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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 11 . COMMUNITY DEVELOPMENT Permit #: ELR2009 -00092 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2009 Parcel: 2S102DA00401 Jurisdiction: Tigard Site address: 13125 SW HALL BLVD CITY HALL Subdivision: — Lot: 0 Project: City of Tigard -Town Hall Project Description: Install data cabling. Job No. 73454 Owner: FEES TIGARD, CITY OF Description Date Amount 13125 SW HALL BLVD Restricted Energy Permit 03/19/2009 $75.00 TIGARD, OR 97223 12% State Surcharge - Restricted Energy 03/19/2009 $9.00 PHONE: Contractor: E C COMPANY PO BOX 10286 PORTLAND, OR 97296 PHONE: 503 - 224 -3511 FAX: 503 - 295 -3512 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: Boiler Controls: CCTV: Clock Systems: Data & Telecommunications: Y Fire Alarm: HVAC: Instrumentation: Total $84.00 Intercom /Paging: Landscape /Irrigation: Required Items and Reports (Conditions) Landscape Lighting: Medical: Nurse Calls: Protective Signal: Security Alarm: Other: Other Desc: 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 • • •N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0r 0 through OAR •52 ■01 -0100. ou may obtain a copy of the rules or direct questions to OUNC by calling 50 6699 or 1.800.332 23 . • • Issued ' , ' _ 4 . _ . 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'N Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. . • . 'li' pia r • 18. 2000 1 : 44PM RECEIVED No. 4265 P . 1 Electrical Permit Application FOR S MAR 10 ZOO City of Tigard Received I / P p q Permit No D i * 13125 SW Hall Blvd.,, Tigar Fax Ole 503.5 9722 4 ( — per) l . Phone: 503,639.4171 9ft.1 �� p v Other Permit; inspection line: 503.639.4175 BUILDING DWISIOI dy y ®See Pag fur Tic; Ar. Natefew /th - _. June: / . pp Internet: www.tigard -0r.gnv Notitiedltvtcthod: SIi lementirt 2 lnrormatioa :.,,..,. • . - ...::: ',:....:..: ... , ,.. ... 01 :',,;::'•: '' , ..• '. . ❑ New construction ® Please check ail that iat apply (submit it sets of plans w /items checked below) ❑ Demolition E3 Other: 0 Service or feeder 400 amps or more ❑ Building over three stories. 1 .,,.. - .... t . on where ❑ Mammas and boatyards. ere I} a available fault CUnenl ■ '.. „ c.ATEGOR'i OF.XQNSTR (; 0Q1Y,, <,j' ': exceeds 10.000 amps et 150 volts or ❑ :''' Floatin buildin "' ' `'' " 1 `' less to ground, or cxerTils 14,000 1- a 2 dwellim 8 [] Com ings. -usr agricaltiml ❑ y g � Cotnntcn;ial/industrial �[� Accessory building amps fura}Ivthcrinatallations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑Firt pump. ❑installation of 75 KVA or i.i " l J k;tnergencY system, larger separately derived system. ; ;', : JI.0; TE�INFORMATII N, - t eP y Ya .' ' „- ❑ Addition of new motor load of ❑ "A» °`E" « l -2» '1-3" Job no.: 73454 lob site address: 13125 SW Hall Blvd I IOOHP Of more. occupancy. ❑ - Six or more residential units. ❑ fteCresiw sal vehicle parks. City/StateJZIP: Tigard, OR 97223 ❑ Healthcarc facilities. ❑ Supply voltage for more than 0 600 volts nominal. Hazardous ous oc- S uite/bldg. /apt. no.: p rirn Project. name: / Town Hall ❑ Service or feeder 600 amps or more j S : : -- Cross street /directions to job silo: `.n ; , .. 'FEE; ',�i:.: : :: ;:: :r" . Dean • ;on �!iaiu®mitim■0 1 single- New residential multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 'fax map /parcel no.: addl 500 or rim 1 .. -• :. .:,, .�. +:i::�l..�., : � ', : �.'.' .,.r:.., portion „, .. .. , . , ... , - ''DE .CR.17UNa,OT;;.►rpR:.. ; ;1.. { 7 , 0 y • Limited energy, multi-family Install voice & Data Cabling r`<;:';?'.. . . 75.00 © s or feeders r in and/or r r 200 amps or less 80.30 2 _r r.'.®':'1PRCaPg10*O E iV ?.(, in: �,JC ' v "" 's Name: City of l'igard - 401 amps to 600 amps 160.60 601 amps to 1,000 amps 240.60 2 Address: 13125 SW Hall Blvd Over all amps or City /State/ZIP: Tigard, OR 97223 Temporary serviCeS r installation, alteration, and/or I relocation • Phone: (503)372 -7459 [ Fax: ( ) 200 amps or loss M 66.85 _ I Owner installation: This installation is being made on property that 1 own which is not 201 amps la 400 tamps 100.30 2 bei intended for sale, lease, rem, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 1 Owner signature: Date: Branch circuits - new, alteration, or extensio cr anti ' ;:. , }, :. _ branch circuits w ith A Fee for brand l AP ,.. \. 41.',`x.1 .�'r;�4 i::.I :� :%• .: \�v i::1�.' l \,11. !( ".:..,.. ,.,...:, . . ..... ..... ... . _ . ' . ,- .:�- ,.�.., ACT > ,`k'�'N:, ; Y; above scrvico orfccdcr fcc. Business name: EC Company 6.65 each branch circui 2 1 -. Pany 8, Pee ibr branch circuits Contact name: Gary Cawley �.�.. -. without service or feeder fee, 46.85 2 4 - _ first branch Circuit • Address: 2121 NW Thurman st Poch add'l branch circuit 6.65 2 —.,- """ Miscellaneous service or feeder not included City /State /ZIP: Portland, OR 97210 Each manufactured or modular 2 1 • t • t Phone: (503) 220 -5319 dwelling, service and /or feeder ( ) Fax: (503) 224 3480 Reconnect only 66.85 2 E -mail: garle@o -c e.eem •.K0,1•}�� .. t S nry, Pump or irrigation circle 53.40 2 _ . : •., ,, - R.._,y... -,., . , . .i;i:M Sign or outline nigh Business name: EC Company Si tat eircuit(s) or limited I co - energy patleI, alteration or j Address: PO Box 10286 extension, Describe: " 2 j Data Telecom _ Cit /State /ZIP: Portland, OR 97296 p " Y Each additional inspection over allowable In a r of the above 1 1 Per inspection 62.50 J Phone: (503) 224.3511 Fax: (503) 295 -3512 3 � hwestigation per hour (Ihr min) 62.50 1 CCB Lie.: 49737 t,. 10 Electrical Lie.: r 4 Suprv. Lie,: 3 4. Industrial plant per hour 73.75 Suprv. Electrician signature, required: /�' " I r3• l (0 —� . " ;';:' .t ECTRICAL± PEyN 1T gU'US . ::°k,. : 1 :• , I -.- - J Subtotal. - 1.5'9'00" 75' i Print name: S� h G 71,9 n Date: 3 r r Plan review (25 % ofpermit fee): — State surcharge (12% of permit fee): 1.9x00- ? . '' Authorized signature'., rpl'AI, NH:KMO'1' wf?l;; I68 be' Print name: Andrea Stin Cr This permit application expire$ if a pcnoit in not obtained within 180 1 g Date: 3/18/2009 day$ after it h }Teen accepted as complete. .t . Number of inspections allowed per permit, j T- Vinnd;nnl$n r ,lRI r'_P,.rn,;$Ann dnr rI P7 t rtri earLea1 cTn I rncrrn *.rnvrn '' Mar.18. 2009 1:44PM No.4265 P. 2 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 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: Fee for each commercial $75.00 system (S} , OAR 918 -309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems f3 Data Telecommunication Installation ❑ Fire Alarm Installation ❑ I•IVAC n Instrumentation n Intercom and Paging Systems ❑ landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other _ Total number of commercial systems: 2 *No licenses are required. Licenses are required for all other installations