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Permit 1� o-- c)g 4i 4 CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00261 A J I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/30/2006 PARCEL: 2S113AB-01400 SITE ADDRESS: 07358 SW DURHAM RD BLDG G ZONING: I -P SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG Project Description: Low voltage for paging station. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES SONITROL PACIFIC 15350 SW SEQUOIA PKWY #300 -WMI 8220 N. INTERSTATE AVE. PORTLAND, OR 97224 PORTLAND, OR 97217 Phone: Contact #: PRI 223 -5822 FAX 503- 973 -7773 FEES Reg #: ELE 26- 370CLE LIC 53535 Description Date Amount SUP 3567LEA [ELPRMT] ELR Permit 10/30/200€ $75.00 [TAX] 8% State Surcha 10/30/200€ $6.00 REQUIRED ITEMS AND REPORTS Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: Permittee Signature: jJIN c ' 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'N: DATE: 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. -. El Permit Application R.'E -V r , FOR OFFICE USE ONLY City of Tigard �� 20 06 !E !ie '? ,3p A. Permit N.4 _ , Other Permit: 13125 SW Hall Blvd, Tigard, OR 972 Pho ne: 503 .639.4171 Fax: 503.598.1960 1 AR II Date/By: TIGARD Inspection Line: 503.639.4175 .'t �to Read /B y: Juris: El See Page 2for . Internet: www.tigard - or.gov BUILDING D t<'otified/Method: Supplemental Information ,: PLAN REVIEW s + " . . ❑ New construction R Addition /alteration/replacement Please check all that apply (submit 2 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. ' ,..j..,: 50 volts or ❑ Floating buildings. : TEGORY OT CONSTRUCTION ... ,m exceeds O OOO amps at l xc l , .. . . .. i. " CA less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling E] Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ,, Emergency system. larger separately derived system. JOB SITEINFORMATION AND LOCATION:..' ..,,Y;.,,:.. 0 Addition of new motor load of n , r 22 Job site address: 100HP or more. occupancy. Job no.: QV bW1�J 7358 8 -& ' c Vv 1� IZfc 0 or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: — R v " 1 -‘ 0,1 -e0 , , ©?....... Q 7224/ ❑ Health - care facilities. ❑ Supply voltage for more than l ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: W1 t7.yn _1 ;- c , ❑ Service or feeder 600 amps or more. :,! r:FEE SCHEDULE =` ; `? Cross street/directions to job site: Description I Qty. 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 145.15 4 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 • Limited residential 7 2 w h above s ;. 1 ;' ;; DES(?RIPTION ;OF WORWORK ' ;:: ( q ft. ) M Limited energy, multi - family 75.00 2 M U S PS P( Q n3 n residential (with above sq. ft.) v Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ' 0 PROPERTY OWNER , TENANT ,.. ; - 201 amps to 400 amps 106.85 2 Name' 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel g A. Fee for branch circuits with I ' . , '':' above service or feeder fee ® IG ANT•w :> ❑ -- CON'1ACT$:YERSON 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'l branch circuit 6.65 I 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 F ..b,r`' • ,. . 2 CONTRACTOR ^ ` �� � � Sign or outline lighting 5_ .4 Business name: `` ��++. Signal circuit(s) or limited - .5 3(\\ t CA-4s. C energy panel, alteration, or Address: extension. Describe: ) Page 2 �5 2 $2205 Alcnd �Ytk 1Q, Pa/.P . City /State /ZIP: - ibr t dy..... q . 7 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: `� • Fax: Investigation (�:�) 223 � r ZZ ( .503 9 7,3 _7 �� nves per hour (I hr min) 62.50 g P CCB Lic.: Electrical uprv. Lie.: Industrial plant per hour 73.75 .L� ,; ,,;„ .- ELE CTRICAL PER bTIT,'FEES: '.':.: '. „, Suprv. Electrician signature, required: e.,� Subtotal: 7 L Print name:344�s S 3 , ` D ` atee: Z / 4 67 Plan review (25% of permit fee): State surcharge (8% of permit fee): CO Authorized signature: TOTAL PERMIT FEE: O This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. l:\ Building \Pemuts \ELC- PennitApp.doe 05/23/06 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTPAL WORK,ONLY: :.. Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WOI ONLY :; ,::.::. Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) 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 I:\ Building \Pentits\BLC- PerntitApp.doc 03/23/06