Permit CITY OF TIGAR . ELECTRICAL RESTRICTED ENERGY PERMIT
Permit #: ELR2010 00117
• .. ' ' COMMUNITY DEVELOPMENT .
• Date Issued: 07/01/2010
l Tdi"►AD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101 DA01200
Jurisdiction: Tigard
Site address: 7165 SW FIR LP 100
Subdivision: Lot: 0
Project: Alternative Services
Project Description: (2) limited energy for data telecommunications and projector
FEES
Owner: bate Amount
Description
AMERICAN PROPERTY MANAGEMENT
2154 NE BROADWAY, STE 200 Restricted Energy Permit 07/01/2010 $135.68
PORTLAND, OR 97232 12% State Surcharge- Electrical 07/01/2010 $16.28
PHONE: 503 - 284 - 2147
Contractor:
TRITON COMMUNICATIONS, LLC
PO BOX 1091
HILLSBORO, OR 97123
PHONE: 503 - 615 -5800
FAX: 503- 628 -5689
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 $151.96
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: Y
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 dohe 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 OAR 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:�����/r �/ `e1-1'e-- Permittee Signature: dAr` .4" e'.4-;-
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 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.
06/29/2010 11:59 • 5036285b89 TRITON C OMMUNICATION PA 0/03
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a \e aN, City of Tigard ' ��� Recwi!ed' PemtitjIo : r
��� q . A DatelB : ' . 0 ®j1' G / i i ^""Da� / 7 • ,
13125'SW Hall 131vd Tigard,. OR 97223 tan Review
. Ii 's'1 Phone: 503:639:4171 Fax :. 503.598.1960 a � TI ate,/13 ; Other Peimi 0/0 00/��°
. �`,T Inspection Line: 503.639.4175 c, (_ 1tb h y ld See it 2 for
tigatd or.gov BUILDING,
'9Q &hfied/Method: Supplemental Information
s.. isa.�t, .! ' Internet: www: BUILDIN
TYPE OF WORT; ''c' .r'. y ,:', y Jp b ,,. ,r lgw /
❑, New construction El Addition /alteration /replacement Pie= check all that apply (submit 1 gets of plans w /items checked below
❑ UemOliti0tl 11 Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas, and boatyards.
ATEEGO1R11: 'OF GOI iSTRVC I `” exceeds 10.000 amps at 150 volts or ❑ Floating buildings. agriculmrai
❑ I- and 2 - family dwelling Commercial /industrial 0 Accessory building Im o lt other installations. s.
❑ Commercial -use
g amps for all other inetallatione buildings,
11 Multi=4arily ❑ Master builder El Other: ❑ F pump ❑ Instailstion of 75,KVA or
JOB SITE N
IFORMATION. AND O
LCATIQN ❑ on of new motor toad of ❑ larger separately "1 - 3 ", d system. . ❑ Addit „A„ "E", "1 ,1.3
Job no.: 3579 I Job site address: 7165 SW Fir Loop 100HP or mare. occupancy.
❑ Six or more residential units. ['Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
O Hazardous locations 600 volts nominal.
Suite/bldg. /apt, no.: 100 I Project name:: Alternative-Serviees ❑ Service or feeder 600 amps or more
r.'W.$CII 1DVL ':'
Cross street/directions to job site: nesenvium
1 Qty. l P« 1 Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:
1,000 sq., ft. or leas 168.54 . 4
Ea, P4d'1 500 sq, ft, or portion 33,92 1
Tax map /parcel no.: Limited 'energy, residential
67.84
• °'DESCRIPTION : WORK t (with above sq- R en
Limited energy, multi - fatuity 67.84 2
Voice/Data cabling and projector install residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 1 2
❑;.r R(YPlt1tT's Q'V1f$1t . ]` T 133.56 2
4. 201 am to am
Name:
401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or irolts 552,26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
200 amps or less 59.36 1
Owner installation; This installation is being made on property that I own which is not 201 nmps,to 400 amps 125.08 2
untended for sale, lease, rent, or exchange, accordizrg to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits new, alteration, or extension, per panel
' Owner signature: Date; A. Fee for branch circuits with
erf
(l CONTA P,ETZSONI abovtservtce or ed ee
:: ❑ "APPLICANT` .. 7,4z 2
each branch circuit
Business name_ B. Fee for branch circuits without
service or feeder fee, first
Contact name: branch circuit 56.18 2
Each add'I branch circuit 7 42 2
Address: Miscellaneous (service or feeder not i ncluded)
Ci / State /Zf P; Each manufactured or modular 67.84 2
ty dwelling, service and/or feeder
Phone: ( ) Fax: ; ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 N
E -mail:
.Sign or outline lighting 67,84 2
_ CONT,RAACI'OR .. / . Signal circuit(s) or limited - energy • •
:narrle. Triton Communications, LLC .� pan alteration, or extension. 2 Page 2
Business 135 2
Each additional inspection over allowable in any of the above .
Address: PO Box 1091 Additional inspection (1 hr min) 66.25/ hr .
City /State/ZIP: Hillsboro, OR 97123 Investigation (1 hr min) 66.25/ l r
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 615 -5800 Fax: (503) 62 -5 89 inspections for which no fee is 90.00/ hr
�- --- • / i specifically listed (% hr min)
)V CCB Lie.: 154665 V Electrical Lic.: 34648CLE Supry Lic.: 2826LEA ✓ „ ELECTRIC ,1� : `
Subtotal: 135.68
Suprv. Electrician signature, required: ' r y �
Plan review (25% of permit fee); 0
Print thine: Aaron Van Fleet Date: 6/29/10 State surcharge (12% of permit fee): 16.28 /
a.. _ TOTAL PERMIT FEE: 151.96 ;/
Authorized signature; '
Thin permit appUCO cxpirm if a Permit is not obtained within 180
Print name: Aaron Van Fleet Date: 6/29/10 days After it has been accepted as complete.
• c lamber of inspechDxls allowed per permit,
I: l6uildioopr.. Per.nitrlpp•d.,. taolro9 440 -4615T(t1 /OE /COM/WEB
06/29/2010 11 :59 5036285689 TRITON COMMUNICATION PAGE 02/03
Electrical Permit Application. City of Tigard
Page 2 - Supplexnental Information
LIMITED PERMIT FEES:
RESIDENTIPILW(RK 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 WORg ONLY
Fee for each commercial $67.84
system
(SEE OAR. 918 - 309 - 0000)
Chcck Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ I-IVAC
❑ Tnsnvmerntation
❑, Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
® Other Project r
Total number of commercial systems_ 2
No licenses are required. 'Licenses ace required
for all other installations
] 03uilding1Penrite \ELC- Permi1APp.doe .10/01109