Permit .................... ...
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
$ COMMUNITY DEVELOPMENT Permit #: ELR2013 -00035
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/13/2013
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 101
Project: Illo Chiropractic Subdivision: VARNS ACRES Lot: 3
Project Description: (1) low voltage for Data/Telecommunications
Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: HILLTOP BUSINESS CENTER LLC
1709 SE 3RD AVE HUNZIKER LLC
PORTLAND, OR 97124 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 234 -9900 PHONE:
FAX: 503 - 234 -1001
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/13/2013 $75.00
12% State Surcharge - Electrical 02/13/2013 $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 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 -101-009o. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80
Issued By: ���J �- ►• Permittee Signature: O� �0 �O
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 503.839.4175 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.
Electrical Permit Application k 'T_ EE
b , � FOR OFFICE lltie ONLY
City of Tigard Received
Date:By: 3 s Permit No,:E� ,'to/ 3 ) oo3s
13125 SW Hall Blvd., Tigard, OR 97223 1 2013 plan Review a ( ! 3 p
Phone: 503.716.2439 Fax: 503.5981960 Date/By: Other Permit: �1, .Q/ 3 - 0007
I I (; n R I) Inspection Lane: 503.639.4175 CITY OF TIGARI) Date Ready /BY: kris: � / � El See Page 2 for
Internet: www,tigard- or.gov Notified/Metbod: , C Supplements] Information
❑ New construction M Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more CI Building over three atones,
❑ Demolition El Other:
where the available fault current ❑ Marinas and boatyards.
'1 t ev y t1:- •' ( , ; exceeds 10,000 amps at I50 volts or 0 Floating buildings.
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVAor
❑ Emergency system. larger separately derived system.
' 0 `' i*,,Olt ❑ Adddion of new motor toad of
0.. „ E . ,. 12 ., „
Job no.: 55799 Job site address: 7340 SW HUNTZIGER RD
100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97224 ❑ Health facilities. ❑ Supply voltage for more than
❑ (Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 101 Project name: ILLO CHIROPRACTIC ❑ Serviceor feeder 600 amps or more,
Cross street/directions to job site; Descriptive D .
I Orv. I Far. 11 Total i � ••
I New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. fl. or less 168.54 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
,, t J1...s ; y (+ts '- . .? ,t, ''' (with above a1. IL) ,
' T imited energy, multi - family 75.00 2
LOW VOLTAGE VOICE & DATA CABLING residential (with above sq. ft.) _
Services or feeders Installaation, alteration, and/or relocation _
200 amps or less I 100.70 2
- 201 amps to 400 amps 13156 j 2
401 amps to 600 amps 200.3.4 2
Name: 601 amps to 1,000 amps 301.04 2
Address: , Over 1,000 amps or volts _ 552.26 2
City/ State/ZIP: rel Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
20! amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 r 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: — _ _ Date: A. Fee for branch circuits with i
y - '_ above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit t
- Each add'( breach circuit I 7.42 2 .;
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: !Each manufactured or modular
6714 2
tY dwelling, service and/or feeder
Phone: ( ) Fax :: ( ) I Reconnect only 67.84 2 .
Pump or irrigation circle 67.84 12
E -mail: Signor outline lighting 67.84 1 2
1 ' .r:. ' ..... ' .. , Signal circuit(s) or limited - energy 111 • Business name: OREGON ELECTRIC CONSTRUCTION, INC panel, alteration, or extension. 1 Page 2 75.0° , 2
Each additional inspection over allowable in any of the above
Address: 1709 SE 3” AVE Additional inspection (1 br min) 66.25/ hr
City/ State/ZIP: PORTLAND, OR 97214 investigation (1 hr enin 66.25/ hr
)
Industrial plant (I hr min) 78,18/ hr
Phone: (503) 234 -9900 Fax: (503) 234 - 1001 Inspections for which no fee is 90.00/ hr
— ' specifically listed (h hr min
CCB Lic.: 203 Electrical Lic.: 26 -95C Su .. Lic.: 4818S 1p,
Subtotal: 75.00
Suprv. Electrician signature, rexluired: 7 ,. ' '
Plan review (25% of permit fee):
Print name: MARK WEINBENDER Date: 2/13/13 State surcharge (12% of permit fee): 9.00
� TOTAL PERMIT FEE: 84.00
Authorized signature: f: l(� ,, This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: MARK WEINBENDER Dat 2 /13/13
• Number of inspections allowed per permit.
MBuddingTermis1Et .GeermitApp.doc 07/01/10 440A615T( I IIOSICOMLWEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
a
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ B urglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
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
1.1 Data Telecommunication Installation
❑ F ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ L andscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
O Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7340 SW HUNZIKER RD 101, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
02/26/2013 00:00
ELR2013-00035
PASS - No C of O
Violation Summary:
Inspector Contractor