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Permit . : .. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00283 T!G , 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/2/2008 PARCEL: 2S102CB -03200 SITE ADDRESS: 09975 SW FREWING ST 1020 ZONING: C -G SUBDIVISION: MASSIH OFFICE BLDG LOT: 021 JURISDICTION: TIG PROJECT: VISION WORLD Project Description: Low voltage for voice and data system and vacuum system. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: VACUUM X TOTAL # OF SYSTEMS: 2 Owner: Contractor: MASSIH LLC CSHARK NETWORKS PO BOX 108 5111 FIRWOOD DR. BEAVERTON, OR 97075 WEST LINN, OR 97068 Phone: Contact #: PRI 503- 697 -1818 FAX 503- 697 -1818 Reg #: ELE CLE23 FEES LIC 164236 Description Date Amount , [ELPRMT] ELR Permit 10/2/2008 $150.00 [TAX] 12% State Surch 10/2/2008 $18.00 REQUIRED ITEMS AND REPORTS Total $168.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct question to OUNC at 503.246.6699 or 1.800.332.2344. , Issued By ....40 Permittee Signature: / i = . ��� 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'N: 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. VVV �� ✓// -k,. h �, .; x 4 (r 't d 4-r' •�} l4 ' " S . Electrical Permit A lication ` ; � , ,'FOR OFFICE US ON LY ,j r` O 3.f' "e M 4 .., :• .4. :.c ix R . , . -, , _. _x , Ivo., a : , � em . , ; ; City of Ti gard `�� � � l R�e cerved / /7 Am/ permit No.: 114 at / V 13125 SW Hall Blvd., Tigard, OR 97223 , ' eview / Phone: 503.639.4171 Fax: 503.598.1960 � ' NW a • l Other Permit: �q/�'CJCd6 - i .— - , Ei ; Inspection Line: 503.639.4175 ` �� ® ®e '• -'te Ready /By: RI See Page 2 for —, _ ., Internet: www.tigard or.gov �w tK \ � N Supplemental Information TYPE OF WORI M" - PLAN REVIEW . N ew construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ 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 ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOBS " INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ", Job no.: Job site address: IooHP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Su /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE' SCHEDULE' - Cross street/directions to job site: Description 1 qty. 1 Fee. 1 Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or Tess 145.15 4 Ea. add] 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK . sq. 75.00 2 . (with above s fl.) Limited energy, multi - family 75.00 2 / �v r p[ f/ Q-- vG Cet LI r- S / crn residential (with above sq. ft.) (/ ( / Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ' ',C PROPERTY' OWNER ' • 0 TENANT . 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with PLICANT .❑ CONTACT - : PERSON. above service or feeder fee, 6.65 2 each branch circuit Business name: •/ =, j /�,J� _i ___z____ e,_ B. Fee for branch circuits / —{ /' without service or feeder fee, Contact name: -1( �Ge first branch circuit v lr . 46.85 2 Address: �- 1 Each add'I branch circuit 6.65 2 ��� f G(l/1 ©c Miscellaneous (service or feeder not included) City/State /ZIP: n - /�A/N Q Each manufactured or modular C ff (( 90.90 2 / dwelling, service and/or feeder Phone: �g) �— /84 ,r�Fa�x :: �— 47 Reconnect only 66.85 2 E -mail: 7- "'7/'�e , J , . _ 7 . . _ - so Pump or irrigation circle 53.40 2 - .. CONTRACTOR • . - - . Sign or outline lighting 53.40 2 Business name: �k /t" t'( -S • � Signal panel, er or limited- o or � � energy panel, alteration, or ` � Address: ,/ ��$6 - "` `� � extension. Describe: �` Page 2 / 2 City/State /ZIP: (.1....15-6T Investigation 4//1//t/, O, 2 g • Each additional inspection over allowable in any of the above Phone:1> G 'J) �� /g /e / Per (93) /C9�� "8 inspection in 62.50 a p er hour (1 hr min) _ ( Fax: l v 62.50 CCB Lic. /c,L/ l Electrical Lic.: Z. Suprv. Lic.: Industrial plant per hour 73.75 f/ I �" '. ELECTRICAL PERMIT FEES. .- Suprv. Electrician signature, required: Subtotal: / Print name: Date: Plan review (25% of permit fee): 6 State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: / This permit application expires if a permit is not obtained within 180 . Print name: 6. - *h.- - ,r "� Date : /Q V g . days after it has been accepted as complete. /! • Number of inspections allowed per permit. 1:\Building\Permits\ELC- Permit App.doc 05/23/06 440 -46I5T( 1 1 /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* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: i COMMERCIAL. WORK ONLY: ._ . Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock S , nrs• �b ata Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* El ective Signaling Other U ('GG1✓h 5/1j,�r,..5)41717,..... Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \Building\Permits\ELC- PermitApp.doc 03/23/06