Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
II
p Permit #: ELR2009 -00096
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/01/2009
Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD, STE# 201
Subdivision: Lot: 0
Project: Steele & Nannini
Project Description: Install limited energy for voice /data.
Owner: FEES
HILLTOP BUSINESS CENTER LLC & Description Date Amount
HUNZIKER LLC, 9430 NW KAISER RD Restricted Energy Permit 04/01/2009 $75.00
PORTLAND, OR 97231 12% State Surcharge - Restricted Energy 04/01/2009 $9.00
PHONE:
Contractor:
AF TECHNOLOGIES
1418 HEMLOCK ST. NW
SALEM, OR 97304
PHONE: 503 - 932 -6657
FAX: 503 - 362 -2382
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. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. / 0 .se rules are se • OAR
952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699�>' .800.332.
• /'_ L 1'LQ 11 /)
Issued By: � .L
0 , � 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 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.
- e=lectrical Permit Application ; -14 ' - ;FOR OFFI USE ONLY'. W u t }
I'" Received
ny ^ ; 1 ' City of Tigard Date /By Z• . dq Permit No.:Ct 1 coop /_
't 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review V `�
it ;; (' hone. 50.3 639.4171 Fax 503 598 1960 Date /By: Other Pei nut'
TIGrARD' Inspection Lmc • 503.639 4175 Date Ready /By, lulls El See Page 2 for
1 :x t)5t .jmm• Internet' www tinard or.gov Notified /Method T Supplemental Information
I a,
i ' ' TYPE O "YORK, , f ' 7 a ;PLAN': ;REVIEW'
; ID New construction ® Addition /alteration /replacement
Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards
t l exceeds 10,000 amps at 150 volts or ❑ Floating
CATEGORY OF CONSTRUCTION - " 1 g
less to ground, or exceeds 14,0(10 ❑ Commercial - use agricultural
❑ I - and 2 family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or • 1013 SITE, IN�ORI9ATIO V ,AIVp LOCA;I3I ❑ Emergency system. larger separately denved system.
� - . -, . ❑ Addition of new motor load of ❑ "A" "0" "I 2" "I_�
1001-10 or more occupancy.
lob no.: .lob site address: 7340 Hunziker Rd
!(
❑Six of more residential units ❑ Recreational vehicle parks
City/State/ZIP: Tigard 1=1 Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite /bldg. /apt. no.• Ste 201 Project name: ❑ Service or feeder 600 amps or more
; SCHEDULE - "
Cross street /directions to job site: Description I Qiy• 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 145 IS 4
Ea. add'I 500 sq. ft. or portion 33.40 1
"Fax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK_ . ' - - (with above sq f) )
Voice and Data install Limited energy, multi - family 75.00
2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER - • _ ®"TENANT -, ' "- - • 201 amps to 400 amps 106.85 2
Name: Steele - Nannini 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
' Address: 7340 Hunziker Rd Over 1,000 amps or volts 454.65 2
City /State / %IP: Tigard, Or 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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, per panel
Owner signature: Date: A. Fee for branch circuits wah
❑ APPLICANT ®` °CONTACT5PERSONt above service or feeder fee, 6 65 2
each branch circuit
Business name: B. Fee for branch circuits
u'Nhoul service or feeder fee, 46.85 2
Contact name: first branch circuit
Address:
Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone ( ) Fax: : ( )
Reconnect only 66.85 2
F -mail: Pump or irrigation circle 53 40 2
CONTRACTOR Sian or outline lighting 53.40 2
'il' Business Hume. A F Technologies Signal circuit(s) or limited-
it energy panel, alteration, or I 75.00
/ \ddress• 1418 Hemlock St NW extension. Describe. Page 2 2
Data/Comm
fi City /State /ZI P: Salem, OR 97304 • Each additional inspection over allowable in any of the above
Per inspection 62.50
,r Phone: (503) 362 -2364 Fax: (503) 362 -2382 Investigation per hour (1 hr nun) 62.50
111 CCB lie.. -1-91(}E - .� 00 k Electrical Lie.. CLE 10 Suprv. Lie.: 2903LEA Industrial plant per hour 73.75
���pp . ": - _ , " ELECTRICAL PERMIT, FEES"' '
„ Suprv. Electrician signature, required: Subtotal: 75.00
Print name: Carl Robins Date: 4/1/09 Plan review (25% of permit fee):
State surcharge (12% of permit fee). 9.00
Authorized signature: TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 18(1
Print name: Carl Robins Date: 4/1/09
days after it has been accepted as complete.
* Number of inspections allowed per permit
I:A Budding APet inns AELC- PerninApp.doc 05/23/06 440- 4615T(II /05 /COM /WEB