Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELR2012 -00101
TIGARD . 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 103
Project: Eagle Home Mortgage Subdivision: VARNS ACRES Lot: 4
Project Description: Data telecommunications for TI in Suite 300.
Contractor: MATRIX NETWORKS Owner: HILLTOP BUSINESS CENTER LLC
4243 SE INTERNATIONAL WAY SUITE C HUNZIKER LLC
PORTLAND, OR 97222 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 654 -3000 PHONE:
FAX: 503 - 513 -9201
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/21/2012 $75.00
12% State Surcharge - Electrical 05/21/2012 $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 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 -00 - 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232987 503.232.1987 � 23 A �0J
Issued By: Permittee Signature: /7
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 603.639.4176 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.
Fax Server 5/18/2012 1:37:52 PM PAGE 2/004 Fax Server
RECEI. E
Electrical Permit Application I ;.. OI
: I C 1 l si,_c�, L
s'e 1.2.. ��Q�O%? 00 /p/
City of Ti and MAY 18 2012 • Rr .•rte permit No
t
1>ate,CCC
I I ° 13125 SW Ilan Blvd . Tigard, OR 9722•' Pisa Revie �
??- . n . . Phone.: 503.718.2439 Fax: 503.598.1V1a T Y OFTIGA. D Aa tc!13v• Other Permita �/.2, 052
_
TIGAR'I�i In' cction Line • 503619 /�i DIVISION DatrReady /fry Jug 0 See Pa e.2 for
w• - -
Internet: ww.tignrd- or.gos BUILDING CJ . l J Notified/Method: �(j Supplemental
TYPE OF WORK PLAN REVIEW
Now construction: ®,. Addition %a)teratiorv'reptecetttent Please cheek all that apply (submit 2, sets of plans w/items checked below);
❑ Service or feeder 400 amps or more ❑ Building over three stories. 1
^ [3 Demolition ❑ Other_ _ where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION .
exceeds 10,600 amps at 150 Volts or 0 Floating buildings.
-?'� • •less to ground. m exceeds 14.000 ❑ Commercial -use agricultural j
0I- and 2- family dwelling El Commercialiindustrial ❑ Accessory building amps for all other installations. buildings.
0 Multi- __ __ Master builder ❑ Other: j ❑ Fire pump, ❑ Installation of 75 KVA or
JOl3 SITE INNFOR'SLATION AND LOCATION — -- r i ❑ em. " A - , F " - 1 7- , - 1 . . v ysrcmt.
__. - __-._..._— ❑ Addition of new motor teed of L7 "A'" ` , .
r i ) °I t" ,
Job no:: Job site address: 7320 SW Huniker Rd looliP or more. occupancy.
0 Six or more residential nnitc. ❑ Recreational vehicle paths
City /State /ZIP: Tigard, OR 97223 J I ❑ Healib•care facilnies. ❑ Supply' voltage for more then
. ❑ Ha, Irrations. 600 volts nomica:;
Suite /hldg. /apt no.: 300 Project name: Eagle Home Mortgage • I ❑ Service . or feeder 600 amps ormore.
' : .... . ..... . ..FEE SCHEDULE
Cross street/directions to job site: ueteriptton 10n. I Fee. I Total I •
- - -- - - -- - ' - - New residential single- or multi family dwelling unit.
Includes attached garage.
•
Subdivision: z Lot no.: 1,000 sq. ft. or less 1
.._i_ 168.54 1 4
- - -- - -- — — Fa. add'i SOO sq. ft, or portion 33.92 - -�� 1
fax t rap /parcel no.: -
-. - __..._ Limited mew, residential j 75.00 2
DESCRIPIION OF WORK (with above sq. ft.)
- Limited energy, multi- family -
' Data Cable /Low Voltage __residential (with above sq. ft.) 75.00 2
^- -- - Services or feeders instillation; alteration. and/or relocation
200 amps or less I I 100.70 2
0 PROPERTY OWNER - I. . 0 TENANT . . : 201 amps to 400 amps 1 133.56
— - 401 amps to 600 amps 2 00.34 � t -2
Name: �_._. - -_ - b01 amps to 1,006 mops .301.04 I 1 2
Address: Over 1,000 amps or volts ; 552.26 ! 12 1
Cit }' /St ate'[. IP: Temporary services or feeders installation; alteration, and /or
relocation
_
Phone: ( ) I Fax: ( ) . 200 amps or -less 59.36 1 I
(-- -- — l 2n1 amps to 400 amps .125.08 2
Owner installation: This installation is being Made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447. 449. 670, and 701. 401 amps to 599 amps 168 54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits _ with
0 APPLICANT . . 0 CONTACT: PERSON : ._ • • ! above service or feeder tee. ? 42 2
each branch circuit-
.
Business name: 13. Pee for branch circuits without
- -- .. -- • _. I service or feeder fee, first.
Contact name: I branch circuit- 1 56.18 • 2
---- •-- --- ----- ---- - -- �_...._ - -- Each - add') branch circuit j 7.42 t
Address: Miscellaneous (service Or feeder not included)
or modular
City/State/ZIP: 67 84 2
L
- _ - _ - ___•_ _ - ..____ - dwelling, service and/or feeder
Phone: ( 1
n Fax: :( ) Reconnect only 67.84 2
° ° — - - -1 -- — Pump or irrigation circle 67.84
(: -mail: i Sign or outline lighting 67.84 2
CONTRACTOR:
. ... —.._. Signal larcuit(s) or limited -energy
Business name:. Matrix Networks panel, alteration, or extension. I Paget 7400 2
- Each additional inspection over allowable in an y of the abov
'Address: 4243 SE International Way, Ste C.' Additional inspectiou(1 hrmie) 1 6,6.25/ hr
f
r - - - Investigation (1 hr mi 66.25/ h
City/Sratc. ZIP: Portland, OR 97222 i
— I industrial plant (1 hr min) _- 78.18 / hr I
Phone: (503) 654 -3000 Fax: (503) 513 -9201 Inspeetions for which no fee is
-• - -_---1 specifically listed ('h hr Min) i I 90 00/ hr I
C(: B Lie.: 74332 Electrical Lic.: 26 - 694 1. I Sum. Lie._: i _ .ELECTRICAL :.PER' 1IT: FEES • I
Suprv. Electrician signature. required: I Subtotal.. i 75.00
... - - -__ — -- Plan review (25% of permit fee): __I �L8 3S�
Print itante: i I Date: - State surcharge (12% of permit fee): 9.00
L ' _' ......
Authorized signature: i > �f TOTAi. PERMIT FEE: 1.02.75
. -- - ; n This permit appiicalioo expbres if a permit is not obtained within 180
['riot Warne: Eric Sehwarikopf t
1 I Late: 5/18//2012 days after it bas been accepted as complete. n� ....---- -
-- - -•,_ -- --• / _- _ e Number of inspections allowed per permit 4
o e
I`d1u ;Lint'• Per »:r.\l'LC- PrmitAppdac 07 /CIR0 440- 16IST(lt /05RAMJWEB
Fax Server 5/18/2012 1:37:52 PM PAGE 3/004 Fax Server
Electrical Permit Application - City of Tigard.
Page 2 - Supplemental information
LIMITED ENERGY PERMIT FEES: •
RESIDENTIAL WOItg ONLY:
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
C Audio and Stereo Systems*
❑_ Burglar Alarm
❑ Garage Door Opener*
❑ Healing, Ventilation and Air Conditioning System*
H \'acuurn Systems*
❑ 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
.
H. Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
• HV AC
❑ instrumentation
❑0 intercom and Paging Systems
❑ 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
Suddingll'mniUlFl.C•PtmiilApp da 07/01 /14
Fax Server 5/18/2012 1:37:52 PM PAGE 1/004 Fax Server
)
matrix.
NJ E T W C) R K
FAX
To: Permits
Company: City_of_Tigard
Fax: 5035981960
Phone: 503 -718 -2439
From: Schwarzkopf, Eric
Fax: 5035139364
Phone: 5035139164
E - mail: erics @mtrx.com
Comments:
Electrical Permit w /CC payment
•
•
4243 SE International Way, Suite C
Portland, OR 97222