Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2012 -00046
TI G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/14/2012
Parcel: 1 S136DC04600
Jurisdiction: Tigard
Site address: 7255 SW DARTMOUTH ST
Project: Office Max Subdivision: 1995 -013 PARTITION PLAT Lot: 3
Project Description: Low voltage for data.
Contractor: AMERICA'S PHONE GUYS Owner: COMMERCIAL NET LEASE REALTY, INC
PO BOX 873279 450 S ORANGE AVE, STE 900
VANCOUVER, WA 98687 ORLANDO, FL 32801
PHONE: 360 - 904 -6782 PHONE:
FAX: 360 -254 -1967
FEES
Description Date Amount-
•
Specifics: Restricted Energy Permit 03/14/2012 $75.00
12% State Surcharge - Electrical 03/14/2012 $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 issu- • •'ect 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 a =•rdance with - • •roved • . s. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
' days. ATT• TION: Oregon la - quires •u to follow the rules adopted by the Oregon U' • 'n r. Those rules are set forth in OAR
952-001-0 throu • h OAR 952 : r 1 090' ay obtain a copy of the rules or direct questions to O C by calling r :70‘ • :7 or 1.800.332.2344.
Issue • By: Permittee Signe r. ' .f lff C
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' — _ �I/ j G1/ 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.
03/12/2012 10:47 3602541967 PHONE GUYS LLC PAGE 01/02
• Electrical Permit Applies is 1 cE ! t. I OROI:F ICI , .l.SI. ONI.l
Re ceived Permit No.; Ektg.,9/61, •-• 666 ` ,
City of Tigard R I 3 2012 e xN+ d A�
i 3125 SW Hall Blvd., Tigard, OR 9 Other Permit.
' a [tone: 303.7182 Fax: 503 960 net : n,,,, ® 3�e p a for
I I k ::'. r•, P ins Line: 503.639.4175 OF T' $ _ Naotified/Meetthood: Supplemental Information
Internet: www ttgard -0r Gov BUILD' 1 r , • - ,w. - T { �
r w ,r r , " i r ' : ; - , \ r •• ' t/ -•• i, Cd below): ., �..;;b � , •s ® Addition/alteration/replacement k �' " Phase check all th5 apply (submit 2 sets of plans wIitcros •
❑ New construction ❑ service or fecdcr41)0 amps or more D Building over three stories.
❑ Demolition
Other.. Where the available fault currant D Marinas and boatyards.
,-. J.; . ,,, w r . , c r ‘ ' �. =MI6 eY=MI6 10.000 amps at i50 volts or CIFl g buildin gs.
`
.,F ', , .'.:4Ig ' lC_. ?rr ,.$4 .rJ, ;: v... '7- ...4,'Y st� , .a i .0 ,. P� to . exceeds nd. or exceeds 14,000 0 Commercial -use agricultural
1:1 i - and 2. family dwelling . al Commercial /industrial ❑ Accessory building Braes for all other installations. buildings. of 7s Kva or
Master builder ❑ Other: U Fire pump I separately 7 derived VA o system.
13 Multi-family D DEmcrgettcy
� ' 1- y
b '''-'''''''''.1:i''''.71' of ^ 9 , "E"."1.2", "1.3„
..,•-•", 1 , ,{,, 1-4. - .. , ,' t-'4 4 . f , ,1 . �.,: ,,. .. > , . , i_., ❑Addition of new motor load of ❑ A
;_. ,:� occupancy.
t OOHP a route
Job no.: P4975360P4 Job site address: 7255 SW Dartmouth Rd. 0 S or more residential units. Q Recreational vehicle parks.
0 Health- ire facilities. 0 supply voltage for more than
City /State /7.iP: Tigard. OR 97223 0 Hazardous locations. 600 volts nominal.
Project name: OfficeMax 1287 El Service or feeder 600 amps or mac
Suite/bldgJapt no.: I J 5::' . ' -', `, ., r •
Cry t� yUeet/dirGetiOnd to job sift:
Desalinise Qty. Fee. 1 0
New residential s ..... or mnkf -Mmity d.rening, nnit
includes attached garage.
1.000 sq. ft. or loss 168,54 4
Subdivision: �l Lot no •
- Ea add'' 500 sq. {l, or portion
Tax map /parcel no.: Limit energy, residential 75.00 2
a I • 7' -P".' ' ; G j n ' , iy }" � i 1 F ( above sq. R)
r' n.. ; V4/ r ' 5 rr�' f Jw " - .. a✓- a . , . e 1:., r , Lim►ted energy, multi - family 75.00 2
Data cabling for WAP residential (with above sq. It,) ,
Services or feeders instaliation,_alteratlon, and/or relocation
200 amps or lets 100.70 2
H amps to � amps Pi'?;:::,,,'!..,,,:, ' :61;,2,44••; - rzi ^ sc t :r r - , * . , . , , .. r, . . .. ... . .... 201 1 00. 2
_2
4±.1� ,:'
u „:
.�, � ., � ;tyr`ki'�- .r.'i\. r•� . �n1 : , r 1 ,. r, ...,, . 401 at11pS to amps �
200.34
Office Max Store #337 _ 601 amps to 1,000 amps 301.04 2
- Address: 7255 SW Dartmouth Rd.
Over 1,000 amps or volts 552.26 2
temporary services or feeders installation, alteration, and/or
City /State/7_1P: Tigard, OR 97223 relocation
200 amps or Ices 59,36
Phone: (503)598.0288 Fax ( ) 201 amps to 400 amps 125,08
Owner installation: This installation is being made on property that 1 own which Is not 401 amps to 599 amps 168.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Breech circuits - new, alteration, or extension, per panel
Owner ai nature Date: �� A. Fcc for branch circuits with
above service Cie teener fee, 7,42 2
.,.. . , n :: 4 I '` rf5 1 r't�'"'� "'. r ,, -.. ,t, t i- } .- �. `r } „l,{ _ cast, branch circuit
1;.. . jl , �. - ea a,7 ( .r u , .. r.n L. .
13. Fen for branch circuits wtfv
Business name: Arn erirn's Pliant. Guys -8.
or feeder fro, first 58,18 2
Contact name: Bert Alvaro branch circuit
Each add'' branch circuit 7.42 2
Address: PO Bua 873279 Mierellaneous (,sett or feeder not included)
Each manufactured or modular l 67.84 2
City/State /ZIP: Vancouver, WA 98687 dwelling, service and/or ibeder I
Phone: (360) 834.3522 Fax:: (360) 254.1967 RcconneCt 67.84 2
- 2
Pump or irrigation circle 67.84
E-mail: lots(a7amcrica9 honeguys tom Sign or outline lighting 67 2
_ -' . •
., ,,.,. }.J,b ✓r.. l. r ,a,.,w,. ..,L. r-, �:rr...,,! ,: , -
' 1 •• r .,r.,.r , Signs. rwr.01 OT limi cncreY 1 75.00
Stir .n 2
Business name: America's Phone Guys •- ncl alteration or extension. P. _ 2
Each additional insQectlon over allowable in an , of the above
Address: PO Box 873279 _ Additional inspection (1 hr min) j 66.25/ hr
Investigation (1 he min) 66.25/ hr
City/State /ZIP: Vancouver, WA 98687 Industrial plant (1 hr min) 78,18/ hr
* Phone' (360) 904.6782 Fax: (360) 234.1967 tncpeehnna for which no fee is 90,00/ hr
ificall listed -
CCB Lic.: 174014 Electrical L .. • .2 . Suprv. Lle.: 3541LE13 ., ,> �.,.,r. __._ewe,,,- .:_'.+•,. - !� ' ='
_ a Subtotal: 75.00
Suprv. F,iectricien signature, required ', J ' _ -- io Plan review (25% of ,atmit fcc): -
Print name: Bert Alvaro T Date: 3/12/12 State surcharge (12% of permit fee): 9,00
i� • ` TOTAL PERm1T FEE: 84.(10 Authorized signatures � S l . P �` �G �- This permit application expire; Ira pc rmit is not obtained within 140
I
- _ _ v days after it t tu htu been accepted its complete-
Print name: LOTS Cook Date: 3/12/12 • Number of inso mane allowed per permit.
tineiidini\'er"ib\ L,C-PertnitApp.dec 07 /01 /l0 440.4615T(11/05/COM/vna
03/12/2012 10:47 3602541967 PHONE GUYS LLC PAGE 02/02
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
❑ G arage Door Opener*
U J Heating, Ventilation and Air Conditioning System*
O Vacuum Systems*
❑ Other _
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
El Data Telecommunication Installation
El F ire Alarm Installation
E HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
Li Landscape Irrigation. Control*
❑ Medical
❑ N urse Calls
0 Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other. installations
T:\ DuignRV 'a+nitdEL.C- t'pmlrApp.doc 07A1lto