Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELR2012 -00175
T WARE) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/07/2012
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 145
Project: Cundiff Engineering Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: (1) low voltage for data /telecommunications for TI
Contractor: CACHE VALLEY ELECTRIC COMPANY Owner: PACIFIC REALTY ASSOCIATES LP
6200 SW ARCTIC DR ATTN: N PIVEN
BEAVERTON, OR 97005 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 -431 -6600 PHONE: 503 - 624 -6300
FAX: 503 - 624 -1436
FEES
Description Date Amount
Specifics: , Restricted Energy Permit 08/07/2012 $75.00
12% State Surcharge - Electrical 08/07/2012 $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- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 .232.19877or
Issued By: Permittee Signature: 19k., A PLI C.. Pt 1 C Oki
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.
08/06/2012 14:51 FAX 425 424 9966 CACHE VALLEY ELECTRIC gi001
tz:e; RFf;r _ Electrical Peirma t Application ere•r •� FOR 0FP10E 1S1?. ONLY .
C i t y of Tigard AU G 0 6 2012 C Inlea Permit No.: G ate i a. co tr7 -
13125 SW Hall Blvd , Tigard, OR 97223 Pisa Review j R��� _ 00 fib
g Phone: 503,718.2439 Pax: 503,598.196(c' ' 7f +^' rIG p , 1 : OtherPeltlhit
�+� i +-� .ti ; ! Id see Page 3 for
TIGAR6 Inspection
ntern onLitta: 503.639.4175 r q �0 ,- -.,. Dta d /By NM SuppLemeale!Information
Internet tw w,tigard- or.gov my L � '_':� il1v1S1, .., , ....ad:
r —. w ":i a=,;:f r.: .`•' -`�sar - F ier -
❑ New construction ® Addition /alteration/replacement Please eh • ail that apply (submit 2 sets of plans.rPtems checked below):
Ei Service or it:eder400 amps or more 13 Building over three stories.
❑ Demolition ❑ Other. Ogre the available radt current El Marinas and boatyards.
:x > ` : , exceeds 10,000 amps m ISO Sulfa or ❑ Floating buildings.
s Ett �?`�t =Y�" � t � iY r° : _ ° " `` j � lessto mooed, or exceeds 14,000 Q Oommesetal- useagrieultoral
❑ 1- and 2- family dwelling ISI Commercial/industrial ❑ Accessory building swops tar all niter installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fins pump. ❑ lastallatlon or7s KVA or
t ,•. ,- x.a 0 Emergency system. larger separately derhrdsystem.
IS sr 4 1BI RQ L Q. ' _ �- 6uy e = . :el 0 Addition draw motor load or ❑ , A ", % - ,"1 - r,"1 - r,
Job no.: 44449 I Job site address: 7007 SW Cardinal Lame teollror moro o< l -
CI Ste or mom residential units. 13 Recreational vehicle t -
City/State /ZIP: Portland, OR 97224 ❑ Health-care facilities. El Supply v �8a more than
0 liarandous locations, 640 soils
Suite/bldg./apt. no.: 145 I Project name: Cundiff Engineering 0 Service or Ruler 600 amps ormore. �,+
�7 1 EP1t � :.x:11..
Cross street/directions to job site: n • • Ilaa on Fat. roles •
. New residential single• or malH-111tnbiy dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,0008q. 0. &less 168_1 4
Ea. add'l SOO sq. it. or portion 33.92 1
Tax map /parcel no.: , energy, residential
1x ...t.41-37,s21...41:1-M.,..-W0- _ .0v u- 7 � s .o. ,g`u�':.� „. . -: .r (with abovo sq. it) 75,00 2
:�r%. ..1 { w•�a:'�a fad • �� '`� }� ' Limited energy, multi
voice /date low voltage installation residential (with above sq. ft) i 75'00 2
Services or &earn installation, alteration, and/or relocation
200 amps or less 100.70 2
{,
/” igl t�` gitigMil ',,,r_`.x . ' ,' 3 lS j 201 amps to 400 amps 13356 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 maps or vote 552.26 2
Temporary services or keders installation, alteration, and/or
City/State/ZIP: relocation and/or
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner Installation: This installation is being made on property that I own which is not 201 ampler 400 amps 1 I 1258 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 clops a 599 amps 16854 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Data A. Fee far branch circuits with
% �,. $ �— above service or feeder Re 7
1 r l a yer - d "n ` :. \7i t mti. :L „a : :
:��= .. . ._ a H e .. _ e e �`^, . .42 2
� �T" «. .. � d ..���. . � � each branch circuit
Business name: Cache Valley Electric B. Fee for branch circuits u'idwar
service or feeder fee, fast 56.18 2
Contact name: Vanessa Martin finch dreuit
Each addl branch circuit 7.42 '2
Address: 6200 SW Arctic Drive Mli ellancous (service or feeder not included) -
City/State/ZIP: Beaverton, OR 97005 Each manufactured or modular 67.84 2
x dwelling, service antler feeder _
Phone: (503) 431 - 6600 I Fax:: (503) 624 - 1436 ' Reconnect O°ly 67.84 2
Pump or irrigation circle 67.84 2
E - mail: vaness sign atonable lighting 67.84 2
40r.0AilitAgi-`rft1RtkgrAONO :�"_� a�,i:�s�a ltin Signal x3rcuit(s)orlimited•energy 1 f
Business name: Cache Valley Electric panel, alteration, orextensian. - Page 2 t 2
Each additional tnspeedon over allowable in any of the above
Address: 6200 SW Arctic Drive Additional inspection (1 hr min) 6625/ hr
Investigation (I hr min)
City /State/ZIP: Beavorton, OR 91005 .
Indthstrlelplant (1 hr min) 7866.25/
78.1818
/hr
Phone: (503) 431 - 6600 I Fax: (503) 624-1436 ' Inspections for which no fee is 90.00/ is
s• 4' dealt •listed hr mot
,CCD ` Lie.: 148222 .Fitfetrical Lie.: 37- 976 -C oSulsrv. Lie.: 50 S t :. :. 'o;. : girl: e. ( 1'E1 hnt9' ES ::a -4` —y
w� Subtotal: 75.00
Suprv. 8lt ctriclan signature, required: _ . 1 -. � �, —
�L f� _ Plan review (25eYo of permit fee):
Print n a m e : � � 0 re ;r J / Date: S _ G _ iZ State strtdtarge02%of permit fee): 1125
TOTAL PERMIT FEE: 8625
Authorized signature: This permit application expires it o permit is not obtained within 180
Print name 11]ate: N umber of days after 11 bas been accepted at complete.
inspecionsallowed per peewit. g q
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