Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELR2013 00051
I c. ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2013
T
Parcel: 25101 CB00400
Jurisdiction: Tigard
Site address: 12700 SW HALL BLVD B
Project: TCTPI LLC Subdivision: 2007 -064 PARTITION PLAT Lot: B
Project Description: (1) low voltage for Data/Telecommunications
Contractor: CALLAHAN ELECTRIC Owner: TCTPI LLC
4830 SE CONG ST 4260 GALEWOOD ST, STE A
PORTLAND, OR 97206 LAKE OSWEGO, OR 97035
PHONE: 503 -421 -4553 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/11/2013 $75.00
12% State Surcharge - Electrical 03/11/2013 $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 952 -001 -0090, You may obtain as copy of the rules or direct questions to OUNC by calling 503.232,1987 or 1.800.332.2344.
Issued By: '14Aftif tC�►' Permittee Signature: D^ ^� r t(
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.
03/11/2013 1@:34 50335303.25 MILWAUKIE FEDEX OFFI PAGE 04/06
RI3CEIVE
Electrical Permit Application 1 FoR 01.111 F 1 SE (NI.1
li City of Tigard MAR 1 1 2 013 Dt itecei Al ed y: 311 i 113 s'i' Permit No.: ir 9 e ) /3 - 000(
_ 13125 SW Hall Blvd., Tigard, OR 97223 Man Review
11
. Phone: 503.718.2439 Fax: 503.598.196it rry oF TIG , ' i Dateat Y _. Other Permit
Inspection Line: 503.639.4175
jud Yik , ruppiem :41.mo/in
. 1 1,,-,ARI) BUILDING DIVISII ronfieddeZ:
Internet: www.tigard-or.gov
''''''''-".:'..-..', i:''J''-'`..:INt"t'ifit '' ''e3g
Li
I' New construction 0 Addition/alteration/replacement Please check all that apply (submit a seta of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
4.1iiiirix
0 iii,1610,41
ettok:.:,:',.." ,,,",.;',,-., ..,,,: , exceeds 10,000 amps at 150 volts or I3 Floating buildings
": 4 1 . 1 gIt ' ? , :• ': : ::; :i."-: - '::: ,... i """ , • ., + 0 :4 , ..'-, .,. A %:' . ''';:".... .‘''',''' ';,.'" '',; l ess t wo or exceeds 14,000 13 commerciatuse agncumant
CI 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
El Multi-family 0 Master builder 0 Other: ['Fire pump. El Installation of 75 KVA or
• larger separately derived system.
4f40 r'='- E BT AZtl e ; c :f sYste ni.
new moter ID load of "A" r
, "E". "I-, "1-3",
t;',4V.';;;;11,03"...1,j'ARii.:'' i ■,----- i'-': i. , 'A,' •-■,,,, ,c %;,-,,,,,,, r„,,,, ,„ , ,,,;-,---'`,
10011P or more. occupancy.
Job no.: Job site address: 12,100 5 ki 411 8Lt/6 0 Six or more residential units. 0 Recreational vehicle parlcs.
City/Stale/ZIP: Ti 91, iCd / dK.- q 1 CI 2/V) El Healdi-care fiteilities.
0 Harardous locations. Supply voltage for more Man
600 volts nominal.
SuitelbldgJapt. no.: d Project name: C414, (41.0% El Service or feeder 600 amps or more.
.,,._k:::::.;2:7.;W$,C110 :tHA::..V,-,Tii;:,:',a0TvIY..7'.'iM:'
Cross street/directions to job site: 5v J4 66, , b I S'- (3,,NA 144..... De;ertpdon 1 Ply. I Fee. 1 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
Ea. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential above sq it) 75,00 2
..:7, (with .
11,0011010:*:0t1*510,C (wi
IV):
Limited energy multi
75.00 2
residential (with above sq. ft.)
Services or feeders installadon and/or relocation
, 200 amps or less 100.70 2
' - ' - - """-'''''''''" amps 400 amp
fiotxfoyitroy*A.IsOgitEV::::'-S',g,.-‘14-.,.1:1i-0_*11:1.-..,-- 201 ams to
, ,z 401 em amps 133 ps to 600 amps 200.34 2 2
.56
Name:
601 amps to 1,000 amps 301.04 2
. ..
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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
• , . ,- above service or feeder fec,
4:{ ;' ' i t4 V.t .: a ''' .. '1 1 1 4::.,i:"5' - i;;CO :l i] ' ;`,: , 7' 7 V4g0;`.0:0:: . ;' 1 0*A0 - 10.K''' ' ;;X .7 .,. each branch circuit 742 2
Business name: B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Esch manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E
Pump or irrigation circle 67.84 2
,, Sign or outline lighting 67.84 2
it . , :'•::P,Ottg:147.401k..t,..:::--;:!;;;...f..:,.,,:-;,,,,,,,.....St;:,..,3.:;, signal circuit(s) or limited-energy i
Business name: CAllAJ RI-C-CiIN't, panel, alteration, or extension. i Page 2 7 y 2
Each additional inspection over allowable in any (lithe above
Address: 4/0,30 co' LIAM if-- Additional inspection (1 hr min) 66.25/ hr •
City/State/ZIP: p Investigation (I hr mm 66.25/ hr
n) 6 ,,+1,,,, t , , ark.. q 7 2, 0 (0
Industrial plant (1 hr min) 78.18/hr
Phone: ( /..) ) qv( 41ST) Fax: ( ) Inspections for which no fee is
90.00/ hr
specifically listed Ch hr mm)
CCB Lic.: / q 57 eo Electrical Lic.: Cc r- Suprv. Lic.: 5 7i. 15 •-. , _,
s/ jg
61?)!,,,‘,1(___ Plan review (25% of permit Subtotal: Suprv. Electrician signature, required: •
Print name: 5 tukt 1kk4,1 th Date: 3 b i / J pi State surcharge 0 2 0,f. of permit fee): /
' .
TOTAL PERMIT FEE: ,,, y
Authorized signature: e-( r ,
_,.57,. e,......_ This permit application expires if a permit is not obtained thin 180
Print name: )4i-1 C4 itottAt _I Date: 3/ /1 ) days after it has been accepted as complete.
• Ntunber of hispections allowed per permit.
lAlluilding\PerraietkE1.C-Permi1App.doc 07/01/10 440-4615T(11/05/COM/WEB
03/11/2013 10:34 5033530125 MILWAUKIE FEDEX OFFI PAGE 05/06
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENER
y yG�Y PERMIT RMIT FEES:
Fee for a ll 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.
Fee for each commercial $75.00
system
(SEE OAR 91 8 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
y d Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instruumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
p 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: VBvifdiesTamlisSEL6rnmanpp.aoc 07/01/10