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Permit
a CBTV ®F T IGAR® ELECTRICAL RESTRICTED ENERGY PERMIT a COMMUNITY DEVELOPMENT Permit #: ELR2010 -00100 T t G UARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/03/2010 Parcel: 1 S 136DC04400 Jurisdiction: Tigard Site address: 11945 SW 70TH AVE Subdivision: DARTMOUTH SQUARE Lot: 30 Project: TVF &R Command Center Project Description: Low voltage for voice /data on 1st, 2nd & 3rd floors. FEES Owner: TUALATIN VALLEY FIRE & RESCUE Description Date Amount 20665 SW BLANTON ST Restricted Energy Permit 06/03/2010 $203.52 ALOHA, OR 97007 12% State Surcharge - Electrical 06/03/2010 $24.42 PHONE: 503- 649 -8577 Contractor: E C COMPANY PO BOX 10286 PORTLAND, OR 97296 PHONE: 503 - 224 -3511 FAX: 503 - 295 -3012 Type of Use: COM Class of Work: ALT Total Number of Systems: Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: y Fire Alarm: N HVAC: N Instrumentation: N Total $227.94 Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N 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 thr g 6FC' 952 -e 0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 6.6699 or 1.800.332 2344. s Issued By: � Permittee Signature: / OWNER INSTALLATION ONLY The installation is being made on property 1 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 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. Jun. 2. 2010 12:55PM j , Eli' x 14"11 G � � � r Jr �+ No 6372 P. 1 r 1?i :� ��1 `{ qY JY`� ii fl�P fil ^ rC h t v1� � �`�� htl Fa 1",.. � d #'r".� a� s t 'r, � i d e w ' a ' i � i dyl � I Electrical Permit A,pplicati i` ti Q �Q 'c�$$ 4�'� Il;o,� , g (#r 1 r 7..41�� F x t,ril l} t It, f 1ta tiF � ) 1'b r °k� ' , u+Pu i� t�¢ b!, �r ;.�; , � • ^ / f� i 1 �bl ,�a tr.4 rr1 't,'i iwa1..44 4 ix.O l a A , .. , K A,. rr� o,. ,- tir,71� , ,d �, .4.,,t „�T ,k1 l `,;r 1{, :,, � lx City of Ti gard �U Date/13 : � ' - at 13125 SW Hall Blvd., Tigard, OR 97223 �p plan Rovr ©/� 1 Permit No.: /. • • (� c = Phone: 503.639.4171 Fax: 503.598.1 OF T`GA patelB : Other Permit: r ,01 ry 1 ?1� Inspection 503.639.4175 ?'))' [t`` 1tsl� E ��S orris:' ■ 41 , a � ::4•.: :s Internet: www.tigard- or.gov � 7v�` - ® ilV a1 Date t a S upplemental IInformation . TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wlitema chocked below): Other: ❑ Service or feeder 400 amps or more El Building over three stories. Q D emolition 0 where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings 0 1- a nd 2 •i$mil dwelling Commercial/industrial Accessory building less to ground" or exceeds 14,000 ❑ Commercial-use agricultural Y g ® ❑ ry g amps for all other installations: buildings. Q Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION 0 Em system, larger separately derived system. ❑ Addition of new motor load of ❑ "A', "E", "1 -2 "1-3 ", Job no.: 73849 Job site address: 11945 SW 70 ave IOOHP or mom,u>aocv. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: Tigard, OR 97223 ❑ Health-care facilities. 0 SuPPiy voltage for more than ❑ Hazardous locations, 600 volts nominal. Suite/bldg. /apt. no.: Project name: TVFR CBOC ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Dewription 1 Q. ► For. l 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.: ba. add', 500 sq. ft. or portion 33.92 1 Limited energy, residential DESCRIPIION OF WORK (with above sq. It) 67.84 2 Limited energy, multifamily 67,84 2 Install voice/data cabling, cable tray and equipment racks on floors 1,2 & 3 at residential (with above sq. ft.) Services or feeders lnstallatton, 1feraiion, and/or relocation new TVR &R CBOC facility 200 amps or less 100,70 ' 2 ® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 13356 2 401 amps to 600 amps 200.34 2 Name: Tualatin Valley Fire & Rescue 601 amps to 1,000 amps 301.04 2 Address: 20665 SW Barton st Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City /State/Z1P: Aloha, OR 97007 relocation Phone: (503)259 -1196 Fax: ( ) 200 amps or less 59.36 1 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 599 amps 168.54 2 Branch circuits — new, alteration or extension, p er panel Owner signature: , Date: _ A. Fee for branch circuits with El APPLICANT I 0 CONTACT PERSON above service or feeder fix, 7 2 each branch circui Business name: EC Company B. Fee for branch circuits without • service or feeder fee, first 56.18 2 Contact name: Terry Callahan branch circuit Each add'i branch circuit 7.42 2 Address: PO Box 10286 Miscellaneous (service or feeder not Included) Ci IState/ZIP: Portland, OR 97296 Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder Phone: (503) 224 -3511 Fax: : (503) 295 - 3012 Reconnect only 67.84 2 E -mail: terryc@e Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 - .....L. s CONTRACTOR _ - Signal circuit(s) or limite - vi y Business name: EC`Company panel. alteration, or extension. 3 P. • 2 203 2 Each additional luspecdon over allowable in any of the abov Address: PO Box 10286 Additional .inspection (I hr rain) 66.25/ hr City /State/ZIP: Portland, OR 97296 Investigation (1 hr min) 66,251 ht Industrial plant (1 hr min) 78.18/ hr Phone: (503) 224 - 3511 Fax: (503) 295 - 3012 Inspections for which no fee is 90.00/ hr - -. specifically listed (L hr min) CCB 1.ic.: 49737 Electrical L' • 26-4 Suprv. Lie.: 7 3 C� ELEC TRICAL PERA FEE Suprv. Electrician signature, required: / 1 Subtotal; 203.52 _ I Plan review (25% of permit fa): \, Print name: Ron Coffman Date: 06/02/2010 State surcharge (12% of permit fa); 24.42 ) Authorized signature: TOTAL PERMIT FEE: 227.94 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Andrea Stinger Date: 06/02/2010 * Number of inspections allowed per permit. 1: &rildlaaermirblELC- PUmiNpp.doc 10/01/09 440 - 46151(11 /05/COM/WEB Jun. 2. 2010 12:56PM No. 6372 P. 2 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 Conditioni.ug System* ❑ Vacuum Systems* Other: COMMERCIAL WORK ONLY: Fee for each commercial $67.84 system (SEE OAR 9I 8-309 -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 1:18uadin3To mits\El e- PcrmitApp.doc 10/01/09