Loading...
Permit _ \pr��k v .,. ELECTRICAL RESTRICTED ENERGY PERMIT CITY OF TIGARD ' COMMUNITY DEVELOPMENT Permit #: ELR2010 00041 T t G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/10/2010 Parcel: 1 S134B000300 Jurisdiction: Tigard Site address: 12264 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Snap Fitness Project Description: Low voltage systems for security and data. ADDED (2) low voltage 3/18/10. Owner: FEES FW OR- GREENWAY TOWN CENTER LLC Description Date Amount PO BOX 790830 Restricted Energy Permit 03/10/2010 $135.68 SAN ANTONIO, TX 78279 12% State Surcharge - Electrical 03/10/2010 $16.28 PHONE: Restricted Energy Permit 03/19/2010 $135.68 12% State Surcharge - Electrical 03/19/2010 $16.28 Contractor: CASCADE ELECTRICAL CONTRACTORS INC PO BOX 13519 SALEM, OR 97309 PHONE: 503 - 302 -6130 FAX: Type of Use: COM Class of Work: ALT Total Number of Systems: 2 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: y Fire Alarm: N HVAC: N Instrumentation: N Total $303.92 Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Required Items and Reports (Conditions) Nurse Calls: N Protective Signal: Y Security Alarm: N Other: N Other Desc: 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 IoAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: IPA` _ - , . & �� �. �, �' Perm ittee 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' e)(k n ok A Date: LICENSE NO. Cali 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. 4i r `': CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT f o :', COMMUNITY DEVELOPMENT Permit #: ELR2010 -00041 T t GARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/10/2010 ., ., . ,..,., Parcel: 1S134BC00300 Jurisdiction: Tigard \ Site address: 12264 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Snap Fitness Project Description: Low voltage systems for security and data. FEES Owner: FW OR- GREENWAY TOWN CENTER LLC Description Date Amount PO BOX 790830 Restricted Energy Permit 03/10/2010 $135.68 SAN ANTONIO, TX 78279 12% State Surcharge - Electrical 03/10/2010 $16.28 PHONE: Contractor: CASCADE ELECTRICAL CONTRACTORS INC PO BOX 13519 SALEM, OR 97309 PHONE: 503 - 302 -6130 FAX: Type of Use: COM Class of Work: ALT Total Number of Systems: 2 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: t Y Fire Alarm: N HVAC: N Instrumentation: N Total $151.96 Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Required Items and Reports (Conditions) Nurse Calls: N Protective Signal: Y Security Alarm: N Other: N Other Desc: 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 • • - nc- • approved plans. This permit will expire 4 work is not started within 180 days of issuance, or if work is suspended for more the 180 days. A NTION: Oregon - • ui :s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0r -0010 through OAR 952 -0• -0100. may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6. • •r 1.800.332.2344. I Is. ued By: ■ At ai s LAit 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. ELE' • .i ,r Or `/ , » Date: 1 LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. �a i �'rt 1 1-cv. ic- Npi*Ar w-.5w lxtsc a m r -. �' _ ' Electrical Per»t.Amaliication " Ca t , ; �r "' F,0RIOFFI('FI.S ,E" zR = ,I s ,,, ..J. a Received °', a € 1 Of �'I ` ard Permit No : kkaO/O ..046/1/ s tar g Darr v e it, t D <j�Q j f V. v 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review - K S Phone: 503.639.4171 Fax: 503.598.1960 Datr By ther Per mit Inspection Line: 503.639.4175 Date Read rBv: Rani ICJ See Page 2 for Tal'G FLD N otified/Method: Supplemental Information r. o Internet: www.tigard-or.gov �� pp TI PE OF WORK PLAN REVIEW . • ❑ New construction ❑ Addition/alteration/replacement Please check all that apply isubmit 2 sets of plans warns checked below T ❑ Service or feeder 400 amps or more ❑ Building over three stories. , ❑ Demolition Other: where the available fault current ❑ Marinas and boatyards. C _ATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ; Commercial/industrial ❑ Accessory building amps for all other installations. buildings ❑ Multi- family 0 Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system JOB SITE INFORALaTION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "1 - ", Job no.: Job site address: (a.a ) r 4 2,'d 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: 4-..�� �- ( ❑ Health -care facilities. ❑ Supply voltage for more than U( ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 1 3 1.1 .-e Y I ' Es ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 w 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'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energ }.residential 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) ` Limited energy. multi - family 67.84 2 I ` a S t J II P t ,. t - Sys'yt.. 4- ,PAo 'i- CI tale/ residential (with above sq. ft.) U Services or feeders installation, alteration turd /or relocation (....0---e_a_LSTI Y,S 4-( 200 amps or less 100.70 2 ❑ PROPERTY OWNER TENANT 201 amps to 400 amps 133.56 2 Name: 1)C(Jd 1 i 401 amps to 600 amps 200.34 2 1 1�� 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Ct / State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( 5 - 63 ) 333 - 3666 Fax: ( ) 200 amps or less 59.36 1 201 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 -147. - 149.670. and 71)1. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration or extension. per panel Owner signature: Date: A. Fee for branch circuits u,rh ❑ APPLI('ANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B. Fee for branch circuits a ir/lo,rr service or feeder fee, first 56.18 2 Contact name: branch circuit _ Each add'I branch circuit 7.42 2 Address: Aliscellaneous (service or feeder not included) Cl / State/ZIP: Each manufactured or modular City/State/ZIP: dwelling, service and feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67.84 2 C'ONTRAC'TOR Signal circuit(s) or limited- energy Business name: C xc,t.e e l , d C ' I 63,1 ka S / v.0 panel. alteration. or extension. _ _ Page I Each additional inspection over allowable in any of the above Address: Po tg(5 X k 3 519 Additional inspection (1 hr min) 66.25/ hr City / State/ZIP: Sq I'e I Oe 97308 Investigation (1 hr min) 66.25/ hr 1 Industrial plant (1 hr min) 78.18 / hr Phone: (5-03) 302- 6130 Fax: ( ) J Inspections for which no fee is 90 hr \\\ ?PM specifically listed (14 hr min) CCB Lic.: 1520S Electrical Lic.: -z.4 -5 t Suprv. Lic.: SQLI,C1 S ELECTRICAL, PERMIT FEES Suprv. Electrician signature, required: L -� i% ft° Subtotal: 3S" 6 S Plan review (25% of permit fee): / Print name: srt{A - e,"- C. , Date: 3 — / ©- /0 State surcharge (12% of permit fee): 16 4 TOTAL PERMIT FEE: 1 S( • ? 6 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: + Number of inspections allowed per permit. Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY Fee for each commercial $67.84 system (SEE OAR 918 - 309- !$)oo) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems X . Data Telecommunication Installation ❑ Fire Alarm Instillation ❑ f IVAC ❑ Instrumentation • Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling NI Other ..JC'(,U ( I -1 Qcw'\\�- S v j S Total number of commercial systems: *No licenses are required. Licenses are required for all other installations