Loading...
Permit �r CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT } � tiR Vt 1 .+ t Permit #: ELR2010 00138 4 = a rrt_ COMM UNITY DEVELOPMENT :-=',10. Date Issued: 07/29/2010 +TIC , i. 17? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 ti *a ..: w Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 200 Subdivision: TIGARD TRIANGLE CENTER Lot: 0 Project: CNA Insurance Project Description: telecom cabling • FEES Owner: PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 07/29/2010 $75.00 PORTLAND, OR 97224 12% State Surcharge - Electrical 07/29/2010 $9.00 PHONE: 503 -624 -6300 Contractor: DYNALECTRIC 5711 SW HOOD AVE PORTLAND, OR 97239 PHONE: 503 - 226 -6771 FAX: 503- 226 -7720 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 $84.00 Intercom/Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Required Items and Reports (Conditions) 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 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. �q / Issued By: /' l Permittee Signature: O/J A Q t - +T - '1 / 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. • CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT Ii COMMUNITY DEVELOPMENT Permit #: ELR2010 -00138 T t G A R. D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2010 Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 200 Subdivision: TIGARD TRIANGLE CENTER Lot: 0 Project: CNA Insurance Project Description: telecom cabling Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 07/29/2010 $75.00 PORTLAND, OR 97224 12% State Surcharge - Electrical 07/29/2010 $9.00 PHONE: 503 - 624 -6300 Additional Inspection 08/31/2010 $132.50 12% State Surcharge - Electrical 08/31/2010 $15.90 Contractor: DYNALECTRIC 5711 SW HOOD AVE PORTLAND, OR 97239 PHONE: 503 - 226 -6771 FAX: 503 - 226 -7720 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 $232.40 Intercom/Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Required Items and Reports (Conditions) 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 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: Permittee Signature: 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 603.639.4175 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. 2010. JUL, 28. WED 09:17 DYNALECTAIC SALEM FAX No, 503 391 - 2817 P. 001 • RECEIVED ••• .. Electrical Permit Application . :tog OFFICE, USL•ONLY . City of Tigard JUL. 2 8 2: U i R eceived }�� Permit No.: y 13125 SW Nall : Blvd., Tigard, OR 97,22— ®F T Plan Review ... Other Permit: • Phone: 503.639.4171 Fax 503.59 - Dnte /B : A .. i . _ ■ r TiGAicD Inspection Line; 503.639.4175 UILDING DIVISION DnleReady /By: 1wis; Pagc2for Internet' www.tigard-or.gov Nerified/Method: Supplcmcutol Inrormation ,;Y.r "Y ciat•i'1'.. «; "' `o;Y •_i: : •r - i r:; yy .n a`w 1"£�re+� + F; "C'.',. rr >:1W "�. ;';ril «;, °'il 0 � ?i.•i fM rd t Ta v V.���/y,��y� +.�r. t.. ,M 1 i.e 1 i Yg♦l ip ^•,.Sn3'i Y,ht f "�Q KI FtF •w> r �/ ,1' 7� 4 U t- r a`�.r t tl�l \N'JI *C� )'t' I. k e nL: Y e ! yq`,7 r, �Tit.ti 14'�2Yr,;..W -: car.0 y...r r���,. ...F.11. ...TCt ra,iAr "C. ^Z•.; .f:�'4s.eS�iXSXa :. . ,•l y. ,.�Sa .- Y�t� ±1k� t�Y at„i .. ♦l, . o. 1�, ,t t. � :..i . X.':. .. i! Please check all that apply (submit a sets orplans Wilms checked below): ❑ New construction Addition/alteration/replacement ❑ Service or rheder 400 amps or more 0 Building over three stories. 12 Demolition 0 Other: where the available fault current ❑ Marinas and boatyards. �f, � t . ,� ^ ;^ u ir +' ik ,Q ° ,,�, Y. pt., 1 t ' . [ s 'g N * / 1 u exceeds 10,000 atn s at 150 volts or o Floatin g buildin . ..,,a t,,:„, ft�7 h „ '� ,,,,,..:a T � , , . : .$�ti i� a ,. ,1 1 �� .,,,, �� .. }_ i , r,1'l P b b 6• less to ground, or exceeds I4,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building amps for all other installations, buildings. Multi- family El Master builder ❑ Other: ❑ Fire puinp. ❑ installation of 75 KVA or ).i "el; , .4"1 tf i ; a3 9y�,t�•i, .� ;S dB ' 9 - v t i , •• ONl A>ti ° .. .. t 9 a: S$>, i4a� ""air eti, ., .a.,o,,,, 0 Emergency system. larger separately derived system. iYJI' , ctn.,l •,t t,� a..W4 •lt,,..,,,t . 0/92 , ,A ,l I �.Juw .r , 1 iPt �, . , : ,t'n, ,,m. Addition of new motor load or ❑ .. ..E....1_2•• ..1 _3» 1A �y [I W /_CS rj 1 Si. or is more. occupancy. Job no.: " I Job site address: 7�t e7 Sl/07 YL r” ❑ s or more residential units. G Recreational vehicle parks. f' City /State/ZIP; - / /� • • ❑ Hcalth -sue facilities. ❑ Supply voltage for more than 1 F� . © � � ❑ Hazardous locations. 600 volts nominal. SUite/bld$- /apt. no.: Project name: A ❑ Service or feeder 600 amps or more ., . 1 ..J V;iam. >,�•�t� GIti45lw tt $ R O.Cr +� , ..i0. � .�,m t ° , r ., '� :.r, ,rk7,;.Yr�'Y; l.,,b. t.�+t� I S�•� .43 _: 1 r, v i ' Cross street/directions to job site: nceert ttan x•711 " 'reset ---- New residential single- or multi - family dwelling unit. lnciudee attached garage. Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 • 4 Ea. add'l 500 sq. ft, or portion 33.92 1 �� Tax map/parcel no.: Limited energy, residential ?4l ? g' '.tTip f- 1 .1, r.�W 0'+,, C . '..'!0' u ii:XES X T1S �� (with above so. ft.) 67.84 2 Limited energy, multi- family 67.84 2 • m ,� residential (with above so. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 �? `; i � '� �;; ' , o WigriC� W �. `q* to ` . ` �.tr'li t • •,, ' i�Wutl l' t :7 ° a ` 1 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 20034 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 • 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or n relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 0 1 Owner installation: This installation is being made on property that 1 own which is not 20] snips to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 • Branch circuits ncw,alteratiorl, or extension, per panel Owner signature: Date: A: Fee for branch circuits will: i t t l +t;l t€ii ' Q' 1 A 1 Btf , 7 ' ii " fig y vry `r (j t r'v'� above service or feeder fee .42 2 ratAt each branch circuit Business name: B. Fee for branch circuits Contact name: wl/houl service or feeder fee, • 56.18 2 first branch circuit Address: Each add'1 branch circuit 7.42 2 Miscellaneous (service or feeder not Included) City /State/ZIP: • Each manufactured or modular • dwelling, service and /or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 • 2 4 a .u:V'' < t ti r9N r.,�p' ?.. < t w Ihry } „': ^'y ix f n n 3;. . ;,, „ ry 4 4 1 tl Sign or cutline lighting 67.84 2 �it'rtis �v3., rPa. Y' .�r�f�'t� Y,r•����,;`+ �,�a�•�_��R�.'i ur. rdruwl �t�'�fi��'•,, ;t, r� 1j, ze ;.ah: g Business name: Signal circuit(s) or limited- ? 5 A , i l , - o_ r+ energy panel, alteration, or Address: extension. Describe: / Page 2 2 City /StateJZIP: y'4'1 a y 00._. c 72 Each additional inspection over ... allowable In any of the above Per inspection 66,25 Phone: (l 3) 22(p .. 1611 1 Fax: ( �5 ) 2 — - 7 ' 1 6 �y investigation per hour (1 lirmin) 66,25 CCB Lic.: Electrical Lic.: Zt Suprv. Lic.: Industrial plant per hour 78.18 :Aeg ; 4 '.1 fi 5LECTRLCA:L FIP,+iRIVIILT,,EEE.B, , r — Suprv. Electrician signature, required: - \ i i. '` E ���` g Subtotal: 4.7.-90.-- ?S Print name: 1--..z,A Date � l 3 L Stnt ■ Plan review (25% of permit fee): ' 4 e surcharge (12% of permit fee): 40 q Authorized signature:0 1 t a Q • r TOTAL PERMIT FEE: 8►/ — �"' This permit application expires it a permit Is not obtained within 180 7 Print name: M Date. 7M- ., days after it has been accepted as complete. * Number of inspections allowed per perinil. t:l auildinsAPermits lELC- PermitAon.dot 10/01/09 440- 4015T111/05/COM/WE8 2010. AUG. 30. M0N 14:00 DYNALECTAIC SALEM FAX No, 503 391 - 2817 P. 001 Electrical Permit Appl , -< �.!.e. FOR OFFICE IJSI: ONI.V City f Tigard Received d . 131 25 SW W Hall Blvd., Tigard, OR` 97223 Review A I _,�� • ' g Phone: 503.639.4171 Fax: 503.598.1960 Date/B , Other Permit I r Ci A KD Inspection Line: 503,639.417 r '' ; '. :. C j- 'd;2 Date Ready/By: • Luis: ® Sec Page 2 for w Internet ww.tigard -orgo i T •t,r. 'ii , h-.l Notliied/Method: ('p Supplemental Information C'r'1'7A S �l.,ita1:. <' ; aj�}+ •:r•:,1 , 10.0,7 4, ,]‘ Q14,2: S %if*.:;.I1.,�� al ;.1 -P:'; 'r .1I ' '` `).. -li,7- •,, : �. i. .'{;, -.y „ New construction R1 Addition/alteration /replacement Please check all that apply (submit a sets of plans w/neme checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories, ❑ Demolition ❑ Other: _ wham twat the available fault ❑ Marinas and boatyard& ligig� : e` (�'�' �, ' �= 6: to 4, i-rr3 5.- • n(Oj� „ •y CI exceeds 10,000 amps at 150 volts or Floating buildings. " ^�' 9 " less to ground, or exceeds 14,000 ❑ Commerclalwse agricultural 0 1- and 2- family dwelling J Commercial/industrial ❑ Accessory building amps for all other installations. buildings. [f Multi-family ❑ Master builder ❑ Other: ❑ Firs pump. ❑ Installation of 75 KVA or }; _,,, ��,/,�,�- �; r z ter; i �,�,p-� -1 ` 3 "rr: rr .r.-7, ❑ Emergency system. lager separately derived system. gW ELV -rs. };.._`.lo?.. u R... ti ii..a?Sr�iir! ' F: .rI .` :i l ❑ Addition of new motor load of "A ", "E", "1 -2 ", "1 -3 ", Job no.: 1100 3' Job site address: 11-A10 'A 51J3 !Atl 4_) 10011P or more. occupancy, ❑ Six or more residential units. ['Recreational vehicle parks. City /State/Z1P: T��, �, �� Dg.., 41- 2 ? 3 ❑ Health -care facilities, ❑ Supply voltage for more than " � �` r ❑ 11azardoos locations. 600 volts nominal. Suite/bldg. /apt. no.: 2q0 I Project name: (, t pt • ❑ Service or fader 600 amps or more. . Cross street/directions to job site: o . Qr " " l i'(07- P .... �'_�? ..f Y � 'W4. : Dercri on 917. Wee • New residential single or multi- family dwelling unit. Includes attached garage. . . Subdivision: Lot no.: 1,000 aq. ft. or less 168.54 4 Tax map/parcel no.: Eli add'I 500 sq. R or portion • ' . 33.92 • 1 Limited energy, residential _ F777'.47117.. :73,7 x';75 ;" : ::aCk=eciI• t U., :i d+ "` ", x i``:` :VI 4 A ;:.. T" ,1 ,, '•::.s_.�'• (With above so. ft) • • 75 2 , a . .. a1! :'. .n. • �ht,._sS4''''nt:_,...+._ .. & .S :74 /.1lt: ` -.7 -ar� .t l . Limited ed energy, mgn_family -. _ _ Services .' :. _. _ -• 75.00- • • _ 2. Bill ... . ; 'funs . noon residential fee (with above sq. ft.) o r feeders inafallation and/or relocation 9. . e - J. . 0 200 amps or leas - •100.70 2 201 a � '* lil✓a�'�'� +X, 'a� X` <r »'fs v� R ""L to am L� d't,[�iii; ?�.1�r!� '? ��s.c tTC.- °'rw,�.'1`.t -.�9 �' r•46v, ;. �a� -:• IS.� ' at e t ,°�. `.u. ".��.�iL i; . ttWs 400 s 133.56 2 p . 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301,04 2 Address:. Over 1,000 amps or volts j • 55226 2 City/State/ZIP: relocatio Temporary n services or feeders installation, alteration, and/or Phone: ( ) Fax: ( ) 200 amps or leas • 59.36 • • 1 Owner installation: This installation is being madc 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 to 599 cro 168 • .... .2. Branch circuits - new, alteration, or extension, r panel Owner signature: Date: A. Fee for branch circuits with .. . `� ; rw. s c,* _. �. -, above service or feeder fee, q. t t y��y E ,s 1 ,..ttl? 2171( 4 Y .atlti t iiii 4:1 =;l;�a.'� •ni�C'trcRy'sZ each branch circuit 7.42 2 Business name: B. Fee for branch circuits wtrhout service or fader fee, first - • 56.18 2 Contact name: branch circuit ... ... . . . ... • Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) • . • • Ci /State/ZIP: Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84' ' 2 'E -mail: • . . ?!y " t�, , -t� Sign oroutlinelighting 67.84' 2 "b " M j� t i7_ "" o tf' cn3 . o . 7 s" :sf:"�r+'s�'� ��: 4'r�7 'St*ln ra Signal circuit(a) or limited -energy . • - Business name: D 14a -}.r 4 panel, alteration, or extension. Page 2. . 2 Each additional inspection over allowable in any of the above Address: 5--1, L` b C cot k Additional inspection (1 hr min) 2, 66.25/ hr Iv_ City /State/ZIP: r.�6. f - Q. a n 23 • Investigation (1 hr min) • 66.25/ hr + Industrial plant (1 hr min) 78.18/ hr Phone: (50) 3'. (o1 k I Fax: (50 ,,) y�,(p 4 ? - 1 - 1 F inspections for which no fee is 90.00 / hr specifically listed (%r hr min) CCB Lic.: ( 4 -- 1 0, - Electrical Lic.: 1(o -S°lC_ Suprv. Lic.: & rti, y ,. l. I t ;' `y . _ � .' Suprv. Electrician signature, requ ri, ;Ar' ): Subtotal: 1 9') n4 � r . L� r Plan review (25% of permit fox Print name: _N Date: trM l � $talc surcharge (I2a/a of penult f✓ e): (5 i TOTAL PERMIT FEE: .1 o Authorized signature: / This permit application expires if a permit Is not obtained thin 180 • Prim Warne: 01,14. days after it has been accepted as complete. 1 I Date: /3o / Lb • Number of inspections allmved per permit • I: l8wldiagPermits\ ELC.Pe,mitApp.dae 07/01/10 44o4615T(11/05/COM/wEB 0 K ct- -- t Crz _) - ,,AA 2010. JUL. 28. WED 09:17 DYNALECTR I C SALEM FAX No. 503-391-2817 P. 002 Electrical Permit Application - City of Tigard Page 2- Supplemental Information . LIMITED ENERGY PERMIT FEES: • WO.VONIMMOt*TOS103.39P.MentanD Fee for a11 residential systems combined $67.84 Check Type of Work Involved: Audio and Stereo Systems* 0 Burglar Alarm 1:1 Garage Door Opener* 0 Heating, Ventilation and Air Conditioning System* • Vacuum Systems* Other: Fee for eull commercial $67.84 • system (SEE OAR 918-309-0000) Check Type of Work Involved: 17 Audio and Stereo Systems • Boiler Controls E Clock Systems rA Data Telecommunication Installation Fire Alarm Installation 111 O Instrumentation • D Intercom and Paging Systems O Landscape Irrigation Control* •E] Medical LIJ Nurse Calls Ej Outdoor Landscape Lighting* Protective Signaling CI Other Total 'number of commercial systems! I *No licenses are required. Licenses are required for all other installations • 1:15111clinecrmitaLC-PernthApp.dot I0/01/09