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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 11111 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00183 TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2011 Ii Parcel: 25101 DB00104 Jurisdiction: Tigard Site address: 7300 SW HUNZIKER RD 200 Project: MD's Subdivision: Lot: Project Description: Audio system. Contractor: A C & E ELECTRIC Owner: HILLTOP BUSINESS CENTER LLC 3535 DEL WEBB AVE #100 HUNZIKER LLC SALEM, OR 97303 9430 NW KAISER RD PORTLAND, OR 97231 PHONE: 503 - 363 -2301 PHONE: FAX: 503 - 363 -2302 FEES Description Date Amount Specifics: Restricted Energy Permit 08/02/2011 $75.00 12% State Surcharge - Electrical 08/02/2011 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: Y Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N 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 ob - .. • .f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. l Issued B • / _� _ 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. 08/01/2011 14:58 5034850586 raj .� n AC &E ELECTRIC PAGE 01/03 Electrical Permit Application f " � II Li FOR OFFICE USE,' ON IX City of Hall a 0 1 zoii n�ieB ° `` , /� � � • P m]itNo.: o� r . Review 13125 SW Hal Dlvd., Tigard, OR 97223 Plan Ri tvJ6� I N _ Phone: 503.718.2x39 Pax; 50 3.548.19601 AUG - � ! Da[c/B ; Other Permit! / � —00 1 '16 p OF TIGA ? Date Jespcction 503,639,4175 BUILDING 1 i /IIy; All* Sea Page 2for Internet: www.tigard- or"gov L LDING DIVIISION! Noti6cdMtetho41: 9 r r Supplemental information "- ",y�,��y,� ,wv����!ny[ ^�r)�( Y 'al�� M1: ;rile .Y�i- J" Ic. - �ir�h r �. r' ;�u .r'_.nu1:y.� ♦.�� f +.y.�iy.K " ��•�'r41 :4c4: -t , I • ..:, y _' y .G 1[ WA•" ♦V alt "IP;11�1 . V� +i '�i' ���'.C' '' 1 1 a �i w l -"; Nl1 1 #A y ' LtAr,'.P,r.^,. 1 Y • I �' - 1 ,z;;,r,1� „ o- a,X1 wry ±•s ■ f�. ,?�`!.`+, .x. " -,� '�+�d"'` ❑ New construction F;, Addition/alteration/replacement Please check all that apply (submit 3 sell Of plena w /items chocked below): ❑ Serviee or feeder 400 amp or more ❑ Building over three stories. ❑ Demolition © Other: where the available fault current d Marinas and boatyards. .• r, / t. '6 I " "a � , + , e` " "'];= t'aB I, • : ' , i exceeds 10,000 150 volts or a�;:, . - ...'.:_ ,• �'``�1td: ":"':� t,Ct,. '�'��R+ .' lti ;C '�SI�S > ;' , 1 , ,fi•'�: ;' v. or exceeds 14 amps Floating buildings. � toss to ground, o Commercial-usc agricultural -� •, ;'%, .:� ,..,, �...,.' ... „t .. .�,..,; t- �<.:',.,.'i�`: " , '. i�°'{rF ;':.���'"' : OA © is a 'auld 1- and 2- family dwelling IN Commercial /industrial ❑ Accessory building amps for all other installations, buildings. a Multi - family ❑ Master builder ❑ Other: p1 p. Installation 75 s,,�g� ❑ Firc pulp. I n n n of KVA or d;;. :u±ln > ' ^tl ",)t. ' A °'17 1 "F' 'bbl T� ":I' ' r , ° Emergency system, larger separately derived system ?, .' � l� Y- +�. �,.��rv -,��„ , , �,' ; 4r'��a,1. ;;.; � i:. ❑ Addition of new motor load of ❑ "A 'H , „ 1 -2 ' ^, �;,5'P+• �. 'a � ,. , em.;, 9'; BMt;7''��`'' � Job n0 Job site address. '73 c 10014:P or more, R c r eatio n — u_Y17 , s ., -_ _ 0 Six or more residential units. Q Recreatlanal vehicle parks, City /State /ZIP: .. t Q ��-�d (r�� q } r ❑Jicalth -earc facilities, ❑ Supply voltage for more than y_ , I�f-23( Cl J•iaxardous locations. • 600 volts nominal. Suite/bldg. /apt. no.: AO p Project name: ),AV I L ( ❑ Srs oe M feeder 600 amps or more. i ,�'.tl1 5ailw1 rA:� A1�V"..•�• r S Ar.'�'nV' ,. W�ei4n��t...l�� ��1� i, '' s I'�.�' '�>d,�JLE "' i�' "l ,fir. a', :� Cross street/directions to job site: Description ) Fm . To New residential single or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq, ft. or teas 168.54 4 Ea. add '1 500 sq. ft, or portion 33,92 1 Tax map /parcel no.: Limited energy. residential n' - ,. W °, 'i'r` M, "' �i c il'r;fa. (with q, 75.00 2 ',"rt ti°�"' ziT ,,,,,,Ti: ' ' �' tr^. L: it^' �l�T��R� "�")<;'�'!l+ +• ° ' " "f, ; ; ;w;� ; , � � x, i ?", ( above s R Limited energy, malts- ftmily residential with above sq. ft.) 75,00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 100,70 2 'm:...r .Ar::' ,.,a, _ - - j,� `>1?$i;(�''''. 'aC'1 ' ' .: '} a s:.''.,.. °m a✓',`Iiar�Aff' 201 amps to 400 amps 133.56 2 f ' P PIIAS I`r t�F, ` ., °�" 'F� wr sv PI! .' T�E " '> 1• 200.34 2 Name: 40l amps to 600 ramps . . _ 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: ( ) I Pax: ( ) 200 amps or lass 59.36 I Owner instaTlAtion: 'This installation is being made on property that T own which is not 201 amps to 400 amps 1 54 2 intended for sale, lea 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 iel Owner signature: Date: A. Fee for branch circuits with i r' ...�.i...., ",.,, . , .� iu n ( above service or feed fee, 7,42 2 • ^ ° " C1�PIr9f(;N. i' , i ` ' :. 1: „I ' , x dr4 f !;?C , k;ttS: ' �� . '� ,- �'�L'a each branch circuit Business [lame: B. Fen for branch cireuils without . . . service or feeder fee, first 56,18 2 Contact name: branch circ _ _,, - Each add branch circuit 7.42 2 Address; miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67,84 2 y dwelling, service and /or feeder Phone: ( ) I Fax: ; ( ) Reconnect only 67.84 2 Pump or irrigation circle 67,84 2 E - mail: 67.8 Sign or outline lighting 67.84 2 "', x ", a . ;,• i+ • '� '" . `t . l 0 " t :Ti '� r i i M , t ; `J`1 , : 1 w ` % `,' ' '° V S eircuit(s) or limited - energy _ Business name: IN�,r L. c panel, alteration, or s extension, Page a n 3 _ _Each additi inspection over nitnwable in any of the above Address: 3 s ,t, Ll'p.,1ob { � S I u Additional inspection 0 hr min) I 66,25/ hr v Invesligation (1 hr min) 66.25/ hr City / State/ZIP: Q p ( Jndu.strial plant (1 hr min) 78,18/ hr Phone: (.5 1 (03 .x'30 t Fax: (503) 5G3 3QD-. inspections for which no fee is 90.00/ hr specifically listed CA hr min) CCB Lie,: s� k Electrical Lie,: 2%4,1 , j Suprv. Lie.: 531 i 5 / '':, ,,,i- r:7 :i:, lan ,,E , • k Tr: i " ,fs 1 , N r'.' . Suprv. Electrician signature, required: Su it ft `7 . Plan review (25% of permit ice): W Print name: e Date: + - I ( State surcharge (12% of permit fee): 9 , °C ' • " n� � TOTAL PERMIT PEE: 4' 84 . 330 Authorized signature: This permit application expires if a permit is not obtained within 180 clays after it has been accepted as complete. Print name: Date: a Number of inspections allowed par permit. I: \liuihlitiR \Permits \ELOPamlitAUD.4Ina 07 /01 /I 40- 4(i1ST(11/05 /COMfW61S 08/01/2011 14:58 5034850586 AC &E ELECTRIC PAGE 02/03 Electrical Permit Application - City of Tigard for all other installations Page 2 Supplemental Information LIMITED ENERGY PERMIT FEES: «�.'� .;�.. : r P7 F . iC'F: Ia1'«nlf Pee for all residential systems $75.00 combined Check Type of Work Involved_ ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener" ❑ Heating, Ventilation and Air Conditioning System's Vacuum Systems* ❑ Other: Fee - for each commercial $75.00 system (SEE OAR 918 - 509 - 0000) Check Type of Work Involved: 0 , Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ F ire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems I I L andscape Irrigation Control" ❑ Medical ❑ Nurse Calls ❑ O utdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: "No licenses are required. Licenses are required 0; 0u11dir earmita151,C- PcrmitApp.doc 07/01/10