Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2009 00125
Date Issued: 05/05/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel 2S102DA00401
Jurisdiction: Tigard
Site address: 13125 SW HALL BLVD PERMITS
Subdivision: Lot: 0
Project: Permit Center
Project Description: Installation of restricted energy for access control wiring in Permit Center.
FEES
Owner:
TIGARD, CITY OF Description Date Amount
13125 SW HALL BLVD Restricted Energy Permit 05/05/2009 $75.00
TIGARD, OR 97223 12% State Surcharge - Restricted Energy 05/05/2009 $9.00
PHONE:
Contractor:
E C COMPANY
PO BOX 10286
PORTLAND, OR 97296
PHONE: 503 - 224 -3511
FAX: 503- 295 -3012
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: Boiler Controls:
CCTV: Clock Systems:
Data & Telecommunications: 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: Y
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. 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 You may obtain • copy of the rules or direct questions to OUNC by calling 50 - • 6.6699 or 1.800 33 .2344.
I 1 _
Issued By: - �� _ /. _ _
I • , • Permittee Signature: �.�� -
t
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.
'' Apr. 30. 2009 10: 03AM No. 2022 P. 1
Electrical Permit A .plicatiol I CEI d ED roi3 or FK F. 1. :Sf: 0\ I.‘ .
II ..., City of Tigard nwa • • • • a ' , Permit No.: Ne_r: • O 41 _.
13125 SW Hail Blvd., Tigard, OR 9722 P R 3 0 2009 plan Review
a : Phone: 503,639.4171 Fax: 503.598.1960 DatoJB : Other Permit:
T f G 1 Z t7 Inspection j et; iv i 503,639.4175
CITY OF DIVISION Notified/Methods i1i S See Page 2for
ementat Information
iI
TYPE OF v I t I DIVISION
RE V > �a+
❑ New construction 0 Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below):
O Serviet or feeder 400 amps or morn 0 Building over three stories.
❑ Demolition ❑ Other where the available fault =mot ❑ Marinas and boatyards.
' ' CATEGORY OF CONSTRUCTION . exceeds 10.000 amps at 150 volts or 0 Floating buildings,
•
less to ground, or exceeds 14,000 0 Commercial - use agricultural
❑ 1 - an 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings,
0 Multi-family ❑ Master builder ❑Other: 0 Fire prow. 9 lnstallauon
-° 0 Emergency system, larger separately derived system.
• ' JOB SITE INFORMATION AND. LOCATION 0 Addition of new motor !Clad of ❑
Job no.: 73454 ] Job site address: 13125 SW Hall Blvd. 100HPormore. occaPanny-
0 Six or more residential units, Cl Recreational vehicle parks. .
City /State/ZIP: Tigard, OR 97223 0 Health - care 0cilities, 0 Supply voltage for more than
0 Hazmdous locations. 600 volts nominal.
Suite/bldg. /apt no.: Permits J Project name: Permit Center ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: yDeecripiio° F ( L Tool I •
New residential single- or multi- family dwelling unit.
Includes attached garage. _
Subdivision: J tot no.: 1,000 sq, ft- or less 145.15 4
Ea add'l 500 sq. 9. or portion 33.40 1
Tax map/parcel no.: —
. • , Limited energy, residential
• .. 'DESCRIPTION OF WORK ; . ' • (with above sq. ft.) - - 75.00 2
Limited energy, multi - family 2
Installation of access control wiring in Permit Center -- 75.00
residential (with above sg �)
Services or feeders installation, alteration, and/or relocation
200 amps or less 2030 2
' >, PR OPERT Y OWNER ' ' I 0 TENANT • 201 amps to 400 amps 106.85 2
Name: City of Tigard . 401 amps to 600 amps 160.60 _^ _ 2
601 amps to 1,000 amps 24060 2
Address: 13125 SW Hall Blvd. Over 1,000 amps or volts 454.65 - 2
City/State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)372 -7459 Fax: ( ) 200 amps or Tess 66.85 1
Owner installation: This installation is being made on property that I own which is not _ 201 amps to 400 amps 100,30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2
Branch circuits - new alteration, or extension . • r lane!
Owner signature: Date: A Fee for branch circuits with
® APPLICANT . 0 CONTACT ,PERSON above service or feeder fee,
- each branch circuit 6.65 2
W
Business name: EC Company B. Fee for branch circuits
Contact name: Gary Cawley without service or feeder tee, 46.85 2
_ first branch circuit
Address: PO Box 10286 Each add'! branch circuit f 6.65 1 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Portland, OR 97296 Each manufactured or modular 90 -90 2
_ dwelling, service and/or feeder
Phone: (503) 220-5319 Fax: : (503) 295 -3012 _ - Reconnect only 66.85 2
E -mail: garyc@e-c-co.com Pump or irrigation circle 53,40 2
CQNTKACTOR T Sign or outline lighting 53.40 2
Business name: EC Company signal circuits) or limited -
energy panel, alteration, or
Address: PO Box 10286 extension. Describe: 1 Page 2 75 2 •
access control whin
City /State/ZIP: Portland, OR 97296 Each additional inspection over allowable in any of the above
, _Per inspection 62.50
Phone: (503) 224 -3311 Fax: (503) 295-3012 Investigation per hour (i 1m min) 62.50
CCB Lie.: 49737 Electrical Lie.: Suprv. L.ic.: 2- 95 Industrial plant per hour 73.75
ELECTRICAL : • FEES
Suprv. Electrician signature, required: , ` 0 10 - l • t 6 Subtotal: 75.00
Print name: G 1 r y l Date: 4, . . „ Plan review (25 %of permit tee):
r State surcharge (12% of permit fee): 9.00
Authorized signature TOTAL PERMIT FEE: 84 -00
Print name: Andrea Stinger Date 4/30/09 This permit application expires if permit is not °braised within l80
days after it has been accepted as complete,
• Number of inspections allowed per permit.
OBUildiogwerm ;uaELC.Aerm;tApp.doc 05/23/06 44044151(11/03/COMfwEB