Permit 9 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
- : COMMUNITY DEVELOPMENT Permit #: ELR2009 -00105
Date Issued: 04/10/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 103
Subdivision: Lot: 0
Project: Cher Ireland
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 04/10/2009 $75.00
PORTLAND, OR 97231 12% State Surcharge - Restricted Energy 04/10/2009 $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:
Landscape Lighting: Medical: Required Items and Reports (Conditions)
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 Cent= . Those ru set •rth in OAR
952- 001 -0010 throug OA' 952 You may obta a co of the rules or direct questions to OUNC by calling 503.246.6• • 1.800.3
Issued By: wl QQ \._ i d /
1 . 0l�Z 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 Ina 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 Applicatio ,RECEIVED FOR OFFICE USE ONLY
City of Tigard Received
Permit No.:
II
° 1312ySW Hall Blvd., Tigard, OR 97223 APR 1 0 2009 Date/By: 64 . O .OS � C (1� 20�Q • �Ol OS
= Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By' luris: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: 1 t C Supplemental Information
` TYPE OF 'WORK . _ _ , , . PLAN REVIEW
❑ 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 stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- 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
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: Job site address: 2 Q � 1001-1P or more. occupancy.
7 3 Y � �� tIJ .J4r v Imo' �� ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 2cl ❑ Health -care ies. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: t iv 3 Project name: Ch elr , 1 lei4 (lt N-1 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE -
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 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
.DESCRIPTION OF WORK (with above sq. ft.)
' l J Limited energy, multi - family
V 0 I L� * b T� ( N s (z.. ( ( residential (with above sq. ft.) 75.00 2
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: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: 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 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, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON . above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name:
first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (- ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53 40 2
' - CONTRACTOR Sign or outline lighting 53.40 2
Business name: / Signal circuit(s) or limited-
l �° Gi7 A , l� L O (e S energy panel, alteration, or
Address: / (pi 4 t`i�°/' i /,,,,,k � Aik/ extension. Describe: Page 2 -73 2
City /State /ZIP: c: aj,C f 0 i2 c 7-34:=, V Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: 6 g6„7„....54 Fax: (5-p 3) e Z -a 3.5;2- Investigation per hour (1 hr min) 62.50
CCB Lic.: /6.70 r Electrical Lic.:CL F_ ( a Suprv. Lic.: 2119 341 Industrial plant per hour 73.75
�
�� ELECTRICAL, PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: t d.. �e,9 !�s Date: Al /� - G Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building \Permits \ELC- PermitApp doc 05/23/06 440- 4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: • i
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
i COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
•
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
►l Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑- Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: \ Building \Permits\ELC- PermitApp.doc 03/23/06