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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ` 2 COMMUNITY DEVELOPMENT Permit #: ELR2012 -00074 T I GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/19/2012 Parcel: 2S101AB00100 Jurisdiction: Tigard Site address: 12023 SW 70TH AVE Project: Red Rock Center, Phase II Subdivision: Lot: 0 Project Description: Low voltage for sprinkler monitoring system. Contractor: T & L COMMUNICATIONS INC Owner: FRY, DOUGLAS - P0 BOX 87387 23077 SW NEWLAND RD VANCOUVER, WA 98687 -7387 WILSONVILLE, OR 97070 PHONE: 360 - 737 -9725 PHONE: FAX: 360 - 737 -9648 FEES Description Date Amount Specifics: Restricted Energy Permit 04/19/2012 $75.00 Type of Use: COM 12% State Surcharge - Electrical 04 /19/2012 $9.00 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: 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:. Y 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 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. Those rules are set forth in OAR 952- 001- 0010 - through OAR 952- 001 -0090. You may obtai • • of the rulquestions to OUNC by calling 503.23 ' ;7 or 1.800.33 .2344. Issued � � ii_.— Permittee Signature: A 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. EELEC' Date: iq LICENSE NO. (7 73 L /9 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. Electrical Permit Application c � FOR OFFICE USE ONLY City of Tigard � � Plan Review J Dates FOR i y' Permit No.: J , / . I L IN • 13125 SW Hall Blvd., Tigard, OR 972 1, C A 0 Phone: 503.639.4171 Fax: 503.598. 1 " Other Permit: �( T I G A R D Inspection Line: 503.639.4175 (� - tom• s, � Date /By: Re Re adyBy: taro: ® See Page 2 for Internet: www.tigard- or.gov t `' �G`' .tified/Method: Supplemental Information TYPE OF WORK � PLAN REVIEW ❑ New construction ® Addition/alteration/re � ' h 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: l et 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 JOB SITE INFORMATION AND LOCATION .0 Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A "E , "1 - ", "1 - ", IOOHP or more. occupancy. ❑ Job no.: Job site address: W 70th Avenue Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: Tigard, OR /1 8 ❑ Health-care facilities. 0 Supply voltage for more than vtw� ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Red Rock Center ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total 1 • 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.) Limited energy, multi- family 75.00 2 sprinkler monitoring system residential (with above sq. ft.) _ Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER 0 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 I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: T &L Communications, Inc. B. Fee for branch circuits without service or feeder fee, 46.85 2 Contact name: Ross Bushaw first branch circuit Each add'l branch circuit 6.65 2 Address: PO Box 87387 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 Fax: : ( 360) 737 - 9648 Reconnect only 66.85 2 E -mail: office @tl communications.com Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: T &L Communications, Inc. energy panel, alteration, or Address: p0 Box 87387 extension. Describe: 1 Page 2 .ESL- 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 Lie.: 37- 428CLE Suprv. Lie.: 684LEA Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Rfil.D42Ai Subtotal: 7 &- Print name: Larry Bushaw Date: 4/ 19/2012 Plan review (2 of permit fee): / State surcharge (8% of permit fee): et Authorized signature: r r ?) _ (� _ ) TOTAL PERMIT FEE: � V` Date: 4/19/2012 This permit application expires if a permit is not obtained within 180 aw Print name: Larry Bush 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