Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2014-00053
T t 0A R.o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/03/2014
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 220
Project: Cheesecake Factory Subdivision: VARNS ACRES Lot: 3
Project Description: Data telecommunications system.
Contractor: OREGON ELECTRIC GROUP Owner: HILLTOP BUSINESS CENTER LLC
1709 SE 3RD AVE HUNZIKER LLC
PORTLAND, OR 97124 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503-234-9900 PHONE:
FAX: 503-234-1001
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/03/2014 $75.00
12%State Surcharge-Electrical 03/03/2014 $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: — �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' 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 hell(ail( I l .1. (1\1.1
City of Tigard �� Deceived a ill` . Permit No.:
Date/11 :• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review -
Phone: 503.718.2439 Fax: 503.598.19 (� Daie/Bv: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: H See Page 2 for
T I G A R D Internet: www.tigard-or.gov r 5\[� Notified/Method: Supplemental Information
TYPE OF WORK 9 s�J PLAN REVIEW
` ♦�� 0� Please check all that apply(submit l sets of plans w/items checked below):
❑New construction ®Addition/alteration/ cemc�,
ON `St ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: �� °` where the available fault current
❑Marinas and boatyards.
CATEGORY OF CONSTR �L exceeds 10.000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14.000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling ®Commercial/industr Accessory building
amps mps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑„A",'G'."I-2 -1-3".
Job no.:530079 Job site address:7340 Sw Hunziker St. 1001-1P or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt,no.:220 Project name:Cheesecake Factory ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross Strect/directions to job site: Description I Qty. I Fee. 1 Total ___1_*__
-°V 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'l 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 7500
Voice&Data cabling residential(with above sq.ft.)
Services or feeders installationtaltcration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:Guness Benefits Group
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone:(503)503-601-5511 Fax:( ) 200 amps or leas 59.36 I
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fez for branch circuits with
❑ APPLICANT I above service or feeder fee,
❑ CONTACT PERSON each branch circuit 7.42 2
Business name: B.Fee for branch circuits without
service or feeder tee,first 56.18
Contact name:Todd Mikalson ...._... circuit
ach add'l branch circuit 7.42 _ 2
Address: Miscellaneous(service or feeder not included)
CitylStattJZIP: Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Phone:(503)849-3508 Fax::( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Oregon Electric Construction,Inc. panel,alteration,or extension. I Page 2 75.00
Each additional inspection over allowable in any of the above
Address: 1709 SE 3rd Ave Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97214
Investigation(1 hr min) 66.25/hr
Industrial plant(1 hr min) 78,18/hr
Phone:(503)234-9900 Fax:(503)234-10(11 Inspections for which no fee is
90.00/hr
specifically listed i'/,hr min)
CCB Lie.: 203 El: :l• ic.: 26- 5c upry Lic.: 4818s ELECTRICAL PERMIT FEES
!
Suprv.Electrician signature,r "' Subtotal: 75.00
Plan review(25%of permit fee):
Print name: Mark Weinbender Date. _ 4 State surcharge(12%of permit fee): 9.00
— TOTAL PERMIT FEE: 84.00
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: Mark Weinbender Date: 03/03/14 * Number of inspections allowed per permit.
19nuilding\Pernuts\FLC-PemutApp.doc 07/01/10 440-46I5T(I t/05/COM'WEB
Electrical Permit Application - City of Tigard
Page 2- Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
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*
nV• acuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
U Boiler Controls
❑ Clock Systems
• Data Telecommunication Installation
IT F• ire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
nN• urse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other Monitors
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I:IBwldiag■PermitaiF1.C-PeruulApp.doc 07/01/10