Permit •
n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
, COMMUNITY DEVELOPMENT Permit #: ELR201000154
Date Issued: 08/13/2010
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 460
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: Greater Giving
Project Description: Data telecommunications
•
Owner: FEES
GK TRIANGLE CORPORATE PARK III L Description Date Amount
BB# 73 - 1771 GK1130, CBRE, PO BOX 2096 Restricted Energy Permit 08/13/2010 $75.00
WARREN, MI 48090 12% State Surcharge - Electrical 08/13/2010 $9.00
PHONE:
Contractor:
CAPITOL DATA & COMMUNICATIONS
11401 NE MARX ST
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503 - 257 -7121
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: y Fire Alarm: N
HVAC: N Instrumentation: N Total $84.00
Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 -I. -0110. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 101)0/ I I - - Permittee Signature: DA/ /5"7 2 % ° (..-/e_19 ---- 77e/\/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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08/13/2010 10:10 5032551966 CAPITOL ELECTRIC PAGE 02
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City a Tigard Plan Review Other Permit:
1. r 13125 SW Hail Blvd., Tigard, O 97223 n U G 1 3 2010 Datc/By:
_ Phone; 503.639.4171 Fax: 503.59$.19so+ Data Ready /By; luris:,43 /?/ • a Pape t for
T [ Cs1' R 1) ingpcctiatt Line: 503,634.41.75 , •+ n ;� Notified/Method: / I- Sappleretenrnt Ioror nmien
Internet: wwvr.t;garcl- on C l 1 ki • 1 lkl t a , (1 ._
— TYPE OF WORK �{'a lei L.6�l�dt•'`' � fSi1.. d PLAN REVIEW
I, j New constnlction ill Addition /alteration /replacement Please check all that apply:
❑ Demolition 771 Other: ❑ Service over 225 amps, come! ❑ Hazardous location
CATEGORY OF CONS'TRUCTI.ON ❑ Service over 320 amps - rating E.] Building over 10,000 sq.ft,
1 •and 2- family dwelling L' i Commercial'industrial L Accessory building Of 1- and 2•famlly dwellings 4 or more new residential
❑ Multi- Oiillily U Master Builder E Other ❑ System over 600 volts nominal units In one structure
JOB SITE INFORMATION AND LOCATION ❑ Building over three stories El Feeders, 400 amps or more
13221 SW 68th PerkwO
El Occupant load over 99 persons U Manufactured structures or
Job no.: C10192 lob yitc address; y ❑ Egress1llghting plan RV park
El Health -care facility ❑ Other. —
City /Slatcl7.1P: Portlan r Submit 2 sets of plans with any of the above.
�� O The above are not applicable to temporary construction service.
Suitc/bldg,/apl:. no.: 460 Project name: Greater giving
PEE SCH12DULE r
Cro9a SITCCI./f irectio Ate: DQi r1ptinn ( Q. f rec. 1 Telal 1 ••
New residential • single or multi family dwelling unit.
— includes attached garage.
Subdivision: Lot no.: 1000 seLft. or less 5 168,54 4
.Tx map /parcel no.; F. Add'I 500 .•, ft OT •rtion 1 33.92 I
- DESCRIPTION OF WORK Limited cncrty residential 5 75 .00 2
Limited cner$y, non - residential $ 75.00 2
Each manu(3cturcd home or modular
- ....,J,_ PROPER'ry OWNER TENANT dwelling Set find /or feeder $ 67.84 2
Service or feeders installation, alteration, and/or relocation
' °,' 200am•sorl004 5 100,70 2
201 amps to 400 amps $ 133.56 2
- Address: 401 amps to 600 amps $ 200.34 2
601 amps to 1000 antes 5 301,04 2
City /; tate/ZIP: P: Over 1000 amps or volts $ 552.26 2
Reconnect only $ 67,84 2
i`hnno: Fax:
503-295.5555 Temporary services or feeders installation, alteration, and /or
—
Owner installation; This installation is being made on property that 1 own which is not relocation
intended far sale. !case, rent or exchange. according to ORS 447, 449, 670, and 701 200 amps or less 5 50,36 1
Owner signature; , 1)a10! 201 amps to 400 amp S 125.05 2
, 401 amps to 599 amps 168.54 2
1 APPLICANT 1 L CONTACT PERSON Bradeh circuits - new, alteration, or extension, per and
A. Fee for branch circuits with
Business Name: _ service or feeder fcc, each
branch circuit 5 7.42 2
Contact name: B. Fee for branch circuits
•
without service or feeder fee,
AdreSS; _ each branch circuit $ 56.18 2
Each additional branch circuit; I $ 7.42 ] 2
Z•11•.y /Stntcl7lP: Mi cellaneousJacrvlcc or feeder not included)
Phone: Fax; Pump or irrigation circle $ 67.84 2
Si nor outline li htin- S 67,84 2
• f° 9tai1: Signal circuils(s) or limited-
: ....... CONTRACTOR energy panel, alteration, or
extension. Dcccrihe: Tait/Duo 1 75 79.00 2
Au•incss Name; Capital Data & Communications, Inc.
Page z
Contact name; Steve Lines 971 -508 -2928 / Each Additional inpection over allowable In any of the above
Y' Per in 'action 8 66.25
Address: 11401 NE MarX Street
itt Invcstip,atiotl per hour (1 hr min) 8 66.25
r� ,,ll industrial plant per hour $ 78.18 C ity /Start /ZiP; Portland, Ore 97220 4/1171:1„ f 1 ELECTRICAL PERMIT FEES'
` Subtotal 75.00
Plionu: 503 - 255.9488 j L / Z f / Pax; , 503,257-7121 ‘'
03 - ,71121 P lan r eview (2S% n�crntit fcc)
S[atc surcharge ( 12% ormit fcc) 9.00
CCB Lie.: 14257 1 penned Lied 26 1 040C1s. [ Suprv, Lie,; 2757LEA If TOTAL PERMIT FEE 84.00
�''� + 9'Itla permit npMlratlnn cxplree II' • permit to m•t obtained wllltrn 11111
SV ,nrv. Electrician aignntorc, rcquircd: � r.�,� `( �� _ ��{� /� I 1
�/ 1 rinyn olio, It l,m been accepted n, rnmple+e
. Ppint Name: Terry Brasch Data; 08113110 • Fee med,odnlogy act by Tri- " " County Building 1n Scrvicc Annrd
Authorized 6t�nalur4; Number of inspections per permit allowed,
t Pdtit Namc: To Brasch
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