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Permit
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 1,1 . ' COMMUNITY DEVELOPMENT Permit#: ELR2013-00230 • 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2013 T(�°.1:R D g Parcel: 25101 DA00100 Jurisdiction: Tigard Site address: 13010 SW 68TH PKWY 100 Project: US Bank Equipment Finance Subdivision: VARNS ACRES Lot: 9 Project Description: Data telecommunications system. Contractor: E C COMPANY Owner: PACIFIC NW PROPERTIES LIMITED PA PO BOX 10286 STERN FAMILY LIMITED PARTNERSHIP PORTLAND,OR 97296 STERN, HELEN R REVOCABLE TRUST 6600 SW 105TH AVE#175 BEAVERTON,OR 97008 PHONE: 503-224-3511 PHONE: FAX: 503-295-3012 FEES Description Date Amount Specifics: Restricted Energy Permit 09/17/2013 $75.00 12%State Surcharge-Electrical 09/17/2013 $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 co• of—or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: — _ _ Permittee Signature: • 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' bate: 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. 13. 2013 2:05PM No. 0899 P. 1 RECEIVED . Electrical Permit Application fOR OrF1i F. t Sr.07,1.1 City of Tigard SEP 1 6 2 013 Received 13125 SW Hall Blvd.,Tigard, Ire 3 Plan Review Phone: 503.639.4171 Fax: 5 y;'?,FTIGARD - »at�a . OtherPermht e ,gyp/ ., , , ,. Inspection Line 503.639.4FUILDING DIVISION Yei teth;d S El See.anal for - Internet: www.tigard-or.eo information ., 1t��� . �. . , �d'FL 6 M red r'-T"T.itie = r ..,.-wffge.., _.....(0 Yf'qw :,,'" °; a M1-5^,::.`'..,_._ ❑New construction E Addition/alteration/replacement Please check all That apply(raft 3 sets of plane whims checked below): ❑Service or facia 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: _ where the available huh cmrtat ❑Marinas and bow arda. ,.:'B;LW 1.: """`` rtiti `" " :..1 mom&10,000 at 150 volts m Ft buildm :::;;;.'.7; ' , .� . r":.:r(ssc'>oiix; ""'# .x. . leesto mod,o accords 14,000 Q C -us caaieabwal•❑1-and 2-family dwelling IN Commercial/Industrial ❑Accessory building amps for all aka iosallations, buildings. . Q Multi-family ❑Master builder ❑Other ❑Fre stow. ❑tnataltatiao of 75 KVA or \F.,. ,.: ` _'?`' :d. ...."•l$• of .._,„:,••, �ti;�;;;; ,: ❑Emerson,hem. larger separately derived system.•'.+r;;° -;�•:ArA7:. .Eff. ')GQCAIYO'°:;,,, ."_,,4:7;-' '�1.7. ❑Addidnn dame motor Ind of ❑"A"."5`."1-2"."1-3". Job no.:75060 I Job site address: 13010 SW 88th Parkway 100HPormore. occupancy. ['Six or more ieaidmtial units. ❑RecRaaonal vehicle parrs. City/State/ZIP'Tigard OR 97223 ❑Health-care facilities. ❑Supply voltage for mere than - 0 Hazardous loeatiom, 600 volts dentinal. Suite/bldgJapt.no.; OD Project name US Bank F.et 4 p D novice err feeder NO amps or more. Ce—S;, o :.,,v. ;,:;a;r;J'.�'iS;iFEE:SC ;.„.— Cross street/directions to job she: uwe.mnw 1 ow. I Fm I Total .. • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot r0•: 1,000 S .it or less 168.54 4 Ea.add'1 500 sq.ft or portion 33-92 1 Tax map/parcel no.: .- ,y ,}_ V Limited energy,residential 75.00 2• ,. • .vy:;1..' .'r'%i" .D&1 j .OF ova "rrn'�,;'=sSW4:�.7ii%(::,',' .,." (with above eq.ft) Install now CAT-8 V/D cabling Limited energy,multi-family 75.00 2 residential(with above sq.ft) Services or feeders Installad o alteration,and/or relocation 200 amps or less U 4 100.70 I 12 PBOPRR'1 Y O iviintt ` :"'-: "`: Z FNAItT 9• ,ff 1 201 amps to 400 amps 133.56 2 Name 401 amps to 600 amps 200.34 2 601 amps to 1.000 amps 301.04 2 Address: 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 leas 59.36 1 Owner Installation:This installation is being made on property that I own which is not 201 saps 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 Branch eircoila—new,alteration,Or extension, r panel Owner signature: - _Date: _-, A.Fec for branch circuits with • . ® APPLICANT . -. .'• j• . '.- 0 CONTACT'PERSON above service or feeder t6a. 7.42 • 2 • each Minch craw Business name: EC Company B.Fee for branch circuits without service or feeder fee,fan 56,18 2 Contact name: Kathy Kelley branch circuit - Each add'1 branch circuit 7,42 2 Address: PO Box 10286 Miscellaneous(serviee or feeder not included) IP Each mzuarfacmred or modular 67.84 2 City/State/Z Portland, OR 97296 dwelling.service and/or feeder Phone:(503) 224-3511 Fax::(503) 295-3012 Reconnect only 67.84 2 E-mail: kathyk @e-c-co.com Pump or irrigation circle 67,84 2 CONTRACTOR 67.84 2 Sign or outline lighting . Signal circult(a)or Ilmited•etterlY Business name: EC Company - ' panel.alteration.or extension. 1 Page 2 75.00 2 Each additional inspection over allowable in any of the above Address: PO Box 10286 Additional inspection(1 hr min) 6625/hr Ttivestigation(1 hr mitt) 66.25/hr City/State/ZIP: Portland, OR 97296 industrial plant(1 br min) 78,18/hr Thone:(503) 224-354/ Fax:(503) ''5-3012 om for which nofixis specifically listed CA ht atilt) 90.00/hr CCB Lic-: 4 973 7 Elecrri-. Lic.: 64,- `a Sttprv.Lic.:2,39 S-S 1r�.trrrt:It;AL pEltM1T,; y--Suprv.Electrician signature,required: / �1� - Subtotal 75.00 Plan review(25%of permit fee): Print name: Ron Co f fman Date: '/i; 13 State surcharge(12%of permit fee): 9.00 / /+vim TOTAL PERMIT FEE: 84.00 r/ Authorized signature: - LJ �a`I wr This permit application expires if a permit Is not obtained within 180 days after It bas been accepted as complete. Print Hama Anna He t t Date: l ] 13 • Number of impocsiens allowed pa pesmit tusulkireamtw\tc-temdappaoc 07101/10 44oae15r(11/05/CO+t/wm = Sep. 13. 2013 2:06PM, No, 0,899 P. 2 Electrical Permit Application- City of Tigard Page 2-Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined......., $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ 'Other: raigiafril Fee for gad commercial $75.00— system (SEE OAR 918-309-0000) 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:. I • *No licenses are required'. Licenses are required for all other installations tis+d Para CPamwradx O 51/tO Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13010 SW 68TH PKWY 100, TIGARD, OR, 97223 Commercial - Electricial Limited Energy 199 Electrical final 2014-02-18 00:00:00 ELR2013-00230 PASS - No C of O Violation Summary: Inspector Contractor