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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2010 -00070 T [ G AR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/10/2010 Parcel: 2S101AC00900 Jurisdiction: Tigard Site address: 7128 SW GONZAGA ST 100 Subdivision: Lot: 0 Project: Holmes & Co Project Description: Add /alter (25) branch circuits, and install (2) limited energy systems to demo existing walls and t -bar ceiling, reinstall fire alarm and path reconfigured. Owner: FEES BARMASS LLC Quantity Description Date Amount PO BOX 69409 25 crt Branch Circuits 02/10/2010 $234.26 PORTLAND, OR 97239 wo /Purchase Service or PHONE: Feeder 2 ea Signal circuit or Limited 02/10/2010 $135.68 Energy Panel Contractor: 1 ea 12% State Surcharge - 02/10/2010 $44.39 BUILDERS NW LLC Electrical 20420 NE SUNNY CREST NEWBURG, OR 97132 PHONE: 503 - 869 -5829 FAX: 503 - 538 -7976 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $414.33 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 AR 52-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 0.33 • Issued By: IA Y 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' Date: LICENSE NO. Call 603.639.4175 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. 3 ( 0.14L4Ate._ 6e_ e t cod, L. CIT F TIGARD ELECTRICAL PERMIT t 0 Permit #: ELC2010 00070 COMMUNITY DEVELOPMENT Date Issued: 02/10/2010 f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101AC00900 Jurisdiction: Tigard Site address: 7128 SW GONZAGA ST 100 Subdivision: Lot: 0 Project: Holmes & Co Project Description: Add /alter (25) branch circuits and install (2) limited energy systems for data and CCTV. Owner: FEES BARMASS LLC Quantity Description Date Amount PO BOX 69409 PORTLAND, OR 97239 25 crt Branch Circuits 02/10/2010 $234.26 wo /Purchase Service or PHONE: Feeder 2 ea Signal circuit or Limited 02/10/2010 $135.68 Energy Panel Contractor: 1 ea 12% State Surcharge - 02/10/2010 $44.39 BUILDERS NW LLC Electrical 20420 NE SUNNY CREST NEWBURG, OR 97132 PHONE: 503 - 869 -5829 FAX: 503 - 538 -7976 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $414.33 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 -001 ough AR 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. Issue ` A � Permittee 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: ..,411- 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. Electrical Permit Application RECEIVE FOIL UPFIC 1: usl.: ()NIX City of Tigard Date/B ,p1,, Permit No.: O 0 • / • 13125 SW Hall Blvd., Tigard, OR 97223 FEB 10 2010 Received Plan Review II ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit: I' I t It I Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: RI See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISIO'. Notified/Method: iiNIA Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction Et Addition /alteration/replacement Please check all that apply (submit a sets of plans w /items checked below): ❑ 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) ommercial/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 derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ", Job no.: Job site address: 100HP or more. occupancy. 7` / 2_ t', t �l z„,,, k 0 Six or more residential units. 0 Recreational vehicle parks. City/state /ZIP: 71 s►.. I ;Q12 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qtr. I Fee. I 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 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 l Limited energy, residential 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) // ' / Limited energy, multi - family 67 84 2 0 p' e- . • 5 /� t,�/q,(,c c—,4 r— C 3 p— ..-- s 1-J residential (with above sq. ft.) T' (' Services or feeders installation, alteration, and/or relocation f"• " C. Aia An 1' I 4-D / n K,rc) A •Gi 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or 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 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B. Fcc for branch circuits Contact name: without service or feeder fee, 56 18"�4/ g 2 first branch circuit / -� Address: Each add'I branch circuit Lei _ 7.42 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: '' //'' Signal circuit(s) or limited - . h0 I S NAGIJ (IC- energy panel, alteration, or Address: extension. Describe: Z Page 2 2 20q w �It S t�w.tiy 6t l� City/State/ZIP: d te v4 ) 6 oi- (a 7 i t . Each additional inspection over allowable in an of the above Phone: ( b)) 8 (,q-s t4 Fax: ( 5)) —7 q 7 G Per inspection 66.25 B Investigation per hour (I hr min) 66.25 CCB Lic.: (, 00 1 I CI L Electrical Lic.: (a Q Suprv. Lic.: (,�i�RS Industrial plant per hour 78.18 "`�� ✓ ✓✓ ELECTRICAL PERMIT FEE S Suprv. Electrician signature, required: / Subtotal: Print name: / / ,01" Subtotal: 6 l v Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: 4 ( t' f'.'5 6 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 10/01/09 440-4615T(11/05/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 $67.84 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 $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systcms '' 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 1:\ Building \Permits\E1 -C- PrnnitApp.doc 10/01/09