Permit � V CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IF1 COMMUNITY DEVELOPMENT Permit#: ELR2013-00232
Date Issued: 09/18/2013
' TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718 2439 Parcel: 2S101 BB01300
Jurisdiction: Tigard
•
Site address: 11950 SW GARDEN PL 100
Project: Vesta Subdivision: CROW PARK 217 Lot: 1
Project Description: Low voltage for voice and data cabling
Contractor: TELESPHERE Owner: WALTON CWOR PARK BC 8 LLC
449 SW ALDERWOOD BY CTMT-WALTON RE TAX
WEST LINN, OR 97068 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503-880-9412 PHONE:
FAX: 503-638-9286
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/18/2013 $75 00 •
12%State Surcharge-Electrical 09/18/2013 $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 law requires you to follow the rules adopted by the Oregon Utility Notification C-.er• Those rules are set forth in OAR
952-001-0010th ugh OAR 95 001-0r•I You may obtain a copy of the rules or direct questions to OUNC by 32 1987 or 1.800.332.2344. •
Issued By: f /g�� / I Permittee Signatur=. � �� 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 1713 09:39p Telesphere 5036389286 p.2
Electrical '�
ectrical Permit Aaulica 't
. . .
City of Tigard \3 Date/BY tc",; ..\\I
^ 'l� Date av 1131 Permit No: Li ! -cc .
: • 13125 SW Hall Blvd.,Tigard,OR 4 ( 1 3
Q :. `o Date Review Other Permit: �"
Phone 50?.718.2439 Fax 503.598 19� ` ('�P�O Date/By: L(/ v�r�/3-OD,?I'�
f I G A l:D Inspection Line. 503.639.4175 -c\v Date Raady/By /iris El See Page 2 for
Internet: www,tigm-d-or.gov �`� Q`�t\S\O Notified/Method: Supplemental Information
. TYPE OF W \q b.) �1 PLAN REVIEW •
❑New construction ®Addition/alteratMwreplacetnent Rase check at that apply(submit 2 sets of plans whlems checked below)"
❑Scrvtce or feeder 400 amps or more ❑Buttding over.hrce stones
❑Demolition ❑Other where the availablefau!t current ❑Mutnns and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Flooring buildings
less to ground,or exceeds:4,000 ❑Commercta;-use agneulnrol
❑ I-and 2-family dwelling ®Commercial industrial ❑Accessory building
amps for all other lnstallantans building,
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Iisu llauon of 150 KVA or
❑Emergency system[ larger separately deriv-_d system
1 JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","E"."i-2."I-3",
Job no.:4941 Job site address: 11950 SW Garden Place teoifp cr m.re o«epa tom.
❑Su or more residential units. ❑Rec e:Aiunal vehicle parts
City/State/ZIP:Tigard,OR 97223 ❑health-care facilities ❑Supply voltage for more that
❑Hazardous locations 600 volts nominal.
Suite/bidg/apt.no: /66 Project name Vesta TI ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job sue.Pacific Hwy and Garden Place DeserIptloa I Qty. I Fee. I Total I •
New residential single-or[multi-family dwelling unit.
217 to 99 south to light left on hall left on Garden Place left on Garden place Includes attached garrge.
Subdivision Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.odd'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.' Limited enemy.residential
DESCRIPTION OF WORK- (with above sq 11) 75.00 2
Limited energy.multi-family 75.00
Pull back and reuse cable where possible.Install new voice/data cable as needed i residential(with above sq.ft.)
o Renewable Energy _ ❑ See Page 2
Multiple phase project affecting about 80%of facility Services or feeders installation,alteration,andior relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less I 100.70 2
201 amps to 400 amps jI 133.56 2
Name: 401 amps to 600 amps 20034 2
Address: 601 snips to 1,000 amps 301.04
Over 1,000 amps or volts 552.26
City/State/ZIP. Temporary services or feeders installation,alteration,and/or 2
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
untended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 199 amps 168;4 2
Owner signature Date: Branch circuits—new,alteration,or extension,per panel
❑ APPLICANT . I • . ❑ CONTACT PERSON A.Fx for branch circuits with
above service or fecder fee,
7.42 2
Business name: cads branch circuit
B.Fcc for branch circuits without
Contact name: service or feeder fee,first
56.18 2
branch circuit
Alines Each adl'l branch circuit 742 2
City/State/7P: Miscellaneous(service or feeder not included)
Each manufactured or modular I 6-r 84 2
Phone:i an
dwelling,service=dim feed=
Fax::( ) Reconnect only 67.84 2
E-mail
Pump or imgalion circle 67.54 2
CONTRACTOR Sign or outline lighting 67.84 2
usuless name:Telesphcre Signal circuits)or limited-energy 1 Sea 75 00
j pastel.altoatinn,or extension. Page 2 2
i,UYA` Address 449 SW Alderwood Dr Each additional inspection over allowable in an}of the above
Adddional inspection(1 he min) 66.25/la
City/State/ZIP:West Linn,OR 97068 Investigation(1 hr ruin) 66.25!hr
Phone:(503)830-9412 Fax:(503)638-9286 Industrial plant(1 hr min) 78 18i hr
Inspections for which no fee is
CCB Lic.: 194154 Electrical Lie: CLEI 1 g Suprv.Lie.: 4551LEB specifically listed(t;hr min) 90.00/to
—
ELECTRICAL PERMIT FEES
Suprv.Electrician signature;required Subtotal. 75.00
Print name: Michael Ciccotelli Dote:Dote: 9-17-13 Plan review(25%1,of permit fee):
Stale surcharge(12%of permit fee): 9.00
Authorized stgteture , ' I TOTAL PERMIT FEE: 84 00
Print name: Frederic 1.Ciccotelli ' Date: 9-17-L3 Thls permit application expires If a permit Is not obtained within 180
days after it has been accepted as complete.
• Number of Inspections allowed per pernut
I:t BwUubjec.-mtntELC_PerrnrNpa_ELR_ERE.doc Rev 050 Ina 13 440Je15T/11/0..00Mr0.T•B
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11950 SW GARDEN PL 100, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-12-19 00:00:00
ELR2013-00232
PASS - No C of O
Violation Summary:
Inspector Contractor