Permit •
If CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1111 COMMUNITY DEVELOPMENT
Permit #: ELR2012 00173
Date Issued: 08/02/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S136DA00101
Jurisdiction: Tigard
Site address: 11410 SW 68TH PKWY
Project: PERS Subdivision: PFAFFLE PLAZA CONDO Lot: GCE
Project Description: Data telecommunications.
•
Contractor: TRUEDGE COMMUNICATIONS Owner: OREGON, STATE OF PUBLIC
1224 NE WALNUT ST, PMB 249 EMPLOYEES' RETIREMENT FUND
ROSEBURG, OR 97470 11410 SW 68TH PKWY
TIGARD, OR 97223
PHONE: 541 - 464 -4664 PHONE:
FAX: 541 - 673 -1370
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/02/2012 $75.00
12% State Surcharge - Electrical 08/02/2012 • $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 $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OA 95 - 01 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23321987 or 1.800.332.2344.
Issued By: Permittee Signature: e " .1 e-Rtoe'fee,-7-7onl
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 603.639.4176 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each Inspection.
8/2/2012 11:29 AM FROM: Fax TO: 1- 503 - 598 -1960 PAGE: 003 OF 004
r:
E E
Electrical Permit Applicatio . FOlz.OrrICE (JSI O.NL.Y
II City' of Tigard AuG o Reuie
4 Phone S50 Hal! Blvd. Ti and. OR 9 ?223 Dnte.'Hy: 477 /0 4 6i,
g Plan Rev
2 .
Phone 5113.71 ti2439 Pax: 503.593. A (` "� Dale y � Oilier Permit. rt1447749192 -.6742/23
i .; RD Inspection Line: 503.639.4175 , � ,.. - .,rnP 1 Date Ready:By: 1 ills *. Set Paget for —
Internet: www.tigard- or.gov' BU P.r.' ' °' ' Matiiledimethpd Supplemental Information
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_ rxw' v =3`!.� s fss. - `f" , - :41 '44P t f; r : s. _ . ". a . _ 'isz�w:c. 1It•P A�ic *E -13s . i.I.r'r x az,.:
_... .,;;. :: r� f.�.�_,.�P ♦ZI.i- . -. -� � .:-$ z'��x : ?R,'�"✓4 _ . b : - i i"�,t • `,f34.�.,, ".?�g ^ m_'�` + - G :a.. F_ , -- -� ..- �'� : «�..f- �� - : - :.�
- 0 New construction ❑ Addition /alteration /replacement Y Please cheek all that apply (submit 2 sets of plans weituns checked below):
' ❑ Service or feeder 400 amps or more ❑ Building over three stories.
I I ❑ Demolition 0 Other: where the r,vailablu Caul: current ❑ Marinas and boatyards.
;�' ' - .:4'7 4, �' ' v AT _ , gfAkl ; - ".4 ;cij' E Z - T0N. x ' 1 +e°" "'.1 $4 exceeds 10.000 amps at !so vuiu nr ❑ I'ioaiing buildings.
Is stir.`} :_Y_ -s .r Y ski- .- _>_ i - -_._ -= -. = =k. � 1: t - 'ttlfi. ' Et n a .. Y.
Itcs to ground, or exceeds 14.000 ❑Commercial -age agriwL'ura!
1 ❑ I- and 2- family dwelling Q Commercial /industrial ❑ Accessory building amps for all alter installations. baildinp.
❑ Multi - family ❑ Master budder ❑ Oilier: • ❑ tire pump. ❑ installation of 75 K \'Apr
• . . , , - - • • - ��. , ,. . - ❑ Emergency system. larger separately derived system. •
:i •. a:�.x.,. ;;ii,;.'. ,. • • • -
, ) r 'tit Q, 1", ASQ441)..N, Tie , - ^ `i?#. ❑ Addition Ito i , '❑ i .. .
-�_- � .. _-_-, : , t:: =34��, � u: <. si�s� -,,_r: �sa..'�``w A lion of new motor load I'
Job no.: 001 i J . Job site address: = t 1 r 1')t 10011r or more. occupancy.
J
--_ i - ! / + 7 / �• U,) � S tL CT . ?J )a t;( ❑ Six or more residential units. ❑ Recreational which: parks.
City /Stale/ZIP: '7Tcr � .7 / , �7 1- - ❑ Health -care facilities. ❑ Supply voltage for more than
/i Ll if ry I ' ❑ Hirsardous locations. 600 volu nominal.
Suitc'hldg.iapt. no.: J - -- Project name: T L(t j &J f 1 _ ,�''9r _D Service t feeder 600; amps or more. = ;
Cross street/directiar.s to joie site: P� n„niyaon ' l Qty. I Fee. ' t Tonal ' .
`— -- New residential single or multi - family duelling unit.
Includes attached garage.
Subdivision: Lot no.. 1,000 at. P:. or lei ®— 4 1
- - i Ea. add'1500 sq. ft. or panion 33.92
Pax map /parcel iio.. a - — - - r.
L imited enrcrgy, idcrcc tia. i
' 3 b } CRfP1 . F`�F4RK -, r � , , x't `''; ; 'p 'if (with above sq. t•)
j � Gmded energy, multi-family l i
`
rl e4. °f ' ii t_ r 75.(10
�.�r 7 t ; e r r Xrrr`t c2 i ,tea, / p residential (with abot'c sq. it.) I I
Y 4 f / Services or feeders installation, alteration, and/or relocation
, 'E CO y n n, sg s/ ' ,a s ' vis 7a eci. r mss^ 200 amps or less 1 100.70
- a - . •�'? {`l --ry : ' :; ' "x- - \ - s # rrri.;r1'i,t- 201 am to 40(1 amps _ 1 i 3_.56 • r R : (1 l 11 ER .,._ . . :_.� ;.. 0 1 S7' R --r-...;",76.74--------- I
- . ^s 4111 amps to 600 amps a
Matte: - -1. - --
--- —_ -. 601 amps to 1,000 amps j 301.04 2
Address: Over 11)0)1 amps o' volts I 55226 2
- -'` - " — Temporary services or feeders installation, alteration, and /or
City ^Spite /ZIP: relocation
Phone: ( ) Fax: ( ) 20u am or less 59.36 1
301 amps to 400 amps 125,08 I=
1 Owner installation: This installation is being made on property that I own which is not
1 intended for sale, lease. rent. or exchange, according to ORS 447, 449, 670, and 701. 40! tulips to 599 :,mpg 155.54
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with 1
_ F } — ---.- ------ above cmce or feeder fee, i
•
Q A 1?LIC� - ' 34?+)T r :, ? `t� :c 3 - ❑TCO>dP' cr P.R1( [tY' "�'x` »« 'i 7.4: 12
i , pp f each branch circuit
I3usne3snamc.j\JE7tCm G L r A c 'i r -P /ri 7N71,i.11AlY7. H Fee circuits ! I ,
• Contact name: brunch circuit
n 4 7 1 service o f ee d er fee, lira 4 56. t 3
I I _
. kssi ct� 1 1 Each add'1 branch circuit t —
-- - '
A. � IA C . plb 19
..4_ 2
Add
ess: 1,.2 Li /vt11.6.1.4 d ?ar 2. Miscellaneous (service or feeder not included)
1 Cif 'u/7_iP: �^ y - ._..._._....... Gash manufactured or modular
I y/ Sta[ p JJ t &t . i ., Gk q7 I U _ l i'eilin service andlor feeder
6, s4
Phone: ( } ( J Fax: : ( l ) 1 Rea�nneo( only 67. 2
r ' y '1 -y. I t' � � -t ��� Pump orinigatinncircle 67.84 1 2
L E- ma il: . e.ss,.. di t o# : zt.l.fl1
� : . 4 , � ,,., , „ : Shenor outline lighting b7.H4 2
.^_
>-.r s > =,CONTRAC frwe TI,PV '_.'... . • t <r. µ
;= ' , 1 e �' :':.• : rt(s) or limited-energy I... Signal ctrcu panel. alienation, or extension Page'_ 16.w 2
Each additional inspection over allowable in any of the abov
Business numL. l l Eyee 1 1, t e C'ib7Ci f t:-ftc r : coervnGt i , cat. Gr'tS
1. ..._.._.._. J f e
\ddress: n N11O f ” �� tilt 27:q1 _ Addiuoaal itupeclion ti hr ruin) 66.25( hr 1
Investigation 11 hr min.) 6625i hr 1
City/State/ZIP: ZIP: ( K. 1:11 Z) — -i - -- I
)GSZf I
! � Industrial plant (I h r n 78.18i hr I
Phone: (54 i ) l.1 V Li _ ti (I. L I Fax: (✓ q i ) 7 3 - ! 3 7 0 Inspections for which no reek. 1
I I
elX:ali,:ally hs,cd (! in nun) dt . ; n'
CCB Lic.: ,, C Electrical Lie.: ••17 I Supra'. Lie. :31732 ,4-4 i444, 0 t- t - r te rip # 4.t
- -- . zi ill / subtntai: z 5 , 0
Spry. Elcctriciai,�Flgt1 tune, required: �f � io T/
- _...... _ + r. Plan review (25% of permit fee):
Print name: RDb 1 -.� �f1 t(� Dale: ?_) - t Statesunharge('12ioofptmtiit fee): �� ,?
Authorized signature: �� g __! r This permit application expires if a permit is not obtained within 180
Jay's after it has been accepted as complete.
Print name:
..--) ,101)cl-it- L. (ff I /PY I Date: g'.- a - f a
— Number of inspections altrmed per permit.
1...nuoldin t'owiRJit.C- ':m,i :Arpdoc Old I 140 -1615 r(1 I.G5 CON.11WEI3
8/2/2012 11:28 AM FROM: Fax TO: 1-503-598-1960 PAGE: 004 OF 004
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information RECEIVED
LIMITED ENERGY PERMIT FEES: Aur, 02 7n17
41t$1.1AW.FtWVOMONEVA:44:**iti444L CITY (r
Fee for for all residential systems combined $75.00 BUM • •
Check Type of Work Involved: TIC MID
Audio and Stereo Systems*
fl Burglar Alarm
Garage Door Opener* •
E i Heating. Ventilation and Air Conditioning System*
LI •
Vacuum Systems*
0 Other:
•
f7
Fee for each commercial $75.00
system
(SEE OAR 918-309-000()
Check Type of Work Involved:
11] Audio and Stereo Systems
O Boiler Controls
fl Clock Systems
Data Telecommunication installation
Fire Alarm Installation
LI 1-1VA C
LIII Instrumentation
O Intercom and Paging Systems
El Landscape Irrigation Control*
0 Medical
O Nurse Calls
O Outdoor Landscape Lighting*
fl Protective Signaling
II
Other
'Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
f-I Iii Venn Its■ELC-Den rti.I pp du, 10:51 10
- — ----• • --•-'-- • • • • .. . — .