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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT S COMMUNITY DEVELOPMENT Permit#: ELR2014-00136 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2014 Parcel: 2S113AC00101 Jurisdiction: Tigard Site address: 16655 SW 72ND AVE 800 Project: Microlnterconnects Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 37 Project Description: Data telecommunications system. Contractor: PACIFIC NETWORKS INC Owner: PACIFIC REALTY ASSOCIATES LP 16869 SW 65TH AVE, STE 373 ATTN: N PIVEN LAKE OSWEGO,OR 97035 15350 SE SEQUOIA PKWY#300 PORTLAND,OR 97224 PHONE: 503-645-4000 PHONE: FAX: 503-352-0202 FEES Description Date Amount Specifics: Restricted Energy Permit 06/17/2014 $75.00 Type of Use: COM 12%State Surcharge-Electrical 06/17/2014 $9.00 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 - - ■ 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 cop of the rules or di ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By:t••" iI_rim — Permittee Signature: 79 0016 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 City of Tigard Rece ed Permit No -� olO,'J ( r� Date - r�/jj� �r� //�- 13125 SW Hall Blvd.,Tigard IP Plan ftevtew s Phone: 503.718.2439 Fax: t • rlQ�� Date/By: Other Permit: �f"�2D,K- )Olciq Inspection Line: 503.639.4175 `V\V , Date Ready/By: lads. See Page 2 for V I Internet: www.tigard-or.gov J � � Notified/Method: t� Supplemental Information TYPE OF S r PLAN REVIEW New construction Addition/al 'ati� laaC meent Please check all that apply(submit 2 sets of plans w/items checked below): ❑ i l 0 Service or feeder 400 amps or more 0 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 ❑ I-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","I-2","I-3", Job no.: Job site address: 16 G 5 ' SW `7 a r a Ave. 100HP or more. occupancy. ❑ f� 1 ❑Six or more residential units. Recreational vehicle parks. City/State/ZIP: Yo(' I to el O l- ).di-4 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: g C)(3 Project name: M Tao r IY)fera In 8/45 GLC ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. 1 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 Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 1 Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) I � Limited energy,multi-family Lo L,, k/011-0,,) Dut-F0, W yt l c G 17i-, h9 residential(with above sq.ft.) 75.00 2 !!! Renewable Energy ❑ Set Page 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER ❑ TENANT 200 amps or less 1 00.70 2 201 amps to 400 amps 1 33.56 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 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 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,per panel ❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, Business name: each branch circuit 7.42 2 B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 branch circuit Address: Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Fax:Phone:( ) ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: r• Q T Signal circuit(s)or limited-energy �{ See 4-51 Pa��tlL vjo KS hC.e panel,alteration,or extension. y Page 2 -4' 00 2 Address: 1 6 U 6q S V GG -t,s Ayes if 773 Each additional inspection over allowable in any of the above L a ke os t,✓e 10 1 © 1, a 7©3S' Additional inspection hr () hr min) 66.25/hr City/State/ZIP: Investigation(1 hr min) 66.25/hr Phone:( 'o3) 645- ?D O° Fax:(9)J ) 3 5 a_0 ?-0,1 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: l31_/d1$c, Electrical Lic.:G L(5,). Suprv.Lic.:S g ii$5 specifically listed(/s hr min) ' Suprv.Electrician signature,required: /4/L itti 10/f I t b ELECTRICAL PERMIT FEES h - Subtotal: 3-7st 00 j2 be / • I Plan review(25%of permit fee): �/I„/V-,.,�- � Print name: tf ✓ Date: (J _ t�atn } t I / State surcharge(12%of permit fee): 1 LQ d Authorized signatetn.. ,_., TOTAL PERMIT FEE: iraq 06 ,� / This permit application expires ifs permit is not obtained within 180 Print name: yr f� [Date: 6 /7� / days after it has been accepted as complete. • Number of inspections allowed per permit I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 05/21/2013 440-461ST(II/05/COM/WEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16655 SW 72ND AVE 800, TIGARD, OR, 97224 Commercial - Electricial Limited Energy 198 Low voltage ﬁnal PASS - No C of O July 11, 2014 at 8:10:29 AM ELR2014-00136 Jeff Grove Violation Summary: Inspector Contractor