Permit (100) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
:7111
COMMUNITY DEVELOPMENT Permit#: ELR2018-00128
Date Issued: 08/13/2018
-FRIAR C7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#220
Project: Total Quality Logistics Subdivision: VARNS ACRES Lot: 9
Project Description: Limited energy for data telecommunication installation.
Contractor: STANDARD UTILITY Owner: TRIANGLE POINTE TWO LLC
12094 EHLEN RD 901 NE GLISAN ST, STE 100
AURORA, OR 97002 PORTLAND, OR 97232
PHONE: 503-849-4828 PHONE: 360-558-4215
FAX: 503-678-2721
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/13/2018 $75.00
12%State Surcharge-Electrical 08/13/2018 $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 Code- and all oyer 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 issuan•-, or if wor is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification C-nter. T •se rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You m obtain a copy of the rules or direct questions to OUNC by calling 503.232. 987 or 1.;00.332.2344.
Issued By: erm-1iitteeSignature:
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 Applicatiw,e-N 7. 'A c:',:D I()12 0 I'I.'I C 1•; l S I:()NI.)
City of Tigard Received Is
A , ,,,,YAMEZ1141117EM
11 13125 SW Hall Blvd.,Tigard,OR 972f U G Date/B .
I ',.' 2018 ,
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Phone: 503.718.2439 Fax: 503.598.1 60 Date/B : Related Permit#:
Inspection Line: 503.639.4175 c T,,- ,'.7 ' ',';:!.•'0 Ready Date/By: Juris: lif See Page 2 for
116A IW
' Internet: www.tigard-orgov :, c, ,,,, ..-- '1 )N Notified/Method: Supplemental Information
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0 New construction Addition/alterationireplacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
7,ISMEMentffiatit:#0Wrj:::::115:1,:::'705111a5IIMILMC exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling 1E1 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agncultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
77,Zligaatig,40.4WCWOW****41a:0. jØ 5VginittaIM El Emergency system, larger separately derived
' 0 Addition of new motor load of system.
Job#: Job site address:13333 SW 68th Parkway 100HP or more.
City/State/ZIP:Tigard,Oregon
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:220 Project name:Zayo 0 Hazardous locations. 0 Supply voltage for more than
o Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: NVIMMOMP,4?,4:16Vi'ziAIESPENISO
Description I Qty. I Each I Total I .
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel 4:
Ea.add'l 500 sq.ft.or portion 33.92 1
11: r.t**.t:1**.101:k7;V.1Viaa4011M0223 Limited energy,residential
75.00 2
a
(with Place new backboard for new splice. Pull 12 fiber through existing conduit per bove sq.ft.)
Limited energy,multi-family
75.00 2
attached scope of work. residential(with above sq.ft.)
.,„ 0. .. ., ,,, Renewable Energy 0 See Page 2
''a';#4.45114 ''''' N''"'I ''' '''W'"4';'''''''''A."in 4b,t104..''—'„'44'*'%'''''''Y*',10''''''k''.
,'''2,..-,,, - ',..'4,,,, ,‘ ,-qifw,,;'",' ,I,'o,,,. -0,%:', .-;14.;''''''F''''' `, —-',Az.'40PPWA:4,-,wo Services or feeders installation,alteration,and/or relocation
Name:Total Quality Logistics-ZAYO-Brian Davidson 200 amps or less 100.70 2
Address:13333 SW 68th Parkway #220 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,Oregon 97223 601 amps to 1,000 amps 301.04 2
Phone:(360)558-4215 Fax:(n/a) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: brian.davidson@zayo.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
70100100: 77,,,twernimowtiotariy7:7.r ,,komori BinFtenecl;ocrbircui:Inceul ilivlittehration,or extension,per panel
A
Business name:Standard Utility Contractors,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Jeff Gallagher B.Fee for branch circuits without
service or feeder fee,first
Address:PO Box 1008 branch circuit 56.18 2
City/State/ZIP:Salem,Oregon 97308 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)364-6611 Fax::(503)364-8844 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:jeff@standardutility.com
, Reconnect only 67.84 2
PlagnatalgarRiaCi:::)rif:*l:?j'(*YigfillfefffiRttltS,OMNI Pump or irrigation circle 67.84 2
Business name:Standard Utility Contractors,Inc. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy es.See Page 2
2
Address:Po Box 1008 panel,alteration,or extension. e
Each additional inspection over allowable in any of the above
City/State/ZIP:Salem,Oregon 97308
Additional inspection(1 hr mm ) 66.25/hr
Phone:(503)364-6611 Fax:(503)364-8844 Investigation(I hr min) 90.00/hr
.\ Industrial plant(1 hr min) 78.18/hr
Email:jeff@standardutility.com 7//4a /0((/20 Inspections for which no fee is
s cifica,listed 'A hr mmn 90.00/hr
CCB Lic.: 66948 Electrical 'c-26-7:ICLE Suprv.Lic.: 92LEB
Suprv.Electrician signature,re. ..ed: Subtotal:
Print name: Jeff Gallagher ' I Date: 8/8/2018 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
( X7f ' ' , ''• • i Vi?i) 'Iri
---- This permit application expires if a permit is not obtained within 180
Print name: Jeff Gallagher Date: --/i':b s... days after it has been accepted as complete.
* Number of inspections allowed per permit.
IABuildingTermits\ELC_PermitApp_ELR_ERE doe Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical.Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
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Description Qty. Each Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
ti Inspections for which no fee is 90min) .00/hr
g � �%;r !/ff``,�f y „s'�`9f^h `
specifically NR hst . Subtotal. t,�.�IFf, f',%`,,%'r`if�! 014
�,. ,i.rs..t., ,�..h s� (Enter
1 ,hr
Fee for each commercial system: $75.00 tal E on Page 1):
y • Number of inspections allowed per permit.
(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:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015