Permit q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
; ! 12 COMMUNITY DEVELOPMENT Permit#: ELR2013-00225
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2013
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 200
Project: Allstate Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Low voltage for data
Contractor: DYNALECTRIC Owner: PORTLAND SW CENTER LLC
5711 SW HOOD AVE BY FELTON PROPERTIES INC
PORTLAND, OR 97239 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503-226-6771 PHONE:
FAX: 503-226-7720
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/10/2013 $75.00
12%State Surcharge-Electrical 09/10/2013 $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: (216L144-4-42 Permittee Signature: L' r l e t l
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.
Sep. 5. 2013 11 :30AM Dynalectric Oregon No. 1333 P. 1
Electrical Permit Application 1 Received. roo.OrricE u ONLY• City of Tigard ! ' r EIVED E+D 9���._J Permit No.:&,..„0/3- 60,2,
;. • 13125 SW Hall Blvd.,Tigard,OR '- x Pt 1 w
Q Phone: 503.718.2439 Fax: 503.9r,J960 5 Dale/B . Other Permit:
:1li;nIiis Inspection Line: 503.639.4175 2013 Dueneady/By; rwia: M See Pegc2 for
Internet: www.ligard-or.gov Notified/Method: Supplemental Information
,P...'.. , - .`_. __ _ : 1:‘S:11-":::-i-6-r.-.\17401 1 - - _ .:.
-'
0 construction Ctton lII Ad •1•7r; • e ',•r•• I; •1, • '
Please check all that apply(su bnit?sets of plans w iem checked below):
12 Demolition ❑Other: ❑Service or feeder 400 amps or more CI Building over three stories.
where the available fault current ❑Marinas and boatyards.
l L,•Idv(11.1; left cl'ipr•.1jtl tl[rlure.: exceeds 10,000 amps at 150 volts or ❑Floating buildings.
-_.--- - -....,......... .... . ...... _ --_ . .. less to ground.orexceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps forall other installations. buildings.
❑Multi-family ❑Master builder [)Other: ['Fire pump. El Installation of ISO KVA or
- D timergenoy system. larger separately derived system.
lei:-) IUIt_ Ir.I,ti)) n jd(0;:: VA)iV.h I '.1U(0 0 Addition ofnew motor load of ❑..A"''F "1-2"."1-3''.
Job no.:1130771031 Job site address:7632 SW Durham Road IO011pormore. occupancy_
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97224 ['Health-cam facitilies. ❑Supply voltage for more than
0 Hazardous locations. 600 wits nominal.
Suite/bldg./apt.no.: iii Project name:Allstate Insurance ❑Service orfeeder600ampsormore. -
- Iii"a::,xt.i;I2lf1eill;; • .
Cross streei/direciions to job site: -bend,Don .. 11111
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.orless 168.54 4
Ell add'I 500 sq.II.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
II - ID f((ltll^7N,(o1 :(o) 1 ia..1 ;.: (with above srl.IL)
F__,__ ..__ --.__... • ____. _ `c -'-- ----' Limited energy,multifamily 75.00 2
Network and Wireless Cabling residential(with above SQ.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
• •E .. ._. _- .. ..--i -.• 200 ampa or less 1170.70 I 2
,:t I ,I.ffte11Yl ,ffil kilt.,: j:� '
f i i, Iii,1H ,.N-:,11
201 amps to 400 amps 133.56 2
_
Name:Allstate Insurance 401 amps to 600 amps 200.34 2
Address:7632 SW Durham Road 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts r 552.26 I 2
City/State/ZIP:Tigard,OR 97224 Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
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 sate,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: - Dale: Branch circuits-new,alteration,or ex tension,per panel
F::::'- 77=:: ' l ‘1111(e Iv!'y �__ I� irlr'row.t'>Yrii IL7(_tU , A.Fee for branch circuits with
- - above service or feeder fee,
7.42 z
Business name: each branch circuit
B.Fee for branch circuits'Yt//rorr/
Contact name: service or feeder fee,first
branch circuit 56.18 2
Address: Each add'I branch circuit 7.42 2
City/State/ZIP: tHlscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
dwelling.service and/or Ibeder
Phone:( ) Fax:.( ) Reconnect only 67.84 2
$mail _ Pump or irrigation circle 67.84 2
' .2: ,,, , tc7 :e'tlT.CI i rl�T
t< . �`.�_---•-•---. ... . . , ( __ _.._-_- - ------- Signor outfute lighting 67.84 2
Business name:Dynalectric Company Signal circuit(s)or limited-energy I See 75
panel,alteration,or extension. Page 2 2
Address:5711 SW Hood Avenue Each additional Inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Portland,OR 97239 Investigation(1 hr min) 66.25/hr
Phone:(503)226-6771 Fax:(503)484-0233 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is ' -
CCB Lic.: 66793 Electrical Lie.: 26-59C Suprv.Lie.: gel 7..s itcallylisted 55hrmin 90.00/hr
k.::r;_£-. :t-.,,':nmZ.1' N:Ellen tf' V ,i1 ryz j-'ii- !:r,.4- .'
Suprv.Electrician signature,required: Subtotal: 75
Print name: c:19e r} JIMIEfflgM Date: Plan review(25%of permit fee): 0
State surcharge(12%of permit fcc): 9
v.
Authorized signature: TOTAL PERMIT FEE: 84
Thls permit application expires Ira penult in not obtained within 180 tit/
Print name: Date: days after II has been accepted as complete.
' Number of inspections allowed per permit.
1.0luildigetPecmitxlE.0 PerrnitApp E.R_ERPdoe RevOS/21/2011 410-161ST(iYDS/CO4IWED