Permit .1 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 -00182
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/30/2013
Parcel: 2S 112AA00600
Jurisdiction: Tigard
Site address: 6713 SW BONITA RD 200
Project: Central Distribution Subdivision: MILLMONT PARK Lot: 49
Project Description: Data telecommunications for Interior rennovations.
Contractor: CACHE VALLEY ELECTRIC COMPANY Owner: WALTON CWOR NELSON 13 LLC
6200 SW ARCTIC DR BY CTMT - WALTON RE TAX
BEAVERTON, OR 97005 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503 - 431 -6600 PHONE:
FAX: 503 - 624 -1436
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/30/2013 $75.00
12% State Surcharge - Electrical 07/30/2013 $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 OAR 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: .etc / I — Permittee Signature: O/ . ('7' / . / e 4.4 9 - 77C),\/
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 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.
07/29/2013 15:30 FAX 425 424 9966 CACHE VALLEY ELECTRIC a 001
RECEIVED ,
Electrical Permit Application - l OF O1 FICL liSF
JUL 2 9 2013
City of 'Tigard Deis 7 . Q _ „4I, itrt -'Z' o2 -O/3 -6d /f
III il
13125 S5V flail Blvd., Tigard, OR f TIGARD Plaalteview
• Photo: 503:718,2439 Fax: 503. 1 DahlH . OtherPerny�tV /3 aQ�, •
1•tc\RD hnspeaionL'eto:503.639,4175 BUILDiNGDIVISIOP Date Ready/By. lilt See Page 2 tor
Interact: www.tigard-or.gov tigardoegav NotiOcd/ltethod: Supplementaltolerwadan
- ' , r ' zS - 4- . ? g •riFw" _ - a , -• ,. IISA x...t;' r a='_a rw.::.. 1- -
i e • g6 k _ 1 t . - , �• it' T j ' a ' ' -' .� , -i •" ty_{ �j(!� !1 ' ,, .. :.�Y�A S' `•t,
s yw :';,�% s;. . �Q : ti,m.� i - � ;-�. - -.r ��: ';`� ;is�Y••� ` F� � �`,:�
1:1 New construction ® Addition/alleration/replacement pkasechecke ilOmta ppty( submit? sets oFpinas wlitemsclteckcdbetow ):
❑ Service or feeder 400 amps or more ❑ Banding over three stories. -
0 Demolition ❑ Other: where the mailable limit;tenni 13 Marinas and boatyards.
V F1r31 j,,;V.<' ' tirttI s• ,�d n > - ccc4 . - exceeds 10,000 amps at 150 volts or ❑ Floatingbuiidings.
le;y to ground, or etsaods 14,000 ❑ Carttmertiel•use agrieotrurai
❑ 1- and 2-family dwelling El Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑ Mull[- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 150 KVA or
�y,ya v y r Ji -. �� S YL- wJ r. no ,._ ., ❑ Emergency system. larger separately derived system. i
a ;t!' ��_ .f gaC Ma it r Oyu : t ' " ' .F !t? ,, 0 &Walesafnew motor loadeE " " " .
Job no..43979 Job site address. 671.3 Bonita Road 1o1111P occupancy.
❑ six or more residential units, ❑ Recreational vehicle ports.
City/State /ZIP: Tigard, OR 97224 ❑idre ❑ Supply wfngefor trrore
❑ Hazardous locations. 600 calm nominal.
�Suite/bldg, /apt. no.: I Project name PCC Central Distribution ❑Scneali ililies
t , y7 a �4,.a= r�. ".�y�y�.,!r�y yy�'4 }:-Y's" $r3'Y•,+i,
G,T�� figi." �:>°s%?tk�:.:l .,., +^aR? �." k-t f:l.Lf'.`�"°P _z-�v:h
Cross street/directions to job site: De,rripttee 10n. I r... ) carol 1
New residential single or multi- Etmily dwelling unit.
Includes attached garage,
Subdivision: Lotno.: _Imo sq. ft. orless 168.54 4
?a. add'I 500 M. ft or portion 33.92 L
Tax map/parcel no.: __ _ Lbuitedenergy, residential
7sK . .c a.:., - ,fee a- ��, i a 754)(1 2
,� � :s. ,� fib' -'� • , (with ebove ft.
rte= 0 �p3j�; ��,w'.��., D X13 � b.F�� �µ..- y� `iv,�� •�- '•'� -.:Ce - --,.x•
Y - _..�:�.:�.,,..,,,�a.: >- "u.zn'PY +`.� .c'1' - ' ... - .� �e ._ _- '`.o2!' � .3, . �^ SQ • I
Limited energy, multi - family 75.00 2
voiceldata cabling residential (wittabove sq. tt ,
Ile'n'eiiabl@luergyct.ia i.;(6i : :- :::,,; +.a "O Sec"rpge2:::: i_= :.i :::;:;; .::a . •
Services or feeders installation alteration, and/or relocation
�y'5F- - . a s ,n: ( a r ,- r? : *,ll fw t.� ._. i Y,,• ct-._ 200 amps or less I 100.70 r 2
r �.
'.�1.,1. ti ;t'iv':z�! �yR{,L x'ri.��cC aX �'--- "n�,iri.7 ;' "r• -+y ^. r
' y'i - �"n'•S'+7^ -��-,' , ''a'N; Y `my1 3; er��': 0. 1 _
Name:
201 amps 1o400atnps 133.56 2
401 amps to 600 amps 200.34 2
6 01 amps to 1,000 am ,
Address: Ps 301.04 2
Over 1,000 amps or volts 552.26 2
City /Slate/ZIP: - Temporary services or feeders Installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 59.16 l l
Owner Installation: This installation is being made on property that I own which is not tot amps to 400 amps 125.08 ` 12
intended for sale, lease, sent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to $99 amps 168,54 r f 2
Owner signature: Date: Branch circuits -- new, al teration, or extension, per panel
.``` ,, = , 4 ,, e .t .. .TAI .1 `; i �J"= a4; - %k + - is _.: :;" A. Pee for branch circuits with
r; cox»,; above service or feeder fee,
Business name: Cache Valley Electric each. branch circuit 7.42 2
B. Fee for branch circuits n'ithorrr
Contact name: Vanessa Martin serviccor feeder foe, first 56,18 2
branch circuit
Address: 6200 SW Arcti'ie Drive Each adril broach circuit 7.42 2
City' /Slate /ZIPt Benvorttdl, OR 97005 Aliscellancous(service or [ceder not It
Each manufactured or modular 67.84 2
Phone: (503) 431.6600 Fax :: (5 - 624 - 1436 dwelling, service and/or feeder
Reconnect only 67.84 2
E - mail: vanessa.inartiu ®cve.com Pump or irrigation circle 67.84 2
%S•,._,,, ..- .,"-,;g;'`; :.r ?n;C QIS Wy:+��"M., �!: °Vrt_. ,.r:i�YE . gne;iaGa ^a .- •w4..• •9 Sign oroullinC lighting 67.84 2
Business m rte: same as above Signal circuit(a) or limited-energy I See
panel, alteration, or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
Cit /Zip:
Gi Additional inspection (1 hr min) 66.25/ in
(,
C I investigation (I hr rain) 66.25 / hr
�Phonee ( ) 4 1 P'>=c: ( ) 1 1 3 4 II I I Industrial plant (l hr min) 78.18/ hr
CCB Lie.: 148222 •4 I 49 I Electrical Lie.: Swab Suprv. Lie.: p t79 $ ' l' ' 90.00/
Suprv. Electrician signature, regial 41111111. !_ Subtotal: 75.00
Print name: Jody Jenkins /�� Date: 7/29(13 Plan review (25%ofpenuitfcc)
State sureharge (12%of permit fec): 9.00 /
A ,
Authorized signature: I TOTAL PERMIT FEE: 84.00 r
Print Blame: 1Date• This permll application eapiresIt n permit Is not obtained within 18o
days sailer It has bcca Accepted as complete,
• Number of inspections allowed per permit.
i :lnuildunglR+m5i LC rcrmitApp 1;T.RRL•RtLdoa Rev 05/21/2013 440.46157(1 u05iCOUM•Ea
i