Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11 q
COMMUNITY DEVELOPMENT Permit#: ELR2012 -00077
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/24/2012
Parcel: 25101 DA00102
Jurisdiction:
Site address: 13221 SW 68th PKWY 450
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: Low voltage for fire alarm.
Contractor: T & L COMMUNICATIONS INC Owner: GK TRIANGLE CORPORATE PARK III
PO BOX 87387 P.O. BOX 130174
VANCOUVER, WA 98687 -7387 CARLSBAD, CA 92013
PHONE: 360 - 737 -9725 PHONE: 503 - 221 -1900
FAX: 360 - 737 -9648
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04 /24/2012 $75.00
12% State Surcharge - Electrical 04 /24/2012 $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: N Fire Alarm: Y
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 issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty •des 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 i -su- ce, or if work is suspended for more the 180
days. ATTENTI • • . : • _ • law requires you to follow the rules adopted by the Oregon Utility Note : ion enter. ose rules are set forth in OAR
952- 001 -00 : rough OAR 95 $0 • ` I. • may obtain a copy of the rules or direct questions to OUNC by calling 03.23 .1987 • 00.332.2344.
1
Issue By: _ / _: /��d �� Permittee Signature: , tall IL I & I'_
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
From:TL COMMUNICATIONS 360 737 9648 04/24/2012 14:10 #159 P.002/003
Electrical Permit Application rf)u tn UNI ON1_1'
City of Tigard Received
% ff�i OI' ,, r a MO
Permit Na: /
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ether Permit
Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
T 1 G n R D Inspection Line: 503.639.4175 Date Ready/By: Jun: RI See Page 2 for
Internet www.tigard Notified/Method: Supplemental Information
.: it . ` .. ` E',,OF, !.ORK Zrg s. . ,.,5 \ \. 4 .. .. :'-:. _i ..0.< , . ; PLAr4 l _' l YW :, V21: V r_ . ?:'.,
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 3 sets of plans wfitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other
where the available fault current ❑ Marinas and boatyards.
'. x ` C41EG 'ONSTR!)C770N \ P ;; exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Y , a A > r ,^ , i� .. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling I Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fie pump. . ❑ Installation of 75 KVA or
1 t Y ❑ Emergency system. ar
lger separat derivd system. e
,/O$ SLTE 1{ - 0,:rtMATION AT: i1,,.. ❑ Addition of new motor load of ❑ °A" 4 '• l-2" "t :e
Job no.: Job site address: 13221 SW 68th Parkway 100HPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97223 ❑ Heahh-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 450 Project name: TCP3 - Suite 450 ❑ service or leader 60o amps or more.
`:41 -'lt : S V
Cross street/directions to job site: Description I Qtr. I Fee I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft- or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
. „ , s , . ,., ;DESCRfP,I'lbP1,' 4P WOQRIC D .. .... , ` ..M (with above sq. ft.)
Limited energy, multi - family 75.00 2
fire alarm tenant improvement residential (with above sq. a.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑. OWNER ,; ,. al.0NAN ' 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 I
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
Owner signature: Dom. Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
'.: .; ®, APPLICANT : , , . ® :CONTACT PERSON `' `' above service or feeder fee,
6.65 2
it
Business name: T &L Communications, Inc. B. hrcirci . Fee for b branranch curries
without service or feeder fee,
Contact name: Ross Bushaw first branch circuit 46.85 2
Address: PO Box 87387 Each add'l branch circuit 6.65 _ 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Vancouver, WA 98687 Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( 360 ) 737 -9725 I Fax: : ( 360) 737 -9648 Reconnect only 66.85 2
E -mail: office @tl- communications.com Pump or irrigation circle 53.40 2
, ,, \.:''; ,J; CONTRACTOR , .,. \.,, .> . .. Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: T &L Communications, Inc. energy panel, alteration, or
Address: PO Box 87387 extension. Describe: 1 Page 2 2
City/State/ZIP: Vancouver, WA 98687 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 360 ) 737 - 9725 Fax: ( 360 ) 737 - 9648 Investigation per hour (i hr min) 62.50
CCB Lic.: 67787 Electrical Lic.: 37- 428CLE Suprv. Lie.: 684LEA Industrial plant per hour 73.75
,
. , ., ,r:itECTRICAI<. � PEIt1VIIT ;FEES ", > „ ; ;;
Suprv. Electrician signature, required:
Subtotal:
Print name: Larry Bushaw Date: 4/24/2012 an review (25% of permit fee).
State surcharge (8% of permit fee):
Authorized signature: �(2/ TOTAL PERMIT FEE:
Print name: Larry Bushaw I Date: 4/24/2012
This permit application expires if a permit is not obtained within I80
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1: \BoadingtPcrmiMELC•PermaApp.doc 0523/06 440.46157(1 t /05/COM/WEB
From:TL COMMUNICATIONS 360 737 9648 04/24/2012 14:11 #159 P.003/003
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
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
❑ Other.
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
E l Boiler Controls
El Clock Systems
❑Data Telecommunication Installation
, /
Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
I:\Buildbleftr its\ELC- PermitAppAOc 03113/06
From:TL COMMUNICATIONS 360 737 9648 04/24/2012 14:09 #159 P.001/003
• •
ommunica i ons
INCORPORATED
ALARM SIGNALING COMMUNICATIONS
TO: City of Tigard FROM: T &L Communications
ATTENTION: Debbie T &L COMMUNICATIONS, INC
FAX #: 503 - 598 -1960 FAX #: 360 - 737 -9648
OFFICE #: 360- 737 -9725
THIS IS PAGE (1) OF: 2 DATE: 4/24/2012
Please see attached, electrical permit application for the TCP3 -suite 450 project.
Thank you and have a great day!
THIS TRANSMITTAL IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED, AND MAY
CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL. IF THE READER OF THIS TRANSMITTAL IS NOT THE INTENDED
RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE TRANSMITTAL TO THE INTENDED RECIPIENT, YOU
ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION, OR COPYINO OF THIS COMMUNICATION IS STRICTLY PROHIBITED.
IF YOU HAVE RECEIVED THIS COMMUNICATIONS IN ERROR, PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE
ORIGINAL TO US.
PO Box 87387 Vancouver, WA 98687 -7387
(360) 737 -9725 Voice (360) 737 -9648 Fax office@ti- communications.com