Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2009 -00031
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/6/2009
PARCEL: 25101 CB -00200
SITE ADDRESS: 08200 SW HUNZIKER RD ZONING: I -L
SUBDIVISION: FOUNDRY INDUSTRIAL PARK LOT: JURISDICTION: TIG
PROJECT: SMITH GERIG WESTERN PROPERTIES
Project Description: Data cable for workstations and server location.
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:
TOTAL # OF SYSTEMS:
Owner: Contractor:
SMITH GERIG WESTERN PROPERTIES L TRITON COMMUNICATIONS
PO BOX 930 PO BOX 1091
WILSONVILLE, OR 97070 HILLSBORO, OR 97123
Phone: Contact #: PRI 503- 615 -5800
FAX 503- 628 -5689
Reg #: ELE 34648CLE
FEES LIC 154665
Description Date Amount SUP 2826LEA
[ELPRMT] ELR Permit 1/6/2009 $75.00
[TAX] 12% State Surch 1/6/2009 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ' 1 Permittee Signature: I\90\11(15;k1U)
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.
01/06/2009 13:24 5036285689 TRITON COMMUNICATION PAGE 02/04
i , - 4 Eil'-.:'
Electrical trical Permit Applicatio 'V
•
l clli t)h h Il ,I t ;s� O l • III City Of Tigard vd Received ` GQ Permit Na.: �2 f� 11.44 JAN 0 Plan l ___
.r" ' 13125 SW Hall Blvd., Tigard, OR 97223 p1 Re
_ Phone: 503.639.4171 Fax: 503.598" 19 . ate : other Permit; t' t (i AR!) Inspection Line: 503.639 CI J U I IGAR " Res /By: la See Page 2 for
Internet: www.tigard or. ov r G DIVI VI I
•.i "fred/Mviethod: Supplemental Information
► •
TYPE OF WORK 47■ '' , ' ' ` „' Cf " •,,, / :
^ New construction E Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items cheoked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories,
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
i3CTlON . "> ' .. CATECORY OF CO1VS "1R exceeds 10,000 amps at ISO volts or D Floating buildings.
.
1 - and 2-family dwelling Commercial/industrial 1055 to r all o , a exceeds
nst&I s installations, ❑ Commercial -use agricultural
❑ y g ® ial ❑ACOessoryhuilding arrtpstorallother buildings.
❑ Multi- family ❑ Master builder ❑ Other: ['Fire Fire pump. ❑ Installation of 7$ KVA or
. - ❑ Emergency system. larger separately derived system.
JLOR' SITE.INFORMATIONA;NT! LOCATION :. :_ ; _ ❑ Mdition of new motor load of ❑ "A E" 1_Z l_3"
10011P or more, occupancy.
El no,: 3230 Job site address: 8200 SW Hunziker Si. or more rcaidcntwl units. ❑ Recreational vehicle parks.
City/State/ZIP: OR 97223 ❑ Health -care facilities. ❑ m for more than
❑ Hazardous locations,
Suite/bldg. /apt. no.: Project name: NW Demo Data Cabling ❑ Service or feeder 600 amps or more.
. '1?'EF,t' % ;SCIIEDi31<: ';,'•1,)
Cross street/directions to job site: oercriptiea 1' OW. I Fen 1 Total I .
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:
1,000 sq. ft. or less 145.15 4
--- Ea, add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no,: Limited energy, �' 75.00 2
1DIFS .... . TION. OF''Wt)RK (with above sq. ft.)
Limited energy, multi- farntly 75.00 2
Data cabling for workstations and new server location. residential with above sq. ft.) _�
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERLY OWNER , „
' ] Li 'TENANT 201 amps to 400 amps 106.85 2
Name: 401 and s 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 _ i
Owner installation: This installation is being made on property that I 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, ter panel
Owner signature: Date: A. Fee for branch circuits with
.., ...
❑ ,#PPLICANT .' .. . 7 CONT,NertERsco :' above service or feeder fee.
6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit __
Address: Each add'1 branch circuit 6.65 2
__. ” Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
- - — dwelling,, service and/or feeder
Phone: ( ) 1Fax:: ( ) Feconnectonty 66 "$5 2
E- mail : Pump or irrigation circle 53.40 2
CONTRACT_ OR.... . . ` : .,,; ' Sign or outline lighting 53.40 2
Business name: Triton Communications, 1(r)LC Signal panel, or alteration, limited-
_ _ energy panel, alteration, or
Address: PO Box 1091 extension. Describe: 1 Page 2 75 2
City /State /ZIP: Hillsboro, OR 97123 Eacb additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 615 -5800 Fax: (503) 628 -5689 Investigation per hour (1 hr min) 62.50
CCR Lie.: 154665 Electrical Lie.: 34648CLE Suprv" Lie.: 2826LEA Industrial plant per
l phour p y � �y� I1,• 73.75
... ... ;'ELEtTK1I 4lJ ).10 M •FE S : ',`q t %i
Suprv. Electrician signature, required: Subtotal: '75
Print name: Aaron Van Fleet Date: 1/6/09 "" " (25% Plan review (25 of pemiit fee):
State surch (12% of permit fee): 9
Authorized signature: G' ^r TOTAL PERMIT FEE: 84
This permit application expires if a permit is not obtained within 180
Print name: Aaron Van Fleet Date: 1/6/09 days after it has been accepted as complete.
Number of inspections allowed per permit.
1.\ r3uilding \PcrmitslELC- PermitApp,doc 05/23/06 4104615T(II/05 /COMrWEB
CITY OF TIGARD
BUILDING DIVISION
A PERMIT #: EUR7009•00031
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 1/G12009
Phone: (503) 639-4171 16, 4■ 4 101;-,l'ill"
Inspection Requests (24 Hrs.): (503) 639-4175 ...7_41- II.
INSPECTION WORKSHEET FOR DATE: 1/1412009 TIME: 7 PAGE: 14
SITE ADDRESS: 08200 SW HUNZIKER RD CLASS OF WORK:
SUBDIVISION: FOUNDRY INDUSTRIAL PARK LOT #: TYPE OF USE:
PROJECT NAME: SMITH GERIG WESTERN PROPERTIES
DESCRIPTION: Data cable for workstations and tierver location,
OWNER: SMITH GERIG WESTERN PROPERTIES1_, PHONE #:
CONTRACTOR: TRITON COMMUNICATIONS PHONE #: 503-615-5800
Inspection Request Scheduled For: Date: 1/14/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 079691-01 503-710-8120 N
c orrals/Com F m i e rsi ntf)Instctions:
NO i .s1 1 (Aczko 00 W ri
( - '\ Aj i
F*PASS E PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
fl CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
Inspector: G^, (" (W)1.--6 Date: 1 - Pi/ .
Phone #: (503) 718- 7446
01/06/2009 13:24 5036285689 TRITON COMMUNICATION PAGE 03/04
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
JRE$IDENTJLA
Fee for all residential systems combined $75M0
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 $75.00
system
(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*
1 Protective Signaling
❑ Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
1.1auildin \ Permi0AELC- PermiIApp.doc 03/23/06