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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' . a . COMMUNITY DEVELOPMENT Permit #: ELR2013-00032 T E GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9759 SW WASHINGTON SQUARE RD D05 Project: The Art of Shaving Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: (1) low voltage for Data/Telecommunications for TI Contractor: SERVICE COMMUNICATIONS INC Owner: PPR WASHINGTON SQUARE LLC 4120 SE INTERNATIONAL WY A -109 PO BOX 847 MILWAUKIE, OR 97222 CARLSBAD, CA 92018 PHONE: 503 - 723 -6415 PHONE: FAX: 503 - 723 -6416 FEES Description Date Amount Specifics: Restricted Energy Permit 02/12/2013 $75.00 12% State Surcharge - Electrical 02/12/2013 $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 $84.00 Other Desc: Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty • Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 52- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1:800.332.2344. Issued By: J�+i O y �-(JLX/t ac Permittee Signature: � 4Pr LI G4. ` I Q11 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the Job site at the time of each Inspection. Feb -12. 201310,22 AM Service Communications, Inc. 503-723-6416 1/3 Electrical Permit AprIIcCEIVED I,i))t OFFIC E USF ONLY City of Tigard n . %ay. a I /3 Cr Pwmit No.: t/ poi 3 0 0 6 3 '- Iii -1,1, , 18125 SW Nall Blvd., TignnI, OR 12 2 013 Plan Review Phone. 503.718.2439 Pax: 303.598.1960 Dato/BY: Other Pumvl: e o_o I A' D .2ig(0 1't r ,, t:! Inspoallon Lino: 503.639.4173 CITY OF TIGARD Daf.ltaady/Ay. hats) ® sec Page I ter Into not: www.tigard- nr.gov NattiletVNIe rut: ¶ / ' nupplemen1u1 Infonnution a <'.. '� °s : ;�$ � r '. .rh - .: �4 , ¢=r i P - < i F 1 n b r .'r. s if . " 1 4 3 t' � x .s' i s t, f t e 1 r } 8:= b “ {' 7 ; } -' ) [4 r� . s ) . . r t , G) < t b w l: `t , , , , r t- 1 ;> i . '� ! ' � � C � y , -' 1 . � i. " 7 t , •:.j,.u.. . ^r bt ) k ) t � L S ) r'� t s ,.t ) t ✓ . _ ' ,�•> ; > >.: , �) be � t :. ..- -- .. - .. � e .. . o �v' - a.:.... „ .. ; . . .0 E .. t�e ...m - ,. v : > ... . q .t paccmenl > . :E, . I,� .. .• .: .. . . i.. n . ,. . r .. . .. ,.. : .. .e llthata apply ,., :., -.n, Yin; ■ N t L • . - .! t Ad I Moue dark all That apply (eubmik 3 ■ croup w4lvme aheckad below): Ncw conBtrUCtiOA ❑ Solo or helot 400 amps ar Mons ❑ Suilding ovar Ihroo stenos. ❑ Demolition ❑ Other: what tits evailahlo uncut current ❑ Marinas end boatyards :o ? °: ai ;1'> .: >ra:f : {:r 3 °`.'i::::S,tB` xi ^, r:U :ky y'R >'St: ^w • ' a ) t e E '� t .. s • `, < ••• :.a a' •s : f %t r i�rrit t , aa +, � r.;:ir 1: €all ' .; > • axcoada t0.000ampsat 130 v It or ❑Fieali nphuildinps. . I '• - 1.g...-:" +-• •• >••• - ' .') Ism ro ground. or oxcao b 14.000 ❑ corwoorciol•uta agrieutlurol 0 1■ and 2 -13)mi1y dwelling ❑ Commercial/industrial ❑ Accessory building amps for an other i,wallauaaa. buildings. [] Multi- l',imlly ❑ Master builder ❑ Other: ❑ roc Pump. ❑ instouadan 0( 73 icon or '�' •:,): :< : >: s)•; „# : ;:. r: a,r): . . . .. g)a t:: 'pba.. };y? : xi v ' . n . r.:k :.. # ... ❑ Itacrgancy egoism. largo s erotol dcriwd system. 3 , . a); - " .. 's t 3'l l i ?l )4 i � .1i�1) a #�rT>o' nlc * f13y i 3 > }r n ll,i lbi f3i < � aP Y Yu '' '.:...,. .ifl l Y.r `, ".ts lkn.?:!i1ai'i`:i'C..f �. : ear.A ort}Ma...F.: :31. ❑Addition El "A "."Fr. u1 , r•,ui.S ", Job no.: MEDC15783 Job site address: • " :5 SW WASHINGTON SQUARE 10011P or mom. occupancy. ❑ as at mum caaiduntiat units, ❑ Raere a tonal which/ parka. City/State/ZIP: PORTLAND OREGON 97223 9 ? g* q ❑ I3oeltlt -csro Wilhite. ❑ Supply whop for mom than © Fluondou, locations. 600 wits nominal. Suite/bldg./apt. no,: Project name: THE ART OF SHAVING ❑ Savior or foudor000 amps or mars. Cross street/directions to job site: WASHINGTON SQUARE ,' is .., , �} s'i:u:i i ts: < .?t . , . > • e ffn .-'�. i? 3F.. # "s... la t h J Q Dual ,aaa ` I E'�� p Now residential single- or ruultidaudly dwelling unit. Inolutloi athtahod :. a 1c. Subdivision: Lot no.: 1.000 oi. R or lass 16854 Bo add't S00 co. It or portion 33.92 Tax map/parcel no Limited umrgy. residential �'"t F s m az•) i t 7 £> o i> y s . t �. arS ∎ iii , T . a ft 'ir s n t'r`' a t. y : ii s,� 7SiT 7 �4 y wilhldtavu :. 73.00 1 �1: .:b �� Y� 3t�� 5'h. ?3�!'J{°h:.aC'4�.:� Y�f:t,3:t ....w'R.ie. S..:..fi��. �at):::7:$� 5 a'" Limitul cnotpy, multi - family 75 2 INSTALL LOW VOLTAGE VOICE AND DATA CABLING raoidontial (with ellen so. I4) &wises or foodors Installation. ultoratlon, and/or relocation 200 amps orlon 100.70 2 } > K �. - ' >., , , ,,,,,, - t n'' k ,,, i m., 14Psit?;1 ;. >c .. v; '..:.. i3 ° ''.. - 4 ik tt ti ; „ V , , e ;.w.`.1..I fF 201 amplato400on •x 19356 � 401 amps to 600 amps I 200.34 iiiii Name: 601 amp to 1,000 maps 301.04 Address: Over 1,000 amps or volts 552.26 City /$lele/ZIP: Totnporary services or fee dors installation, alteration, and/or relocation Phone: ( ) F ( ) 200 amps or loss 39.36 1 Owner installation: This Installation is being made on property that 1 own w) ch is not 201 amps to 400 amps 125.05 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps 16834 2 Brunch circuits - now, alteration, or oxtouslou, per panel Owner signature: Date: A. Fuo for branch cimoults with .l ,,. ,,,,, :e rg : i1.:7.. 73-471-7..y., r <vv`YS:•:a`' ° >`P ahovC fca . " i '> i:a' :.'1, ` C :ii; ' : ' .�5, -' ° - ''i.. <: -' =via* x I t.' ' i { , $ k) s t ft . t t , 1 > ; t ':' i s '.' 't=i ,l caahhm /1401mA 7.42 2 a ,..ati��;z,.z...>..e...r ,.��t)..a,i'. L „:dlta a::,i.,.>, . : .ay.rr, ?i: •;i::z�.� Business name: B. Pao for branch circuits without service or &odor Rio, Gnat 66.18 2 Contact flame: hmnoh °insult Each add'l bmtmh circuit 7.42 2 Address: Miacolluuooas servieo or fonder not Included) C: /State/ZIP: Hach itwrtufovic a or modular III 07 © City/State/ZIP: dtN lli ennriao ataUor fcadlx Phone: ( ) Fax:: ( ) Rvconncet only I 67.54 F..-Mall: Pump or irrigation circlu 67.94 II " -- ^}?:a.° ....�,� #:c-r- ::.r... yt:nSfiS:i:•.. . 'C', ^. n S;.2efi: �g ^ ,.�., ,. Sign of ouallla lighting) 67.84 �P T� '. v . - i:.. :w :o, . .I iii, iaTg - gk, t f€ "i l i k 1 a2A _ I 3> > '> > i '� ,V �t.,.i .:. la..a..nl<nn.;nlva >..ar} }; Signalcinstdl (s)orllntitud•eltctg y Business name: SERVICE COMMUNICATIONS, INC • , uol.altumtion,orastaax►on. l Pak:2 l 2 Each additional inspection ovor allowable In any of the shove Address: 4120 SE INTERNATIONAL WAY SUITE A109 Additional impaction (1 lirmiu) 66.23 /hr Invontigation (1 hr min) 66.25/ hr City /State/ZIP: MILWAUKIE, OREGON 97222 Industrial plant (1 hr min) 75.113/ hr Phone: (503) 723.6415 • ((L( Pax: (503) 723 -6416 Inspeclions for which no fee is Sup 90.00/ hr CCB Lie.: 90115 �� 5CLP• / ' 6oail listed IA hr min _ e:.: f<Is).:1;�`t?�'� Yav;.'�i.�.iLIMJ. t'•, h��tif�).-( i��al� `.�?c�'s:::i;�i�;i':4`i`: Su r v. Electrician signature, / ' 0 P tP' - �1� -:� _ l � /� - 75.00 Print name: DARRIN DliCOS . • ... Date: 02 -11 -13 Simi Surcharge (12% ofpormit ros): 9.00 TOTAL PERMIT PPE: 84.00 Authorized Signature: A �� This permit application expires if a pannit Is not obtained within 150 ys dap anent lo is boon accepted ru complete. Print name: BILL KR AIO 1 Date; 02 -11 -13 ' Numlror of inspections aliawad par permit. InBoodIn PerralulBLC4'amdtApp•doe 07/01/10 440.4a1S1'(I I/0S/CoMA /5B Feb -12. 201310.22 AM Service Communications, Inc. 503 2/3 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: . 1V '�T Fee for all residential systems combined .. $75.00 Check Type of Work Involved: O Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ 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 ❑ 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 Imamercaraenc.r.umppAbe noun.