Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2012 -00260
13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/20/2012
Il , g Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 150
Project: RTM Investments Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: Audio visual wiring.
Contractor: PROJECTUS Owner: PACIFIC REALTY ASSOCIATES LP
6750 SW BRADBURY CT ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300 .
PORTLAND, OR 97224
PHONE: 503 -598 -8968 PHONE: 503 - 624 -6300
FAX: 503 - 746 -9110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/20/2012 $75.00
12% State Surcharge - Electrical 11/20/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: y Boiler Controls: N
CCTV: N Clock Systems:. N
Data & Telecommunications: N 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 95 -001- 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: Permittee Signature: O/) /970,94 �G /6�0A
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.
NOV -16- 2012 09 :35R FROM :PROJECTU 0211 T0:5035981960 P.1
Electrical Perrillit A licatio V 9 ' I•f i )t;ru. u; USU. c)nlA
City of igtard 9 2012 kac4ivod /�� � hermit N
I� • 13125 SW an Blvd.. Tigard, OR .97223 NOV 1 Plan ^ IoW /a?90a 0
Phone: 5031718.2439 fax: 503.598.19 n Of TI t)ate/ny; _ Other �^" l(�� /02 'DD/ 9o
r u ,
Inspection lime: 503.639.4175 I " Dale R i ugr Id See Page 2 for
Internet: w w.ligard.or.gov B 1'L�G �iS� Notified/Method ��; 7 Suppkmentat Information
TYPE OF WORK l:l PLAN 'REVIEW
❑ New construction ® AdditioNallcratiort/replaeement Noose cheek all 11.11 apply (submit j sets of Marra w /items checked beluw)
CI Service Service fee r 400 amps or Mara CI Building over three stories
❑ Demolition CI Other: where Ihu avnd .hie Mall Curtest 0 Marinas anti barnyards.
CATEGORY OF C O N S T R U C T I O N a = v u m h i I,OU .unps oi 150 volts or O Booting buildings.
into to ground .n• exceeds 14,000 ❑ Comnmeial•usc sanonitnral
❑ I- and 2- family dwel ing Commercial /industrial ❑ Accessory building amps for rill n1i1ur installations buildings.
❑ Multi- litmily • El Master builder ❑ Other: ]Piro pump. 0 Installation or 75 KVA or
JO SITE AND' LOCATION OA •.:m high, Fr',"1 - 2","I. ' system
Q Addilion t. •• .note- toad Of 0 "A ^, "R I -2 ",' 1.3 ^, ' i
Job no.: I Job site address: 14945 Sequoia Parkway I un or more occupancy
} ❑ Six or more u: &Alibi units. ❑ ocrcational vehicle mks.
City/State/LIP: Tigard R 97224 ❑ Health-me 1•. Mies. 0 S t f o HMO than
-- 4 ❑ HaZardoni lot manta nta
p /J�� ❑ &mico0, RNA .r r600 umpsixn10re
7 ,.
Suite bldg. /apt, no . l30 l Project name: r /
j_ FEE SCIIEBI.lt,E,.
Cross street/directions tai job site: Carmen Drive /A/✓E371`/ENTS ortEemisil ..
,. I Qr y- 1 vet. I T I •
i New reaidentl,r l single- or multi- famlly dwelling unit.
Includes aitarlicd garage.
Subdivision: I I Lot no.: 1,00084. n u r l. s 168.54 4
• fat add'I 500 an A. ur portion 33.92 1
Tux map /parcel no.: ! I .ilnitcd energy, ',Ildenrlrl 75 as 2
DESCRIPTION OF WORD (with above: I (l)
. 1 Wired cncrgy. 1:tulti- tamily 75.00. 2
• �
Audio Visual Wiring and Installation of Displays and Screens residentnt. gilt above ail. R.) _
S ervIces of ferilera instaltatIon, alteration, and/or relocation
2 00 amps ot Ios, 100.70 2.
T 2 amps to 401• imps 133 56 2
Q P OWNER . • . I • ® TENAN ' .
401 amps V. 60 imps 200.34 2
Name: RM Clarity nits amps to l,t:•r ) amps 30104 2
Address: 14945 Sequoia Parkway, #150 Over 1,000 or volts 552.26 2
— Temporary set vices or feeders InatnllaHun, alteration. and/or
City /State /'LIP: Tigard, OR 97224 rclueattmr _
Phone: ( ) I Fax: ( ) ?00 amps lei• 5036 1
•
• 201 amps to 4th: mmpe 125 08 2
Owner installation: This installation is being made on property that I own which is not ,
6101 amps to sor fmna 168.54 2
intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670. and 701. ltratrch ell coil•. - new, alteration, or ealenslon, Ctcr panel
Owner signature: - _ Date: _ A Fee for iron. I: circuits with
® APPLICANT I . .0 C.ON'TAC'I' .. above sonic. or feeder he. 7 42 2
_ each br . .rcuit
Business name: Projectus �t Pee for bran. I. cireuils without
service or fc• for foe, first 56 1 S 2
Contact name: ,Joshua Haley branch cireuil
I ;bell add'I brat. a circuit . 7 42 2 -
Address: 6750 SW Bradbury Ct. Mlgeellaneow (service or reeder not Included)
--
. mutrui Al a or r modular + 67.84 2
City /State/ZIP: Portland, OR 97224
dwelling, servo . and/or feeder
Phone: (503) 598 8968 I 1 Fax: : (503) 746 -9110 R cconno , t nmly 67 84 2
Pump or irrgtal...n c ircle 67 84 2
E josh(projcc.com Sign or outline l,:thting 6 7 84 2
CONTRACTOR signal circtrit(yt.trlimitgl -encrp
Ausincs:tname: Projaetus panel,altcr-nio ur extension. . 1 _ Page _ 75 2
Each addition,' inspect over allowable In any of the above
Address: 675(1 SW Bra Ct. Additional . don (I hr min) 66.25/ hr
investigation (I rir loin) 66.25/ hr ,
City/Stale/ZIP: Portland, OR 97224
_industrial point ; l hr min) 74 181 hr
Phone: (503) 398 8968 : I Fax: (303) 746 -9110 Inspection{ Ibr hick no fee is 90.00/ hr
V CCB specifically l isb .1 c hr min) Lie.: 157 i80 Hp - q + Electrical Lie.: CLEI 1 i J[ Suprv. Lie.; 4453LE ; . . El I L I CTRICAL PERMIT FEES -
Pill 1011 /i f Subtotal: 75.00
Suprv. El signature, required: I I a,t review (2 tLw)
Print name: Jason Hicks — Date: 11/15/2012
Stu surcharge (129'4 ofpermit fee): 9
TOTAL PERMIT PEE: 84.00
Authorized signature: ; 49" - N,...___ - •. • This permit a,adlrntion empires It a permit is not obtained within 1811 •
de. s otter II has been accepted at complete.
Print ram es ulrf m y Date 11/ 15/2012 • Number. if ii.•,.oclinmmlowedperperrnil.
I• tauitoeunpam if.nrat•- , 'ennitApptine 07/01/10 44Me1SrttI/oaIcOMIwl8
NOU -16 -2012 09:35A' FROM: PROJECTUS,INC 9712490211 TO:5035981960 P.2
Electrical Permit Application - City of Tigard
Page 2'- Supplemental Information
LIMITED ENERGY PERMIT FEES:
rSIDLNTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Doo; Opener*
❑ Heating, Vcn,tilatiun anti Ait Cot System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: • ^�
Fee for &awl commercial .$75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
E Audio and Stereo Systems
❑ Boiler Controls
O Cluck Systems
❑ Data 1'elccommunication 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: 1
*No licenses are required. Licenses are required
for all other installations
I wilting eiosmut. mm i oymoIn