Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•
0'.. COMMUNITY DEVELOPMENT Permit #: ELR2012 -00114
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
TIGARD 9 Parcel: 2S 101 DC04602
Jurisdiction: Tigard
Site address: 7379 SW TECH CENTER DR
Project: Spectra Contract Flooring Subdivision: TECH CENTER BUSINESS PARK Lot: 2
Project Description: (1) thermostat for HVAC
Contractor: ARROW MECHANICAL Owner: MCCORMACK PROPERTIES LP
10330 SW TUALATIN RD 7190 SW SANDBURG ST
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 692 -1565 PHONE: 503 -624 -2090
FAX: 503 - 691 -1879
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/06/2012 $75.00
12% State Surcharge - Electrical 06/06/2012 $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: N
HVAC: y 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 Cen Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. or 1.800.332.2344.
Issued By: ALIA AI JR1.4 t Permittee Signature:
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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received t a l IV 5( Permit No . 2 Ro /02 �1� (
74 2 • 13125 SW Hall Blvd., Tigard, OR 972 Y
Plan Review
:
Phone: 503.718.2439 Fax: 503.598.1960 pa,rA3y. Other Permit:/y&? O/a -003
TI G A R D Inspection Line: 503.639 J o a 2012 Date Ready/B 1�;,
y: � ^_ I See Page 2 for
Internet www.tigard- or.gov Notified/Method G H Supplemental Information
TYPg OF *Otkrry op Ti vAD . . ' . NAN REVIEW
❑ New construction El Addition/alle n ,I ! V ISLOI�1 Please check all that apply (submits sets of plans whtems checked below):
`
['Service or feeder 400 amps or more ❑ Building over three stories"
❑ Demolition — ❑ "tithe[ — - - - - where the available fault current 'a and b atyards.
CiStEI ORY OF CONSTRUC 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 FZI Commercial/industrial ❑ Accessory building amps for all other installations" buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB ;SITE IIYFORIIIATION AND . LOCATC0117 . ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E", "1 -2 ", "1 -3 ",
Job no.: 31 I Job site address: 737/ 6w T &t-i eb7i O/ , I0011P or more. icy.
❑ Six or more residential units.
['Recreational vehicle parks.
Clty /Stat�z>p: { A ,� p 6 r q ?R2 3 13 Healtbcare facilities. ❑ Supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: 6Pe- c -7 -A rke ❑ Service or feeder 600 amps or more.
- Z. F :5 l� . •
Cross street/directions to job site: naaipdaa I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R or less 168.54 4
Tax map/parcel no.:
Ea. add'l 500 sq. ft or portion 33.92 1
Limited energy, residential 75.00 2
;.;,,. DESCRYPTION'O WO RK:,' (with above sq. ft.)
Limited energy, multi- family 75.00 2
A PP LO 1-'6741 F )414v S /I•T -f y6 — 1,A residential (with above sq. R)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
PROPR'li'Y .. , . _ N v'r 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 5 )Dt= c%TI& 6294_11
601 amps to 1,000 amps 301.04 2
Address: 7376i 6 , ye,-- e_ ec 742- Pd • Over 1,000 amps or volts 552.26 2
City/State/ZIP: t dA,2D o �2 CZ � Temporary services or feeders installation, alteration, and/or
J relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: . Date: A. Fee for blanch circuits with
- . ,e - : ®.; APPLICANT . . 1 • , „ above service or feeder fee
�`.CO1VTe#C1'.PER '" 7.42 2
each branch C IrCUIt
Business name: Arrow Mechanical B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: a . f 4 Die: branch circuit
Each add'I branch circuit 7.42 2
Address: 10330 SW Tualatin Rd Miscellaneous (service or feeder not included)
City/State/ZIP: Tualatin. OR 97062 Each manufactured or modular 67 2
dwelling, service and/or feeder
Phone: (503) 692 -1565 I Fax: : (503) 691 -1879 Reconnect only 67.84 2
E -mail:
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
CONTRACTOR_ ' : ;.' Signal circuits) or limited-energy
Business name: Arrow Mechanical panel, alteration, or extension. l Page 2 , 15 2
Each additional inspection over allowable in any o f the above
Address: 10330 SW Tualatin Rd • Additional inspection (1 hr min) . 66.25/ hr
City/State /ZIP: Tualatin OR 97062
Investigation(' hr min) • 66.25/ hr
Phone: (503) 692 -1565 I O� Industrial plant (I hr min) 78.18/ hr
( ) Fax: (503) 691 -1879 \ ` ` ns Inspectio for which no fee is
90.00/ hr
t specifically listed ('A hr min)
/( CB Lic.: 5193 lectrical Lic.: 34 -47CLE I Lic.: 4647LEB ELECTRICAL PERMIT FEES - .
Suprv. Electrician signature, required: Subtotal: `75,
Plan review (25% of permit fee) .--.
Print name: John Chamberlain f Date: 4/ State surcharge (12% of permit fee): 1, a�'1
TOTAL PERMIT FEE t•t,C70
Authorized Signature' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name:
its /_ ^ it 1 Date: 61q1/2. • Number of inspoctionsallowed per permit.