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Permit r N . CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00089 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Date Issued: 03/17/2009 Parcel: 2S113AB00300 Jurisdiction: Tigard Site address: 16037 SW UPPER BOONES FERRY RD 175 Subdivision: Lot: 0 Project: Zip Realty Project Description: Data /telecommunications Owner: FEES OREGON STATE BAR, THE Description Date Amount 16037 SW UPPER BOONES FERRY RD Restricted Energy Permit 03/17/2009 $75 00 TIGARD, OR 97224 12% State Surcharge - Restricted Energy 03/17/2009 $9 00 PHONE: Contractor: NETWIRE COMMUNICATIONS 328 S CENTRAL AVE STE 202 MEDFORD, OR 97501 PHONE 541 - 826 -4824 FAX: 541 - 227 -6703 Type of Use: Class of Work: Total Number of Systems: Audio & Stereo: Boiler Controls: CCTV Clock Systems: Data & Telecommunications: Fire Alarm. HVAC: Instrumentation: Total $84.00 Intercom/Paging: Landscape /Irrigation. Required Items and Reports (Conditions) Landscape Lighting: Medical Nurse Calls. Protective Signal: Security Alarm: Other: Other Desc: 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 rf 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 throug OAR 952 - 001 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246 6699 or 1 800 332 2344 Issued By: c■- k . C _ lall " 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'N Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. 111 CI TY OF TTGAD1 RESTRICTED ENERGY a ELECTRICAL PERMIT C BUILDING SERVICES DIVISION 13125 SW Hall Blvd., Tigard, OR 97223 T I G A R D 503 - 639 -4171 www.tigard - or.gov PERMIT #: e '. e2009 . 000 ER DATE ISSUED: 3. 1 7 . 09 SITE ADDRESS: Q _ . s_- ! 41 ` PARCEL #: BLDG /STE #: 1 7 _ ZONING: SUBDIVISION: LOT: JURISDICTION: q j to, This is an interim permit issued during computer system maintenance. Construction work and inspections may proceed under this permit number. The actual permit will be issued and mailed to the applicant within one week of the date issued above. PROJECT DESCRIPTION: t vi. S\--c,.. l L • . • l-k e` Q .,4 A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK MEDICAL: HVAC: DATA /TELE COMM: )X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LAND LIGHT: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: OWNER FEES Name: Permit Fee $ 76-00 Address: Plan Review Fee $ City /State /Zip: State Surcharge (8 %) $ c (. O G Phone: Other Fee: $ Other Fee: $ CONTRACTOR Total Fees: $ R 1 . C..,0 Name: Address: City /State /Zip: Phone: Fax: CCB Lic #: Elect. Lie. #: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility N • s .. ' •se rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 -0080. You may obtain copies of these rules or direct ques . s to OUNC by c ing 503-'46-1987 or 1- 800 - 332 -2344. Issued By: GI CUL ✓� 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. ELECTRICIAN: DATE: LICENSE NO.: Call 503 - 639 -4175 by 7:00 AM for an inspection that business day. Note: If you cannot schedule an inspection while the system is down, please call 503 - 718 -2433 for assistance. 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. 1: \ Building\ Manual Permit System \ManualLLRpemvt doe 03/14/06 .. RECEIVE I Electrical Permit Application FOR OFFICE USE ONLY City of Tigard MAR 17 2009 Date/By V • I7 • O 444 2 l P11�C9 • 9 Permit No. ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ': II Phone 503 639 4171 Fax 503 598 1960 CITY OF TIG i Date/By Permit TI G A R D Inspection Line 503 639 4175 BUILDING D g ate Ready /By BI See Page 2 for . Internet www tigard -or gov Notified/Method Supplemental Information TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below) (3 New construction ❑ Addition /alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION 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 V Commercial /industrial ❑ Accessory building amps for all other installations buildings ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately denved system ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ", I00HP or more occupancy Job no.: Job site address: /6037 sw 5 id� ❑ Six or more residential units ❑ Recreational vehicle parks Ci /State /ZIP: r ) � q ,� ❑ -care facilities. ❑ Supply voltage for more than ty tL (� (�22 3 ❑ Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: I' Project name: 2 t p eeo l ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4 Ea add'I 500 sq ft or portion 33 40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq ft ) 1 / _( I S Limited energy, multi- family 75 00 2 ..6_ , vvi ( 122.1: (. /L j - Coo ,v o).5 residential (with above sq. ft ) J / 1 Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106 85 2 401 amps to 600 amps 160 60 2 Name: / ��� e�� 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 66 85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6 65 2 each branch circuit Business name: B Fee for branch circuits Contact name: without service or feeder fee, 46 85 2 first branch circuit Address: Each add'l branch circuit 6 65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90 90 2 Phone: ( ) Fax: : ( ) Reconnect only 66 85 2 E -mail: Pump or irrigation circle 53 40 2 CONTRACTOR Sign or outline lighting 53 40 2 i Signal circuit(s) or limited - Business name: AGt7 /70 COI'lvil LA) i act )d energy panel, alteration, or Address: 32,e6 S C>` /c ( /Le 414 247Z extension Describe. Page 2 2 City/State /ZIP: /h - ‘0(d ©/2 '7 so f Each additional inspection over allowable in any of the above Per inspection 62 50 Phone: (9 1 ) ZId _ 24.5 Zy Fax: (5/1 ) 221 - 19 76 3 Investigation per hour (I hr min) 62 50 CCB Lic.: I6,7 Z 7 7 Electrical Lic.: de //7 Su . Lic.: 1 12.C5 LE 8 Industrial plant per hour 73 75 11 cc'' ELECTRICAL PERMIT FEES Suprv. Elect tiCiarlignVul, required 1 r ( 1 0'11( Subtotal 715 , 00 Print name: G 4, ((d Date: 3 Plan review (25 % of permit fee) 1 fo? State surcharge (12% of permit fee) q, Qd Authorized signature: TOTAL PERMIT FEE !`J"[ . 00 Print name: r !� Date: This permit application expires if a permit is not obtained within 180 I �D �// 7 (� days after it has been accepted as complete. • Number of inspections allowed per permit 1 \BuildmgTermitsveLC- PermitAp o c 05/23/06 / 440 -4615T(I I/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: 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: ' COMMERCIAL WORK ONLY: 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 ❑ 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 I \Buddmg\Permns\ELC- PermnApp doc 03/23/06