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Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT • COMMUNITY DEVELOPMENT Permit #: ELR2012 -00192 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/15/2012 T I GARD g Parcel: 2S110DCO2200 Jurisdiction: Tigard Site address: 15660 SW PACIFIC HWY A -1 Project: Petco Subdivision: 1997 -016 PARTITION PLAT Lot: 2 Project Description: (1) limited energy rewire for Data /Communications Contractor: CALLAHAN ELECTRIC Owner: TRC MM LLC 4830 SE CONG ST 5973 AVENIDA ENCINAS STE 300 PORTLAND, OR 97206 CARLSBAD, CA 92008 PHONE: 503 - 421 -4553 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 08/15/2012 $75.00 12% State Surcharge - Electrical 08/15/2012 $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 503.232.1987 or 1.800.332.2344. �] /) f Issued By: PermitteeSignature: /AL PfL � � �^ r �.fL "V'�` 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 503.639.4176 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. Electrical Permit Application I• ( l: ! 11 1 1( 1: 1 ' I i `. 1., li ___ . City of Tigard _ •: � s d ), i 5( Permit .706,2_ ` OD! ' , I I 13125 SW Hall BIv. • ward, OR 9 3 plan Review other Permit: 503.718.24 • Fax: 503.598.19 0 , fjatersy: Inspection Line 503.. - • .4175 1 U ] 2012 Here Ready - ® Ere .Pew z ro>- Internet www.tigard- or.gov Notified/Method; T I (' Supplemental tnfermation 7 �� r YYIQ. OP-'Wb a �1� S ON w: . ❑ New construction Additi `� cited all that nip (submit 2 s ets of wlitGtns aheckvd bofow): CI Service or Stotler 400 amps or more 0 Building our throe stories. ❑ Demolition Other. where the available felt =runt ❑ Marinas and hmay ands • • . r q' . . exceeds 10.000 amps at 150 volts co ❑ Floating broldinto. lea to grotmd, or exceeds 14.000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building amp, for all other installations. buildings, ❑ Multi -family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ installation of 75 KVA or derived system. . °Emergency gram larger . . , i OB . s K'hlyll7 A)!#1 A I : . © Additiat of new motor bad of [] - A ", "E ^1- 22'Y "! -3', • • Job no.: 1 Job site address: /5- !0110 5u,, Prti6 �i' tool�e or mom 0P0°°a"Oy. 7u.- ❑ Six or more residential 'mite. a Recreational vehicle parley. City /State/ZIP: -+ A. C q 71-1 -V f a Ffsahh -care facilities. 1:1 9app1Y voltage kit more then Suite/bldg./apt. / liexmdons locations. 600 volts nominal, g apt, no.: I Project nature: p 0 rc ` 4 1 —d Service or feeder 600 amps or rtrore• Cross street/directions to job site: ' .1 .:' . D ' : • tree. �T wrl ; • New residential single- or multi - family dwelling molt Includes attached garage. Subdivision: I it no.: 1,000 s4. ft, or less 168.54 4 Ea. addl 500 sq. R. or portion 33.92 1 Tax map/parcel no.: United mew, residential (with above sq. ft.) 75.00 2 Limited energy, multifamily C w � : - r'. a - ' . y.. '1- residential (with above eq. R) _ 75.00 2 Services or reedere itpmllatioa, alteration, and/or education ✓� 200 amps or Ices 100.70 2 • . ; D I'Yi ffit 1>tE:t . .1 • . a 'iF' ,rf . • 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps orvolts 552.26 2 City/State/ZIP: relocation Temporary ore rvleea or Feeders installation. alteration, and/or . Phone: ( ) I Fax: ( ) 200 amps or teas 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amp° t94°0 emits 125,08 2 I intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 168.54 _ 2 Branch circuits -- new, alteration, or extension, perrttael Owner signature: bate: A Fee for branch circuits With . ,.' ' .7.. A utA ' • . t a coOrrAC itieciN'. • : ‘ above service or feeder foe, 742 2 • each branch circuit Business name: ( ((rA .IL6 AN '/ ( /' B. Fee for blanch circuits wldm,er L � service or feeder (be. first 56.18 2 Contact name: S / , 4v branch circuit � ` Each WWI branch circuit 7.42 ( 2 Address: . t) .,► C Miscellaneous (service or feeder not included) City /State/ZiP: f a . h /,+..i k an- e � 7 L Each manufactured or modular 67.84 2 7 /" /*ening, service and/or feeder Phone: ( 4[1 ) 14 Fax: : (sb 3) Reconnect only 67.84 ^ . 2 E -mail: I • jA1�f Purim or irrigation circle 67.84 2 t � �"'�a �' Sig/to 67.84 2 • - signal mrcutt(s) or limited -end . , r Business name: n a eJ panel, alteration, or extension. / __ Page 2 2 �� ` c r L � .L Each additional Inspection over allowable in any oit above Address: — L•U S E - , 6, ✓ T _, Additional inspection 1 ( hr min) 66255i/1117 City /State/ZIP: 0 bK 4 • 1, .6 0 Investigation (1 hr min) 66.2 Industrial plant (1 hr min) 78.18/ hr Phone: ( (('z( / g 3 Fax: ( ) Inepectlons for which no fee is CCD Lic.: �% l Electrical Lic.: S Lie.: fib' listed (!5 hr min) 90.001 hr • Suprv. Electrician signature, requited: r / Subtotal: 7:•47 .. - '' a Plan review (25 %of permit foe); 0 • Print name. /! r ,., Date: State surcharge 12•i6 of t fee): �C ' L `fit• • - ( rcnnt ) t' Authorized signature: TOTAL PERMIT FEE: . 5 Li l.. This permit application expires ire wield is not obtained within 180 Print name: Date: days alter it hma been accepted as countless. Number of Inspections allowed per permit. 1: llrulktitet \Prnni,WLC.Pearn;tA5p.d 07/01/in 4404615T0IOSSCOM/Wr,R Electrical Permit Application - City of Tigard Page 2 - Supplemental Infotmation LIMITED ENERGY PERMIT FEES: ::-Restororna,vosgmazi . 7 Fee for a 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: •.0 0i <fraTi . Fee for ta&k commercial $75.00 syste (SEE OAR 918-309-00R Check Type of Work Involved: ❑ Audio and Stereo Systems 0 Boiler Controls ❑ Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ 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 C deq+'Pemr7 07/D1n0 L\ Building \ Faring \PaymentAuthofwation_o3t612tbe