Permit Er CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2012 -00109
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2012
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 300
Project: Eagle Home Mortgage Subdivision: VARNS ACRES Lot: 4
Project Description: Data Telecommunications
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 05/31/2012 $75.00
12% State Surcharge - Electrical 05/31/2012 $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 95 - 1 -009 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: - r�� �,� /e4
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 603.639.4175 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.
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Electrical Permit Applicati EC . 'i 'r OR OH i (F ( SE. O \1 1
>: City of Tigard, �V1AY 2 9 2012 twc!B 4- /2— Pemul .No.: �/j j e:/•04.1.- Wir�,
n 13125 Stir Hall Blvd„ Tigard. OR 9722_ plan Review
' : :, Phone: 503.718.2439 Fax: 503:598.196 /� ,� Dare /13 : Other Permit.
"'' . '' ins ctinn Lille: 503.639.4175 CI OF rIGAi' "�� Dam R e a d y / B y : 2:6 See Puge for
1;1 G C1; 3 o M. A N � Supplemental information • laterite': www- :irardor.gov I ry �1i'
-• - -- - - -- �tJlt- Vii,•;' �f�IR.9 _
TYPE OF WORK PLAY REVIEW - v i
❑ Nev. construction [] Addition: alteration /replacement Please check all that apply (submit a sets of plans w /items checked belniv).
❑ Service or feeder 400 amps or. more ❑ Budding over three stories
o- ® Demolition ❑ Other: — ------ _ _ where t c available fault current ❑ Marinas and boatyards:
_ — CATEGORY OF CONSTRUCTION ezeseds 10,000 arnpsat 150 volts or ❑ Floating buildings.
less to ground, or exeta.ds- 14,000 ❑ Commercial -me agricultural
- 0 1 - and2- family dwelling ®Commercial /inditslrial 0 Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
— ❑ Emergency.systetn. larger separately derives• ystem.
___ JOB SITE INFORMATION AND LOCATION • ! ❑ Addition of new minor road of ❑ ••A" "F" "1 - 2' "I - Y'
'I OOHP or more. occupancy.
Job no.: i J site address: 7 320 SW Huniker Rd ❑ Recreational vehicle
k-
_ ❑ Six or more residential units, parks
Cily /State /Li P: Tigard, OR 97223 ❑ Heahh•cate facilities. ❑ Supply voltage for more than
❑ Hazardous location's. 600 volts nominal.
. Suite/bldg. /apt. no.: 300 Project name: Eagle Home Mortgage ' • ❑Service or feeder 600 amps or more. —
— -- ... — - - - -- `.EEE SCHEDtiLt
Cross'street/:lirections to job site: aauipdan , it . Fie. -- Waal an
- " - " - -- - -- — — - New residential single - or multi - family dwelling unit.
Includes attached garage.
1 ),001) stn. ft. or kiss _ - � 168.54 r 4
Subdivision: — J_Lot no.:
Ea. add'1300 sy ft, or portion 33.92 t
Tax map /parcel no.:
-- ' Limited energy, residential
—
DESCRIPTION OF WORK -_ A�_ (faith above sq. ft.) 7.5.00 2
Limited energy, multi- family • Data Cable/LowVoltage restdentlal (with above sq. ft.) 5 '� __�
Services or feeders installation, alteration, and /or relocation
201) amps nr lraS 100.70 2 _ I,
r ! 201 am t o 400 are 133.56 -- T2
0 OWNER: O. TEl\ANT; III
ps Ps
.......
,-- _ _— ____ ---
401 amps to 600 amps i 200.3.4 12
dame _• -- 601 am to 1,000 am 301.04 i I - 2
Address: Over 1,000 amps or volts 552,26 12
- - - -- Temporary services orfeeders lusta Italian, alitreiiun, and/or
City State /ZIP:
relocation
Phone: ( ) [ ( ) 4 200 amps or less I 59.36 _ 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being madc•on property that i own which is tiot
intended for sale. lease_ rent. or exchange, according to ORS 447, 449, 670, and 701., 40I amps to 599 amps I 168.54' 2 1
Branch circuits- new, alteration, or extension, per panel 1
Owner signature: - -^ Date: — A. Fee for' branch circuits with
bo red f
• ❑ APPI.i('ANT 7.42
o rl service or feeder fez. 2
❑ ,COtiI'AGT PERSON
- - -•- - -- -- each branch circuit
Business natnc: B. Pea for branch circuits without j
service or feeder fee, first I 56.18
12
(intact name: i branch circuit +
— - -- -- i Each add`I branch circuit I 7 L— 2
Address: Miscellaneous (service or feeder notincluded)
Each manufactured or modular I t !
City /State/ZIP: I 67.84 i 2
dwetlm , service and/or feeder
Phone: ( ) ._._ — -- Fax: : ( ) — -- - -- Reconnect only 67.84 . 2
-- — -
Pump or irrigation circle 1 67.84 2
Sa
F.-mail: Si or outline i lighting 67.84 2
CONTRACTOR Sign s s
_
t
��• -• • Signal cinant(s) or limited -energy f
Business name: Matrix Networks panel, alteration, or extension. i Page 2 l 7500 2
-. -- I Each additional inspection over allowable in any of the above
Address: 4243 SE International Way, Ste C ! Additional inspection (1 hrmin) 6625/hr 1
investigation (1 hr min) 66.25/ hr
City /State /ZIP: Portland, OR 97222 .
.-- t _ __ Industrial plant (1 hrmin) 78.18/ hr
'hone: (503) 654 -3000 Fhx 03:) 513 -9201 ! Inspections 'foruihich ho fee is —
- -- 1 -- specifically listed (A hr min) 90.00 / Itr ' -
CC13 Lie.: 74332 Electrical • ic.: 26- 694C1. Suprv. Lie.: • ELECI'RiCAL. PERMiT FEES
001/ Suprv. Electrician signature, required: o Subtotal_ 75,00
Plan review (25 /a of permit fee): 0.40
P rint name: Date: State- surchargc .(12%of permit fcc): 9.00 -
/ — I TOTAL PERMIT PEE: 84.00 V
Authorized signature:
1 _ �., This permit application expires If a permit is-not obtained within ISO
days after it has been accepted as complete.
Print name: Eric Scltwarzl opf IMO Date: 5/29/12 ' Number of inspections allowed per permit.
1 Iu ilaie ocrolIsuLC .t'ermitApp 40L461nTt1IIOLCO51/W8B
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Electrical Permit Application - City of Tigard
Page 2 - SupplementaLInformation
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
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*
❑ Vacuum Systems*
❑ Other.
COMMERCIAL.WORI 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
• Data Telecommunication Installation
❑ Fire Alarm Installation
❑
•
FIVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor. Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: I
*No licenses are required. Licenses ate required
for all other installations
LrBuil.iing\PontnatF.LG- PermaArp doe UP01 /I0
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matrix.
Ni E - r W Cal R K. S
FAX
To: Permits
Company: City_of_Tigard
Fax: 5035981960
Phone: 5037182439
From: Schwarzkopf, Eric
Fax: 5035139364
Phone: 5035139164
E - mail: erics @mtrx.com
Comments:
low voltage permit
4243 SE International Way, Suite C
Portland, OR 97222