Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
c , COMMUNITY DEVELOPMENT Permit #: ELR2013 00180 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/29/2013
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD, STE# 350
Project: Logs Network Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Low voltage for fire alarm modifications
Contractor: T & L COMMUNICATIONS INC Owner: PORTLAND SW CENTER LLC
PO BOX 87387 BY FELTON PROPERTIES INC
VANCOUVER, WA 98687 -7387 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 360 - 737 -9725 PHONE:
FAX: 360 - 737 -9648
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/29/2013 $75.00
12% State Surcharge - Electrical 07/29/2013 $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: 0 Fire Alarm: 1
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 - • - • - •'act to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do - in accordance with = •proved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
day-. ATTENTION: Oregon la r =• r -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR 952 -00 0090. Y • • ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.3 44.
Is ued By: - / � Perm f ittee Signature: ! . djlti�
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.
Electrical Permit Application FOR OFFICE USE ONLY
2
City of Tigard
RECEIVED Received EIVED Date/By: 7 a9 /i3 r Permit No.: e
No.:
o • 13125 SW Hall Blvd., Tigard, OR 9 JJ Plan Review � �� 3 G Q
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Oth Permit f' a.p_-
T I G A R D Inspection Line: 503.639.4175 JUL Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov �,ll_ 2 9 2013 Notified/Method: Supplemental Information
TYPE OF prillyCOFTIGARD PLAN REVIEW
❑ New construction 0 Addition/8191 isioN Please check all that apply (submit 2 scts 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 ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 7632 SW Durham Road IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /Z1P: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 350 Project name: Logs Network ❑ Service or feeder 600 amps or more.
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 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Fire Alarm Tenent Improvement residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
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, . er panel
CI APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
Business name: T &L Communications, Inc. each branch circuit 7.42 2
B. Fee for branch circuits without
Contact name: Larry Bushaw service or feeder fee, first 56.18 2
branch circuit
Address: PO Box 87687 Each add'I branch circuit 7.42 2
City/State /ZIP: Vancouver, WA 98687
Miscellaneous (service or feeder not included)
Each manufactured or modular
67.84 2
Phone: (360) 737 - 9725 Fax: : (360) 737 - 9648 dwelling, service and/or feeder
Reconnect only 67.84 2
E - mail: office @tl communications.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: T &L Communications, Inc. Signal circuit(s) or limited- energy I See Ce
panel, alteration, or extension. Page 2 1 D ' 2
Address: PO Box 87387 Each additional inspection over allowable in any of the above
City/State /Z1P: Vancouver, WA 98687 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
Phone: (360) 737 - 9725 Fax: (360) 737 - 9648 Industrial plant (1 hr min) 78.18/ hr
Inspections for which no fee is 90.00 / hr
CCB Lic.: 67787 Electrical Lic.: 37428CLE Suprv. Lic.: 684LEA specifically listed ( hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: ?s c ' (7
Print name: Larry Bushaw Date:
1)z y113 Plan review (25 % of permit fee):
State surcharge (12% of permit fee): q , O O
Authorized signature: `Z� o _ ` TOTAL PERMIT FEE: S Lt , OU
� f w" This permit application expires if a permit is not obtained within 180
Print name: Larry Bushaw Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building\ Permits \ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440- 4615T(11 /05 /COM/WEB