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HomeMy WebLinkAboutPermit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 111 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00226 Date Issued: 10/21/2011 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Parcel: 2S101 BC00201 Jurisdiction: Tigard Site address: 8255 SW HUNZIKER RD 103 Project: RGIS Subdivision: Lot: Project Description: Data telecommunications system. Contractor: CASCADE UTILITIES INC Owner: JOHANSON TRANSPORTATION SERVICE PO BOX 189 5583 E OLIVE AVE ESTACADA, OR 97023 FRESNO, CA 93727 PHONE: 503 - 630 -8985 PHONE FAX: 503 - 630 -6638 FEES Description Date Amount Specifics: Restricted Energy Permit 10/21/2011 $75 00 12% State Surcharge - Electrical 10/21/2011 $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 Cod- i 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 issu- - or if work is suspen d for more the 180 days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio Thy— rules re et 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 50 =17 or 1 01.332 23 Issued By _ 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. e'Air;) , Electrical Permit Application F R FFI ;e S N ° °� O OFFICE USE ONLY • City of Tigard - '�� Rece Permit No . — ° 13125 SW Hall Blvd. Tigard, OR 97 2 � r P_h,n Revie j' �� Ph 503.718.2439. Fa 503 59811 .` 'V �Q• • CCr) Other Permit: T 1 G A R D inspection Line: 503.639.4175 O� (''`�., ,�� t Date Ready/By. - • kris Fa See Page 2 for Internet: www.tigard- or.gov •O �. Notified/Method: � Supplemental Information a0 a�� -- TYPE OF WORK (j !` PLAN REVIEW ❑ New construction % Addition /alteration/repla Please check all that apply (submit 2 sets of plans w /items checked below) 0 Service or feeder 400 amps or'more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current : ❑ Marinas and boatyards ' , ' CATEGORY OF CONSTRUCTION - exceeds 10,000 amps at 150 volts or El Floating buildings. ' less to ground, or exceeds 14,000 , ❑ Commercial -use agncultui'al ❑ 1- and 2- family dwelling I'Commercial/industrial ❑ Accessory building amps for aft other installations buildings ❑ Multi - family ' ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. - - s larger separately derived system ❑ Addition of new motor load of , , ❑ "A ", "E ", "1 - ", "1 Job no.: Job site address: 2_ 9 1 OOHP or more occupancy. v� �/U• 1 �� �W ❑ Six or more residential units ❑ Recreational vehicle parks. City/State /ZIP 1)(K 101 , 7 I t 4. • � 7' '❑ Health -care facilities. • ❑ Supply voltage for more than' [ ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: /0 L./ Project name: ' S ❑ Service or feeder 600 amps or more ( FEE SCHEDULE ' Cross street/directions to job site: Description ' I Fe e. Qty. I I - Total I .* New residential single- or multi - family dwelling unit. • - 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 • (with above sq. ft.) - f � . - Limited energy, multi- family 7500' 2 Q a * 7 �/CC(//YwYA/1/i '. 7N ` n Ple r residential (with above sq ft ) y ' Services or feeders installation, alteration, and /or relocation ' 200 amps or less 100 70 , 2 - ❑ PROPERTY OWNER , • • t / _ TENANT 201 amps to 400 amps - 133.56 2 Name: iG f _s- . 401 amps [0 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: ' stAi //u h z` / j . ' Oser 1,000 amps or volts 552 26 2 ' 1 ! - Temporary services or feeders installation; alteration, and /or , , City/State /ZIP :5 u f ' e—( y_ 7f Lard ©2 g7zz 3 • , relocation 3 Q /_ s I d ax: (/ ,,, 3) 352_3 / _ • 200 amps or less 59 36 1 Phone: ( p r 4C7 - �✓ . 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 extension, per panel - , Owner signature:. . ' ' Date: ' • A Fee for branch circuits with . ` ', ' . APPIcICANT ' I CONTACT PERSON each branch circuit above service or feeder fee, 7 42 2 ✓ ✓ ✓ ✓ ✓ ✓����`` c .' Fee fo branch circuits with • Business name: - service or feeder fee, first • 56 18 2 • Contact name: v y branch circuit Each add'I branch circuit 7.42 2 • Address: ' O .( A w 6 reel. (a Y • Miscellaneous (service or feeder not included) City/State /ZIP: LS � � 7o Z dwelling, service and/or feeder , 67 84 2 'Phone: 19 (3o .g3J � Fax:: , 630 663 Each manufactured or modular Reconnect only 67.84 2 t! Pump or irrigation circle 67.84 • 2 • E -mail: 'Sign or outline lighting 67.84 2 CONTRA TOR Signal circuit(s) or limited - energy 1 panel, alteration, or extension Page 2 0 D ; 2 ' Business na e: ���n - Each additional inspection over allowable in any of the abov Address: -,r/ 1' re a Additional inspection (1 hr min) 66 25/ hr City/State /ZIP: S / a P ( 7 1 � J _ , Investigation (1 hr min) , - 66 25/ hr �' �/ Industrial plant (1 hr min) , 78 18/ hr ' Phone: 0 ) 6'' 0 ax :49 ) , ti , ' Inspections for which no fee is 90 00/ hr specifically listed (/3 hr mm) - CCB Lic ::�Z M � Suprv. Lie. i ' . , ELECTRICAL PERMIT FEES 0 i ri Suprv. Electrici. I si _n . tire required: — �� : �f � / , 1" t l Subtotal: • Soo Plan review (25% of permit fee) Print name: 'K hp � : Date: AD 2 ( --'' State surcharge (12% of permit fee) I (JV, /� {'- t TOTAL PERMIT FEE: � �( (� Authorized si g n / / / ' ;, 1 - This permit application expires if a permit is not obtained thin 180 • Print name: ` �,�, t) Date: / /Z� f l days o has been accepted as complete; !/ Number of inspectibons ns a llowed per permit ' I \Building \Permits \ELC- PermitApp doe 07/01/10 440- 4615T( /05 /COM/WEB ■ , I - -\ 1 • Electrical Permit Application - City of Tigard • - ' . - - - . Page '2 - Supplemental Information . , . - , - LIMITED ENERGY PERMIT FEES: -- . ESIDENTIALWORK ONLY: ' , ' . - R , , Fee for all residential systems combined .. $75.00 - ' - Check Type•of Work Involved: , , . . - "111 Audio and Stereo Systems *' - . - , • ' ❑ Burglar Alarm - • - - ❑ Garage Door Opener* , ❑ Heating, Ventilation and Air Conditioning System* s ' — '• . n Vacuum System's' ystems* ' ' • - 0 Other: ' • - , COMMERCIALVORB °ONLYY:_ ' • ` - Fee for each commercial $75.00 - . ' , ' system ., - , - (SEE OAR 918- 309 -0000) ' _ ' . - • - " • - , Check Type of'Work Involved: - . El - Audio and Stereo Systems ' '' - • ❑ Boiler Controls , • • - . - ❑ Clock Systems . . . t - • -, ' , Data Telecommunication Installation - - ; n Fire Alarm Installation • • - - . - ' ❑ .HVAC - ' ❑ Instrumentation _ _ ' El Intercom and Paging Systems - • ', ❑ Landscape Irrigation Control* • - ' • - Q Medical - , . , El Nu rse Calls 5 El Outdoor Landscape Lighting* _ ' ❑ Protective Signaling - - - • " . - n Other - . - ` Total number of commercial systems: :(1. , , , _ • . *No licenses are required. Licenses are required - - for all other installations - - • • I \Building\Permits\ELC- PermnApp doc 07/01/10 , • - ,