Pa_c 2 ^ Each additional ins, ection over allowable in an of the above Address: , i s A s .100, Additional inspection (1 hr min) M 66,25/ hr ■ City /State/ZIP: t a c) o S OP,_ —Ns ( [ 0 T Investigation (1 hr min) 66.251 hr 1. industrial plant (1 hr min) MIMI ■ P arte: 141) �gj� L--E'2 Fax:�U)�� J -z. Inspections for which no fee is 11.111 t✓ Electrical s.ecifican listed IA hr min 90.00/ hr ( CCB Lie.: � l4- cal Lic. qq - pry. Lic.: /`/� // c ifiYdti ta ">� %li'" o hiii� _ :J � 3 !r `.; t , +i„ {��i {�, �J� „'t;E � 7��sl�trJ,'I Yl11 rr Suprv. Elect' n g 'e, r 'ut'• L�� / / / Subtotal: j - • Plan review (25% of permit fee): Print name: O i t Date: • • • , State surcharge (12% of permit fcc): Illallin n Authorized signature: TOTAL PERMIT PEE: "”' This permit application expires if a permit Is not obtained w, bin 180 Print name: Date: days after it has been accepted as complete. - "' Number of inspections allowed per permit, htnuiieinSPermita \ELC- Pnmitnpp.d 07 /01hp 440.4615T(tl /OS /COMlW6{8 JUN -06 -2011 15 08 LAN TEL SUCS EUGENE 15416884642 P.02 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all 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: Fee 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 ❑ Firc Alarm Installation ❑ I-1VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical C Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations my , uildivrcrmit,n,c- purnitapp.doc 07/01/10 TOTAL P.02