The URL can be used to link to this page

Permit ', ' ” CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT '. ; COMMUNITY DEVELOPMENT Permit #: ELR2012 -00007 TIGAIW 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2012 Parcel: 2S112DC01400 Jurisdiction: Tigard Site address: 15865 SW 74TH AVE 105 Project: Cognex Subdivision: FANNO CREEK ACRE TRACTS Lot: 4 Project Description: Low voltage for data. Contractor: A BETTER ELECTRICAL COMPANY Owner: JDS LLC 16869 SW 65TH AVE STE 373 CRITERION CREEKVIEW LLC LAKE OSWEGO, OR 97035 ATTN JAMES A MEYER PO BOX 6525 BEAVERTON, OR 97007 PHONE: 503 - 753 -0836 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 01/11/2012 $75.00 12% State Surcharge - Electrical 01/11/2012 $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: Y Fire Alarm: N 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 ' - - - - •'ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be don- ' accordance with : • •roved 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 '•u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - , 01 -0010 thro h OAR 952 -001 -8 19•. ou may ob ' copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. L ____ Is ued By: Permittee Signat— `'°' -- 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. r � Electrical Permit Application " ; f FOR OFFICE USE ONLY City of Tigard I i l Permit No.: a 131 Hal Blvd., Tigard,OR 97223 JAN a 2.012. Received Plan Received Review / // ,A �4��0 /�rO�2 IN 0 : Phone: 503.718.2439 Fax: 503.598.196 �.- �F -� � A I � D DateBy• Other Permit: T1 G A R D inspection Line: 503.639.4175 Date Ready /By: Sufis ® See Page 2 for Internet: www.tigard- or.gov �� ®( � a' {t� 1�� Notified/Method: Supplemental information / TYPE OF WORK PLAN REVIEW ❑ New construction VQ Ad dition/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. CATEG9RY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. , L1_dJ 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", Job no.: Job site address: isj, c / �/ / I OOHP or more. occupancy. Ir �' / '7 �p ` / �� ❑ S ix or more residential units.. ❑ Recreational vehicle parks. City/State /ZIP: 4 D! i ,. 0 R - q 7 L� ❑Health -care facilities. 0 Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Cog p)( ❑ Service or feeder 600 amps or more. V j "J / ) l! ` FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total 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'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 75 00 2 ` ! , 4. c o y y • residential (with above sq. ft.) 1 Services or feeders installation, alteration, and /or relocation • 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City/State /ZIP: relocation Phone: ( ) 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 I 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 E APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit A Business name: B. Fee for branch circuits without / � P�/tGI `t' �/N/G�r (5 //4_&1.4.1c f1�7� ' service or feeder fee, first 56.18 2 Contact name: N vi o S u 0 P branch circuit _ Each add'l branch circuit 7.42 2 Address: f Gj � /t ii 437 2 Miscellaneous (service or feeder not included) Ci / State /ZIP: , 1 v /1-- q 7(7 Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder Phone: ) Z.1 © � t� ( ) Fax: Reconnect only 67.84 2 ( � Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy it 757 GM Business name: panel, alteration, or extension. Page 2 / 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( Fax: Inspections for which no fee is 90.00 / hr ( ) /� /'� ( ��J io4 r /, specifically listed (V0 hr min) CCB Lic.: � l i 1 p 2 Electrical Lic.: C. (-1S Z � Suprv. Lic.: 50055 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: ']S d d y at�� Plan review (25% of permit fee): n 1 Print name: C k P r e4 SO i Date: / °– 1/ — / ) State surcharge (12% of permit fee): y • c7c) ----7-52> TOTAL PERMIT FEE: $ Authorized SigriatUre _ . _ G This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: vow Date: •- //,--- . • Number of inspections allowed per pennit. I: \ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(1 1/05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems n 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 C \Building\Permits \ELC- PermitApp doc 07/0I/10