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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 0 COMMUNITY DEVELOPMENT Permit #: ELR2012 -00193 T t (JARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/15/2012 Parcel: 25101 DA00104 Jurisdiction: TIGARD Site address: 13333 SW 68TH PKWY Project: Clear Channel Radio Subdivision: VARNS ACRES Lot: 9 Project Description: 3rd and 4th level Fire Alarm limited energy Contractor: BERGELECTRIC CORP Owner: TRIANGLE POINTE LLC 13650 NE WHITAKER WAY 901 NE GLISAN ST, #100 PORTLAND, OR 97230 PORTLAND, OR 97232 PHONE: 503 - 255 -1818 PHONE: FAX: 503 - 255 -1919 • 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: N Fire Alarm: Y 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 5 - 001 -0090. You may 1^ obtain ' a + copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1 Issued By: lh 'LLtL�I Permittee Signature: ©A 4 r rUC3M7Tn D a 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. From: Marylou Dark Fax: (503) 255-1919 To: Fax: +1 (503) 598 -1960 Page 2 of 3 8/14/2012 9:21 Electrical Permit ApplicatiRF,CEIV FO12 OFFICE USE ONLY � City of Tigard Received -h5 h z �L Permit No.: C.:=4.4.4. Ca - �I q 13125 SW Hall Blvd., Tigard, OR 9772,1) r 1 4 ? I1 ? Plan Review t g Phone: 503.718.2439 Fax: 503,598.1960 Date/By, Other Permit s Apia 3[ Inspection Line: 503.639.4175 /^t ' �+��r, /� Date Ready /By: Jura: See Page 2 for TIGARD Internet: www.tigard- or.gov l la L U 1 G3 Pa? Not;fied/Method: Ti V i Supplemental Information i F} g ����t1 4F • ._, ,.._....- -_....�_. - -.. ;... ,,_... :_ :- .. ate : r< : :.....,..._.,.J �- ,- � „ -;.r - ❑ New construction Addition /alteration /replaeelnent Please check all that apply (submit / sets of plans whtems checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. - - - - - - - ”' ' - - =-r=•` ' - exceeds l0 000 amps at 150 voles or Floating buildings. - :e� >: - - - P 8 s. B — C `C.. ySfItIt • ._i _ taxi;;; a.` " - "`' � "`' -`'''` ` '' " " - " '�' - less to ground, or exceeds 14,000 ❑ Cotntnereial -use agricultural 1 - and 2 dwelling ornmercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ': '� , 1 , ,... : ^.:r _ - - ` - -- ' _- - - :,- _ - - - �s :7.,e.r_ system. .. , _., �: . _ :>, Emergency syste larger separately � : -� ; a ,. Emerge system. rsepara envetls st "JOB`_ - _ `FORMA UN : LOCATJON '�-_`�'> ; <r -�--- ,::; : �r�'E-ii\ � � T "" -' . .,, - _ ..,: -. ❑ Addition of new motor load of 0"A", ”E" "I -2" "1.1" lob no.. 136y Job site address: : 100HP or more. occupan J . �ZJ J� �'`y ❑ Recreational vehicle /// ❑ Six or more residential units. parks. City /State/ZIP: t,,,,�i_ ®k qq72)-3 ❑ Health - care facilities. ❑ Supply voltage for more than / n ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: C ['Service or feeder 600 amps or more. Cross street/directions to job site: Description 1 Qty. I Fm. I Total I • New residential single- or multi- family dwelling unit. • Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Es. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential �.. -- _ - 75.00 2 ab ve ft - - with o s - - i s f'1i � . tii£�� - �.n � o�v.. � ( I Limited energy, multi - family r• l re 1,'�Ir'41/` O vL taxi 3 o?I4II ('f residential (with above sq. ft) 75.00 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 •, :t z1_ _;. Y,k .;irl.,lai. *' >ig 201 am to 400 am rt'[R�P _7'- �i'�U -- - = - -- =.1�?s =1; J`�'��'- �_,r > - � 2}='" Ps Ds 133.56 2 Name: (tear ( - IA?anNA 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 2625 5 \ 144 , ., ;,..( p r - Over 1,000 amps or volts 552.26 2 City/Stale/71P: 1-1//5.1 9 0/ -2(//.2-41 Temporary services or feeders installation, alteration, and/or relocation Phone: (5091 ) 5-g5 9/Q 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 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits- new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ; _ : - - - _ - - - - _ ,; ; j- .,=. above service e, 4 ,, a,, , Ah'f _ r. ' 's N7TAET R !Y - n - ' = _ or feder fee 2 - each branch circuit Business name: Bergelectrie Corp B. Fee for branch circuits willr,ur service or feeder fee, first 56.18 2 Contact name: Pact P - R,r s}l^. branch circuit Each add'I branch circuit 7.42 2 Address: 13650 NE Whitaker Way Miscellaneous (service or feeder not included) City / State/ZIP: Portland Oregon 97230 Each manufactured a d/ r feed 67.84 2 dwellin(;, service and/or feeder Phone: (503) 255 - 1818 Fax: : (503) 255 - 1919 Reconnect only 67.84 2 Pomp or irrigation circle 67.84 2 E - mail: Wei -cm^ 0 bU•tQt is 1CoU� Sign or outline lighting 67.84 2 _ _ ,; � _, : - � :.,, . _ _ - _ _ _ _ - _. . - : :� = -r �. _.... - ," _._.." ...,._. .... Signal circuit(s) or limited _, . � . -..� •��rTaQ_ -.— ;2_��,_;- <e�' =�_ i Paget � j 2 Business name: Bergelectric Corp panel, alteration, or extension. Each additional inspection over allowable in any of the above Address: 13650 NE Whitaker Way Additional inspection (I hr min) 66.25/ hr City/ State/7IP: Portland Oregon 97230 Investigation (I he min) 66.25/ hr Industrial plant (I hr min) 78.18/ hr Phone: (503) 255 -1818 Fax: (503) 255 -1919 Inspections for which no fee is 90.00 / hr ifically listed (fa hr min CCB Lic.: 110521 I Electrical Lic,: 37 -682C Suprv. Lic,: S485S =: , r ,;>c; • F., t r•.: n e4„j i ` Agi.Vi- „ :` € . :: Suprv. Electrician signature, required: /mil Subtotal: 7 ' f j Pl an rev ( of permit fcc): Print name: e Y r a il r // 7 State surcharge (12% of permit fee): � Date: 0r , r L ur Cj -- TOTAL PERMIT FEE: M— Authorized signature: _ permit application expires if o armit is not obtained within 180 4t I v P PP p P � days after it has been accepted as complete. J / i L iliz //� a Print name: It Date: /7 + Number of inspections allowed per permit” i:\ Dailding 'Permits \ELC.PermltApp.doc 07/01/10 440- 4615T(1 I/n5/COMM'EB From: Marylou Derk Fax: (503) 255-1919 To: Fax: +1 (503) 598 -1960 Page 3 of 3 8/1412012 9:21 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 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: rat?r! 3Y1V1*:001" .�1Sitit lYL3 ..1 + . g n. 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 ire 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 I: Bu tdiny.Permirs\ELC- PemutApp.doc 07!01 /10 From: Marylou Dark Fax: (503) 255 -1919 To: Fax: +1 (503) 598-1960 Page 1 of 3 9/1412012 9:21 Bergelectric Corp. Contractors & Engineers as . FAX T NSMITTAL DATE: NIL1 \17-. TO: Company: C+ A-t _ % Attention: ��4 \ YYlk\ aQ OV. Fax #: FROM: , APc\a r No. of Pages: 8 (including transmittal) SUBJECT: . p‘,9 noi , P& GA-V0 \ cLd L 0- pp. p4 flL cl,p 1■ rind .1 U 1j 1 (ThoVj qp i LrYk 11 ►1-f i1 A ;9A-Lo .� (rm . ,11 -../3. • 13650 NE Whitaker Way, Portland, OR 97230 Tel (503) 255 -181 Fax (503) 255 -1919 PAC. 315