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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2011 -00132 Date Issued: 06/08/2011 TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S101 DC00200 Jurisdiction: Tigard Site address: 13535 SW 72ND AVE 200 Project: Optilink Subdivision: 72ND AVE OFFICE BUILDING Lot: Project Description: Data telecommunications system. Contractor: CHRISTENSON ELECTRIC INC Owner: PNWP LLC #2 111 SW COLUMBIA ST BY PACIFIC NW PROP LTD PTNSP STE 480 PO BOX 2206 PORTLAND, OR 97201 BEAVERTON, OR 97075 PHONE: 503 - 419 -3300 PHONE: FAX: 503 - 419 -3695 FEES Description Date Amount Specifics: Restricted Energy Permit 06/08/2011 $75.00 12% State Surcharge - Electrical 06/08/2011 $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 oft - . - _r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. � R Issued B • /✓ AC/. .0."— s Permittee Signature: •� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sate, 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. JUN -07 -2011 TUE 03:27 PM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01/03 oI ati Electrical Permit Applicon „sc. (: I ISE ONLY d ti i=, �di' � '' Received i Ci of Tigard 6 7 // Permit No,: „. `_ co I _ i3' g Re e ; �wi L / 13125 SW bail Blvd., Tigard, OR 4 t i 7 201i Plan Review ' Phone: 503.639.4171 Fax: 503,59.960 Date/8 : Other Permit: J� (JO , f 16 A K 1) Inspection Line: 503,639 CITY OF TIOAR na ReodyBy Fa See Fuze 2 for lntemet: www.tigard or.gov No t ified/Method: Supplemcntollnformuliun roi l]] roar" r14t;i(�!r"it,1 - a .17 V.7 :rV',7w `:'i. , . .' ....: .., . .. . T+' OP "WORD .l'r ^ .. .., . . . .:PM:AitOS'V'I ' tr' V'.=. r" :" :':i':> " ".b ^a''.,...: -_ n New construction Addition /0.lteration/rcplueement ' 'Masa check all that apply (submit sets of plans w /item;: chocked below): � - i (M Service or feeder 400 amps or more ❑ i3nilding over three stories, ❑ Demolition ❑ Other: where the available fault current ❑Marinas and boatyards. exceeds 10,000 El 1 - find 2-family dwelling TLO Commercial Qj nd ©ACCessory btllId l eas t foe all , or amps at 150 volts d. 14,000 0 or 0 bolding buildings, aue agricultural less to ground, J installations. ❑ b nnrerciagricultural /ages, ❑ Multi-family 13 Master builder ❑ Other: CI Fire pump, ❑ Installation of 75 KVA or JQ13 SITE.XNFORyfdiTION•,'A1V1) LOCATION. ,._____ ❑Emergencysystem. larger:sepuretclyderivedsystem. I: Addition of new motor load of ❑ "A" "F" "1 -2" "1 -3 Job no. Job site address: 100HP or more. occupancy. C1 Six er mare residential units. ❑ Recreational vel.iele parks. City /St /ZIP: ©Health -care facilities, ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: D Project name p.�-1 1 [ ~ Q Service or feeder 600 amps or more. \ ':FEE' SCHEDULE Cross street/directions to job site l a i , Descriptio — ' I Qty. i Fee. I T otal i _ New residential single- or multi- family dwelling unit - Includes attached garage. Subdivision: Lot no,: 1,000 sq. 0. or leas _ 168,54 4 Eu. add'I 500 sq. ft. or portion 33,92 1 Tax map/parcc no.: r ,",,,, ,� Limited energy, residential 75,00 .2 ' a r r ! _ D Or C WORK • (with above sq. !t.) l Limited energy, multi - family j . J � i r ,�, residential (with above Sq. ft.) 75,00 2 � Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 PROPERTY NER• . • ' TENANT • 201 amps to 40 am ps Q' 133.56 2 401 amps to 600 snips 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 /Slate /Z.iP: relocation _ Phone: ( ) Fax; ( ) 200 amps or les 59.36 1 201 amps to 400 amps 125,08 2 Owner installation: This installation is being made on property that I own which is not - 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 extensinn, per panel Owner signature: Date: A. Fee for branch circuits will: 0 .PLICANT . • • CI : CONTACT PERSON above service or £ceder fen, 7,42 2 each branch circuit Business name: B, Fee for branch circuits without �'1�t IL A i service or feeder fee, first 56.18 2 Contact name: branch circuit - Each add'I branch circuit 7.42 2 Address: Miscellaneous service nr feeder not included'` Cit /State /ZIP: Each manufactured or modular 67 2 y dwelling, service and/or feeder Reconnect only 67,84 2 Phone: ( ) Fax: ; ( Pump or irrigation circle 67,84 2 13-mail: - Signor outline lip kiting 67.84 2 CONTIACTOR • r - _ Signal circuit(s) or limited - energy Business nam panel, alteration. or extension. ' Cage 2 2 1L ✓� Each additional inspection over allowable in any of the above Address: `+� 1/ J �� 6 Additional inspec ^ lion (1 hr min) 66,25/ hr -- City /State /ZIP. " 'l / Investigation � ��l))) d il (I hr plant hr / hr i 7 8,18 u induatri¢l plant (1 hr min) 78,18/ hr Phone: 9111„ ) 4 9 Sr Al L 9 Inspections for which no fee is 90.00/ hr � � specifically listed (' /2 hr min) CCB Lie.: t Electrical Lie. / �. Sup. Lie.: I ELECTRICAL PERMIT FEES Suprv, f ecu'ician signature, required: / • Subtotal: . -.y _ . - Plan rev (2S% Of pei'lillt tCC) _ ,, T 'r � qf r.� r.~ i , Print name: . ' Pname: : [ //r te ` 4 r ate � r. , "� State surcharge (12 of permit ;fee); . —+ - •,•— r � '.J�'r V 'fOTAL PERMIT FEE: t (J Authorized signature: This permit application expires if a permit is not obiaine within 180 days after it has been necepteal ns complete. Print name: Date: - -1 '^ 'r Number of inspections allowed per permit. ,r _ I1 Building \Prim,I01.C•PermitApp.dac n7/01/}n rol0 dti 15T(11In5 /Crlt,1 /u�}t (_ sr /9- ` �j''/ 1j°�