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Permit ap : CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00356 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/28/2011 Parcel: 25101 DD01100 Jurisdiction: Tigard Site address: 7051 SW SANDBURG ST Project: Tech Center Business Park Subdivision: A B + E OR LEEK Lot: Project Description: (1) branch circuit for fire alarm panel in electrical room. Contractor: PHOENIX ELECTRIC CO Owner: SUMMIT PROPERTIES INC PO BOX 14037 5550 SW MACADAM AVE, SUITE 205 PORTLAND, OR 97293 PORTLAND, OR 97239 PHONE: 503 - 231 -8006 PHONE: FAX: 503 - 235 -4300 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 06/28/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/28/2011 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 suspende 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 95 - 001 -0090. You may obtain - • • r e rules • = = • uestions to OUNC by calling 503.232.1987 .800.332.23 Issued By: f ' _� Perm ittee Signature: (/1 i OWNER INSTALLATION ONLY U 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 �c FOR OFFICE USE ONLY . , Received • City of Tigard 6,0 ` DateB : 0 M- Permit No.: /' a 13125 S W Hall Blvd., Ti ard O R 9722 g Pl R ev i ew _ Phone: 503.718.2439 Fax: 503.59.- ,," , ,t �Q Date/By: Other Permit: TIGARD Inspection Line: 503.639 9 Date ' adyBy: tur s: ®See Page 2 for Internet: www.tigard-or.gov \O � ,C? r .,,N, , , >i Method: 40 Supplemental Information r / TYPE OF_ WORK:- . , -- o i rr .. , e .PLAN REVIEW ❑ New construction H. u addition /alterationhdliceT [ ✓ Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: `_�,�� ❑ wherecthe feeder current ❑Marinas and boatyards. ,- CATE OF CONSTRUCTION ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 El Commercial-use agricultural 1:1 1 -and 2-family dwelling Commercial /industrial ❑Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A" "E" "I -2" "I -3" Job no.: / Job site address' s� �'. 1 y 100HP or more. occupancy. �..t JW S V Q I I. ❑ Six or more residential units. ❑ Recreational vehicle parks. Ci ty /State /ZIP: Ap.,. •' 1;1? ❑ Healthcare facilities. El Supply voltage for more than J l 0�p c- - O ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: , , i - ❑ Service or feeder 600 amps or more. ] � 1- Des cri ption FEE S CHEDULE ' Cross street/directions to job site: : - er-1 � Ce YJ isr -s I Qty I Fee. I Total I / New residential single- or multi- family dwelling unit. V( x, . Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ;, - 'DESCRIPTION` ;OF, WORK - -` 4'' (with above sq. ft.) Limited energy, multi - family 75.00 2 X % f : , u D 6,</sr/Air, / V KhzgleYI AeLL residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation IG /g Figg , CilfR., �J, fi amps or less 100.70 2 ❑ . PROPERTY OWNER ®TENANT i 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 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 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 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with above service or feeder fee, APPLICANT x . NT la CONTA'CT . ` ,w 7.42 2 . each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first / 56.18 S4 r i y 2 Contact name: branch circuit Each add', branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 _ , _ . ,CONTRACTOR, . , . Signal circuit(s) or limited- energy panel, alteration, or extension. Page 2 2 Business name: c f cnei e— Each additional inspection over allowable in any of the above Address: ,e7 r `,¢b 7 Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: y �. i P4- 97x9.3 Investigation (t (1 mm) 66.25/ hr Industrial plant (1 hr min) 78.181 hr Phone: (5 1,23 _ i Fax: (� ) � ©O Inspections for which no fee is 90,00/ hr n �, specifically listed (V2 hr min) CCB Lie.: r4t� 1 75 Electrical Lie.: l Q I Suprv. Lie.: S7 OS , °ELECTRICAL'PERMIT 'FEES,. Suprv. Electrician' •. a required: 7'it f u HI) o Subtotal: SZ . IS' / g 44� Plan review (25% of permit fee): / Print name: n r G Date: . ?- / r State surcharge (12% of permit fee): 6 ` i [[ TOTAL PERMIT FEE: 6?_,a) Authorized signatur • • / 4 / This permit application expires if a permit is not obtained within 150 � d ays after it has been accepted as complete. Print name: '1 Date: a ��� s Number of inspections allowed per permit. C\Building\Permits\ELC- PermitApp.doc 07/01/10 440 -4615T( I 1/05/COM/WEB