Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
$ COMMUNITY DEVELOPMENT Permit #: ELR2013 -00165
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013
Parcel: 2S101DC04500
Jurisdiction: Tigard
Site address: 7555 SW TECH CENTER DR A
Project: LaCie Subdivision: TECH CENTER BUSINESS PARK Lot: 1
Project Description: Install low voltage for data in entire building, (4) wireless access points.
Contractor: COCHRAN INC Owner: SUMMIT PROPERTIES INC
7550 SW TECH CENTER DR #220 5550 SW MACADAM BLVD STE 205
TIGARD, OR 97223 PORTLAND, OR 97201
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/11/2013 $75.00
12% State Surcharge - Electrical 07/11/2013 $9.00
Type of Use: COM
Class of Work: ALT •
Total Number of Systems: 1
Audio & Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data & Telecommunications: 1 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape /Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 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 R 952-001-0090. 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: ("'� Permittee Signature: �f < <
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.
01 08:52:06 07 -10 -2013 1/3 -
Electrical Permit ApplicatCE+134 • FOR OFFICE USE ONLY .. ; r.
- City of Tigard Received 7 1r> re �� 2 aDG 3 -)) t `�' �
- ° 13125 SW Hall Blvd., Tigard, OR 972!31 / P ermitNo.: r
III Plan Review
j r
Phone: 503.718.2439 Fax: 503.598.1960 0 2013 Date/By: Other Permit: , 3 t� :• 3
Inspection Line: 503.639.4175 Date Ready /By: i'�: RI See Page 2 for
TIGARD CITYOFTIGARD
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
_ RI.t1 J11NGDIVISION . • . TYPE OF WORK PLAN REVIEW .
p New construction 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.
• 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 J Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
ID Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A", "E', "1- 2 ", "1 -3",
_ �� `� I ,^ / Six or or more. occupancy.
Job no.: W Job site address: d W ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 71( 0 e_ e ! 7 ZZ 5-- ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: A Project name: b.l✓v.:3 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: SO 7ZA42)4P° v- Ascription I Qty. I Fee. 1 Total I •
5u) ` `LC.l1 'q )a L New residential single- or multi - family dwelling unit.
l /J Includes attached garage.
ge.
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF „WORK
(with above sq. ft.) 75.00 2
•
_ Limited energy, multi- family 75.00 2
1a15 c toOPe6 E / )otee &D4r» ,446(.1/1 U M enria- residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
Zit& ^ liS7X - GL (j) idnuess ii-eas ?0% /1%- 200 amps or less 100.70 2
❑ PROPERTY OWNER - ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
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: ( ) F ax: ( ) 200 amps or less 59.36 1
201 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 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
El APPLICANT , • :CONTACT; PERSON each branch circuit above service or feeder fee, 7.42 2
each
Business name: (/�/4 � � B. Fee for branch circuits without
JF�' service or feeder fee, first 56.18 2
Contact name: A £ L BA.«. branch circuit
Each addi branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
ty /- �7n C dwelling, service and/or feeder
Phone:: j) (Q 7 7/ 5(p Fax: (971) 7, 6 e / z ' p Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: _ Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy ` p0
Business name: COCHRAN INC panel, alteration, or extension.
I Page 2 7 a ' 2
p[S Each additional inspection over allowable in any of the above
UUU Address: 7550 SW TECH CENTER DR. SUITE #220 Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: TIGARD OR 97223 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (971) 205 - 4242 Fax: (971) 205 - 4268 Inspections for which no fee is 94.00 / hr
- specifically listed (''A hr min)
CCB Lic.: 72942 Electrical Lic.: 37546C ( uprv, Lic.: 3447S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: \�� \ Q
Subtotal: 7e0 DO
l Plan review (25 /o of permit fee):
Print name: KENNETH TO Date: 'j = /D-^ State surcharge (12% of permit fee): T G
tit TOTAL PERMIT FEE: g 0 v
Authorized signature: U lA D This permit application expires If a permit is not obtained within 180 1
Print name: Date:
quo i � iiiCCC 71 days after it has been accepted as complete.
• Number of inspections allowed per permit.
lAtioildingTemlitat.0 - Perini p.doc 07/01/10 440-4615Th l t/05/COM/WEB
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Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
p Garage Door Opener*
❑ Heating, Ventilation and Aix Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
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
ata Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
:Building\ Permits\ELGPe mitApp.doc 07/01/10