Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00198
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/23/2011
Parcel: 25101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Project: University of Phoenix Subdivision: Lot:
Project Description: Low voltage for data, install (22) data drops.
Contractor: IES COMMERCIAL INC Owner: GK TRIANGLE CORPORATE PARK III L
16135 SW 74TH AVE BY THOMSON REUTERS INC
TIGARD, OR 97224 ATTN: MEGAN DOWLING
PO BOX 130174
CARLSBAD, CA 92013
PHONE: 503 - 648 -1900 PHONE:
FAX: 503 - 670 -9572
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/23/2011 $75.00
12% State Surcharge - Electrical 08/23/2011 $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 a ■ • - h 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. AT ' TION: Oregon - requires you to follow the rules adopted by the Oregon Utility Not -t'• - enter. Those rules Care set forth in OAR
952- 001 -'0010 through OAR 952 -00 -r r. Y• may obtain a copy of the rules or direct questions to OUNC : callin. .1987 or 1.800.33 .2344.
irjr
Issue. ;y: � Permittee Sig ,lure: /
% 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 INSTALLATI N 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.
r -k nit C;t
08/23/2011 10 :27 5036709 ' NEW TECH ELECTRIC PAGE 01/03
Electrical Permit Application V FOR OFFICE USE ONLY
City of Tigard A UG 2 3 2011 Received q
y . 2.5 ii, ! Permit No.: tkie dal - 1Q;
Q - "� 13125 SW ITalt Blvd., Tigard, OR 9� }� r D n
Phone: 503.718.2439 Fax: 503.5: -81 60 � r �!"a �+iQ Dmem Other Permit::
"T I GA I'; I) Inspection Line; 503,639.4175 BUILDING DIVISION Dntc Ready /By; ,4iris: la See Page 2 fur
Internet; www,tigtrd- ar,gov _Notified/Method: Supplemental infnrmntioa
,. woRrc! x ilw
' Please chock n1 11,at ripply `,:.:.1' � n N� iz r- f ....... • , ... „ ... ,. .. ,. _.., ....,.
❑ y New constntction E Addition /alt eration /re all (- plans w /itcros below):
L 1 Demolition Service or feeder 40D amps or more 0 Building over three stories.
Other:
:.. r current ❑ Marinas and boatyards,
• , where the available current t
'! 0 GoRV nr CONSTRUCTiION . exceeds 10,000 01111 at 150 volts or ❑ flouting buildings.
coo to ground, or exceeds 14,000 ❑ Commercial -uoo agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps Far all other installations, buildings.
❑ Multi - family 0 Master builder ❑ Other; ❑Fire pump, tl Installation of7S KVA or
`,; ::. JO .. ` .. 1 N 1'O X/ T IO N ' .. A fl .A ;TIO N system
....... • rmcrl;cnc systcm larger separately derived s st
,, ❑ Addition of.ncw motor load of Q "A ", "T^" - '1-7" "1 -3
Job'no.; 63748 Job site address: 13221 SW 68 Parkway 100Tir or mom. occupancy.
❑ Six or more residential units, 1:1 Recreational vehicle parks.
City /State/ZiP: Tigard OR 97223 ❑Hcsltlt -care facilities, Ll Supply voltage for more than
17i-lazarrlcros locutions, 600 volts nominal.
Suite/bidg. /apt. no,: 500 Project name: University of Phoenix 0 Service eor feeder 600 amps or mom,
Cross street/directions to job site: 1r>LE SCIaT1;1fjCJ"S;`
Dhscrinllnn I Q ty rch. I T_ I
New residential single- or mutt-family dwelling unit.
" - Includes attached garage,
Subdivision: 1 1 of no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: 1 Ea, add'l 500 sq. ft or portion 33.92 I
residential •
,:..... ...:, O
E9CItI)'T ' , Limited energy,
0 2
^ .
install ��. .... ,.,;....
(with above sq. ft,)
Limited energy, multi flimily 75 00 2
data drops residential (with above sq t.,l
- _Services or feeders instal alteration, and /or relocation -
;, - 200 amps or less 100.70 2
Q .: RO
PPF:1i:'e OWNEx? . 1. 'CCNANT . ' .. 201 amps to 400 amps 133,56 2
Name: 401 amps to 600 amps 200.34 2
. .. 601 amps to 1,000 amps 301,04 2
Address; Over 1,000 amps or volts 552.26 2
Temporary cmperary services or feeders installation, alteration, and/or
relocation
Phone: 200 amps or less
( ) Fax: ( ) P 59,36 1
201 amps to 400 amps 125,08 2
Owner installation: This installation is being made on property that T own, which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 snips 168,54 2
Branch circuits — stew, alteration, or extension per panel
Owner signature: Date: - _ A. Pee for branch circuits with
�] A PPiL)� i::::,',: ; ',`: above service or feeder fcc,
C4N.
T�ICT P CRS OIV
...:. ... : ,,,
each branch circuit 7.42 2
Business name: a, Fee rot branch circuits without
service or feeder fee, first 5618 2
Contact name: Jorge Algeciras branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP; Each manufbcturcd or modular
dwelling, service and /or feeder 67.84 2
Phone; (503) 648 -1900 I � Fax :: (503) 670-9572 Reconnect only �_ 67,84 2
�W
E - mail; - - Pu mp or irrigat cir cle 67.84 2
1CO1Y71tACTCfkt 67,84 2
.,,,,, Sigh or outline lighting , _
Signal circuit(s) or limited-energ
Business name: IBS COMMERCIAL, INC. panel, alteration, Or extension, 1 Page 2 __ - 2
Each Additional inspection over allowable in any of the above
Address: 16135 SW 74" AVE Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: TIGARA, OR 97224 Investigation (I hr rein) 66.25/ hr
industrial plant (I hr min) 78.18/ hr
Phone: (503) 648 - 1900 Fax: (503) 670 -9572 inspections for which no fee in
—
t specifically listed a hr min 90,00/ hr
CCB Lie.: 182452 Electrical Lie.: 0448 AI I Suprv. Lie,: 4911S p _ --. '..: ,. , .Er FC't"1iYCAL" zTxnItr "11'.E'rS'::': :,',;;;','.::...
Suprv. Electrician signature, required: i Subtotal: 75.00
err.. Plan review (25% of permit fcc):
Print name: COREY J3AYSINOER / / / Date: 08- 22 -11 State surcharge (12% of permit fee): 9.00
Authorized signattp'c: TOTAL PERMIT P1=13; 84.00
t
This permit application expires if a permit L9 not obtained within 180
Print name: Date: days after it has been accepted na complete, %f //
'" Number of inapectfons nliewed per permit.
1: 113vlldIng \PCnnitsmIILC c7 /n1h0 440-16151(17/05 /COMlwpa
08/23/2011 10:27 5036709572 NEW TECH ELECTRIC PAGE 02/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
•
>: SIlO!.>E TIIE W
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
❑ Garage Door Opener*
. ❑ heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
Fee for ge i commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
El Data Telecommunication Installation
❑ rite Alarm Instal.la.tion
n IIVAC
❑ Instrumentation
❑ Intercom and Paging Systems
Landscape Irrigation Control*
❑
Medical
❑ Nurse Calls
Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total, number of commercial systems: 1
*No licenses are required. Licenses are required
for all other, installations
T9 TiuildinE gertnita1Ett-rermitApp.doa m7 /tn