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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT �'!, COMMUNITY DEVELOPMENT Permit #: ELR2011 00216 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 11/01/2011 Parcel: 1 S134AA01900 Jurisdiction: Tigard Site address: 10115 SW NIMBUS AVE Project: Nimbus Center Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: B Project Description: Fire alarm Contractor: PROTEC INC Owner: ROBINSON, CONSTANCE A 720 NE FLANDERS ST BY KILLIAN PACIFIC LLC . PORTLAND, OR 97232 -2763 500 EAST BROADWAY, STE 110 VANCOUVER, WA 98660 PHONE 503 - 235 -4000 PHONE: FAX. 503 - 235 -0363 FEES Description Date Amount Specifics: Restricted Energy Permit 10/04/2011 $75 00 12% State Surcharge - Electrical 10/04/2011 $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 N Fire Alarm: Y 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 • 2- 001 -0090 You may obtain a co• direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 Issued By: / /�!j ..„......-- 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. -..‘ . . Electrical Permit Application • _ •. ' FOR.OFFICE USE:ONLY': _ . . , _ City of Tigard c Received Date/By. 11 MiliErliMfAl Permit No 'et4L2/11/..— a -, IN q 13125 SW Hall Blvd , Tigard, OR 9722- ., Plan Review I ' Phone: 503.718.2439 Fax. 503.5'4! Date/B Other Permit T1dARD Inspection Line 503.639 4175 ;,.,-;to r1-%\\ Date Ready/By El See Page 2 for Internet www tigard gov k Notified/Method. BM Supplemental Information ' c; Vkkir =7-14-4tClv-4h,i,*,;,:!1:1 lig.:4-:' aiiit.01 ,,: , 1 4,,,4,;,,,, ,%,,,,, , , - ti, hh.1 t h h - a s . e h „ - „ h„, h4, h h hh h ■ ,... 'w h h ,. El New construction j1 Addition/alteration/Ve ottc)V1 Please check all that apply (submit 2 sets of plans w/items checked below). 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Mannas and boatyards rwill e-iiiii■igiTen==: l`\\\S)\ exceeds 10,000 amps at 150 volts or 0 Floating buildings less to ground, or exceeds 14,000 0 Commercial-use agricultural 0 1- and 2-family dwelling NI Commercial/industrial 0 Accessory building amps for all other installations buildings 0 Multi-family 0 Master builder 0 Other: 0 Fire pump 0 Installation of 75 KVA or D Emergency system larger separately derived system ''' :6tirSi teN iatfo ' iNii - 'Votliid.Si - ` 41: ' :', : )' 8 46(`' ' ,,, ,,,pl .. , ", -,,,,, `"1 A,,.; n 0 Addition of new motor load of 100HP or more occupancy Job no.: Job site address: 0 G 1,,\ ( Ave.- o Six or more residential units 0 Recreational vehicle parks El Health-care facilities 0 Supply voltage for more than City/State/ZIP: —r-\ 0 1- 2 _ 9 - 72z 3 ) 0 Hazardous locations 600 volts nominal Suite/bldg./apt. no.: Project name: ki re ,..„ , kx 0 ,,,„ ce ...o kic Service or feeder 600 amps or more 4. ' Cross street/directions to job site: Description I Qty. I Fee, 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 §i_Yii_i5,5010:1#7, Pli, 1Z21,-4., c'tii■ilvf51''V4217-,-',;_al,„ (with above sq ft ) Limited energy, multi-family 75 00 2 kr)jk--c.,\\ lk- reAcLin *c7 fvvot r ef:.M- 6\ --RYE residential (with above sq ft ) Services or feeders installation, alteration, and/or relocation 4 \ a op,- p i e..-A, - 200 amps or less 100 70 2 $r., iltiliWg11 201 amps to 400 amps 133 56 2 401 amps to 600 amps 200 34 2 Name: F a ge-C\le- - Ow n.0_4 '.e___+z::. 601 amps to 1,000 amps 301 04 2 Address: < 5 -- (y I S C Couiiw 8 14_ c a A k '7! , ,2 t-/ p Over 1,000 amps or volts 552 26 2 • Temporary services or feeders installation, alteration, and/or City/State/ZIP: Va c p v. Qr t ,.... y ek. q Y6 tp / relocation / Phone: (g( L ets _36, iici 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 1 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 FiciaNcyn RNioik,,Nv ,.% : =-,'Nf;',Iitietislileffas 7)-"Stl above service or feeder fee, 7 42 2 each branch circuit Business name: ii ke I I (.., • B Fee for branch circuits without service or feeder fee, first 56 18 2 Contact name: ri Tv , K--A-5 branch circuit Each add'l branch circuit 7 42 2 Address: ' - 7 N c F D CIP--- Miscellaneous (service or feeder not included) City/State/ZIP: fo e-19-1 0 1 a g— e t 7 2-3 • Each manufactured or modular dwelling, service and/or feeder 67 84 2 T Phone: (S03 ) ).. S7-- C/000 Fax: : (1 -- i 3S--o3ce Reconnect only 67 84 2 Pump or irrigation circle 67 84 2 E-mail: Sign or outline lighting 67 84 2 fin-V:,:r7 :,:q Signal circuit(s) or limited-energy 71.5. 1 C 2 Business name: eo ( . panel, alteration, or extension Page 2 ,, c... i Each additional inspection over allowable in any of the above Address: 1 70 pC.-; f' 4. 5 Additional inspection (1 hr min) 66.25/ hr City/State/ZIP: R Investigation (1 hr min) 66 25/ hr 9(2. 0 e._ q 2-3 - 2- 1 Industrial plant (1 hr mm) 7818/hr Phone: (5?1. ) 7,2 5 cfc90c) Fax: ( Inspections for which no fee is specifically listed CA hr min) 90.00/ hr CCB Lic.: STSlit Electrical Lic.: ii-zi5a-t Suprv. Lic.:A92?zzAt 114F,, - ::--: - .;:,---,----,..roitx- - ;-1 - twxistomer,FEtsxr4T , Ater?, ,,, ,: _ , Subtotal - 7,5 - , 00 Suprv. Electricial alre, required: - ■•.,..-.- Plan review (25% of permit fee). Print name: e ‘ ,/.. . sok? Date: /0 ,3 -// State surcharge (12% of permit fee): ° I • 0 0 TOTAL PERMIT FEE L. ©© Authorized signature: '_...........-.----------,' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 6-0 .3,,, 5-t4_5 Date: /07VA * Number of inspections allowed per permit I \BuildIng \Permits \ELC-PermaApp doe 07/01/10 440-4615T(11/05/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: F RESIDE TAI: s Y Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: .. `, QMIV MIWWOAT ON=T✓Y '" Fee for each commercial ,"/1�Lj �• system �� (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I \Buildmg\Permits\ELC- PermitApp doc 07/01/10