Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2010 -00201
T [ G /111 C) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 560
Subdivision: Lot: 0
Project: Gress and Clark LLC
Project Description: Low voltage for phone /data.
Owner: FEES
WISCO REAL ESTATE EQUITY Description Date Amount
FUND I LTD PARTNERSHIP, BY WYSE Restricted Energy Permit 09/28/2010 $75.00
INVESTMENT SRVS CO, 1501 SW TAYLOR ST 12% State Surcharge - Electrical 09/28/2010 $9.00
PHONE:
Contractor:
FIRE PROTECTION SERVICES
5573 SW ARCTIC DR
BEAVERTON, OR 97005
PHONE: 503 - 590 -3732
FAX: 503 - 628 -6214
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 $84.00
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
This permi • issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do in accordance with aRproved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION: Oregon requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 01 -0010 through OAr • '' - 0 You may obtain a copy of the rules or direct questions to OUNC by calling 5' ..•699 or 1.800.332.2344.
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Is ed B P erm i ttee Si. azure: f% �1>>�
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OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the Job site at the time of each inspection.
Sep 27 2010 7:12IRM FireProtectionServiceslnc (503) 628 -6214 p.1
RECE1V a.
Electrical P • rmit Application ' « ' ' ' ' « . t ':I.; 1 tiN• 1.1
Ci of Tigard S E P 2 8 2011 �, d ' f A fl /d . V Permit No.: alt ,?o /d- CO ‘ 4
13125 . W Hall Blvd., Tigard, OR 97223 . - :...
1 Phone 503.639,4171 Fax 303.598.1960 CITY OF TIGA ° !1' ` ` ` t><har Pemti<.
R ' `I: I, I wwwww Line: v BUILDING DIVIS 1 i: s Supplemental ta for
>I .i 1 151 t1'i mm..s > n apn�Wl>'II 1111 apt 1�'I :i,f)' e•+r. Ili��.1 1 ll . I�rI "� III I Miry, .I i�� t •,I�'I II �9 R�Ifll{�-II•.�I ��.,II$�1b
I Ir�I R,I'(iliAtillfL TIVI it 12, 0• " n�,., �1irriilhiFi19�lIII, Lii` il• °.(iii'i!S(',.ktikJ :glilil' :;ii P.no�;i RVIt pia ;irdli..•.. :!iiAi....v:pn1 111 :�)yft'3tai'�2• :'C:r �
I. �i��. �b .�?c �tllyildl.li , . t.v .. L tr
❑ New constructio ® Addlttonh11teration/replacement Mosso;hook all that apply (submit 1 sets of pip widens eheolud below):
❑ Service of feeder 400 amps a more 0 Building over three stories.
(] Demolition ❑ Other: whom di; available Wit cent 13 Marinas end boatyards.
p 1ssY,•. ; ' , pn :•r. r..;r::: a ��+�� en ,, nos it a „ ; , v ,.. y �� r . ';milt ^ir• i studs 10 000 amps at 150 volts er ❑ Floating build
(l I {If I p, 1 Ut U t?; g n d. 1 I u I 1. t 1 r t i ts, l r P >l
I: �t!'i :,r y �i��l sl l.lzl[� ttl.lill � :.s+� �wur.�.,lll6, t1 : °,f,:clGd,i,t : :31i ,1�ci� :db��lll�,. :: ..� � ill d1f1�1���� rn.11 i top d, •
oraat;nde 14,000 0Coaomemial- usea
o 1• and 2- family . welling rig Commercial/industrial ❑ Accessory building amp for all other Inttellatione, buildiaip.
❑ Muiti- 1'hmi1 ❑ Master builder 0 Other: 0 Piro pump. D Installation of 731 VA or
. r I rt &I Orr �'F 4 1 ■t a oil nt ., v *suit 1, a ;s,`a mi u r i ,� ywei I ,• • Iry • . -o 1 , I � u ❑ �•raaaay sy 1• tarps eaparately derived system.
I 1 f 4 I e r n1 ( :' 1 a , I , a I Id i IT : .,L + A 1 ' 0 Addition of oew meta load of "1 -2 ", "1 -3"
��•�.���IJ�f'Jtc tie;. i�tauL1�. �I, �Ir1�,: I� : :,r:,r�,.,tivlc �...�uG� .. 11,,„1..i, ., r. ,.:4.'^C IIIl�,m• .. u. ❑ ° A ° .'�".
r t, .R. or
Job no.: 2564 Job site address: 9020 SW Washington Square Rd. es . mm�P�y•
D S Sin ix o or r moore re reddendel units. D Arrewaeloaal vehicle parka.
City /State/ZIP: TIg rd OR 97223 ❑ Health -care fa;ilitiee. ❑ Supply voltage for man than
(71 Hazardous locations. 600 volts amble).
Suiteibldg./apt. no.: 560 1 Project name: Gress and Clark LLC 0 Service or feeder 600 or more.
1jf lllaii4j`;iIiI :U. rI VI'k,'a; E:F.E1r" WIlffi IEMIN tlIV
Cross street/directl. , to job site: neewatuo aer. pm •rotor •
New residential single -or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no 1,000 sq. ft. or less 145.15 4
Ea. add'I 360 sq. ft. to portion 33.40 1
Tax map/parcel no. Limited energy, residential
u 1 cr,::,1"a: t .• t n � r w wm, 1 , u r „ W ) T r., 75.66 2
?jell rr I y, a 1' ii 1 ii a I 3 i /1 1 (•" I ': r'' t (with shove so. !!.
1 i !�b�(�,?li& ( „ +j�s A� 1 tl�i,..:.:r,�tt :.r Xl .1 I . ,,,.- :12- ,,: YIN I' I - 'I. . :v i :,i t i. .i i
Phone/Data L residential with stove se. } 75.00 2
Services or feeders 1nstalletionoiteradon, and/or relocatio
200 amps or less 80.30 2
1' ly t 17 r , -.ltd rr'e'r . q bivi""�I: rl.} I . I � f � f �. f 1 . I 7 � N eu�- t� ,.w'� I n. �n I n.��
II<G 1�1 4 am!,,t, I„ II l i It - . 'w 0.1. nn :� :� l i f .i. r 1 1 C iI f. 201 amps to 400 antes 106.85 2
, •3G�Ih..,�k ., J..EI,,,`jl Q i { >I lti II f.l 1 Iii,,, i, w�. L... a [i�,�t�( r� 11 ��I I�� ,
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 454.63 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) - 200 amps or leas 66.85 1
Owner installed; r : This installation is being trade an property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, I ease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, boo, or extension, Ear panel
Owner signature: Date: A. Pee for branch circuits with
1� n * , ■1 , . i t t I1j11�I1A11 �J i 'lids; tic, II. IIY` -, il tl�"r ,I I u"''" "' !'1�!i ( I�'- �l ` yj,�•• ! I•
i iEiliikcil 1 . ilai„I. iu'172 71 6511 1'�.�!.,IFillic 1:1m 9ci���, :;l idii2 :ru 1 ,,vin3r l_ II.,'.;A above service or&oderlbe, 6.65 2
each branch &colt
Business name: Fi ' Protection Services Inc H. Fee for branch oireuils
Contact name: 1 d M Phipps first service or feeder Bee, 46.85 2
branch circuit
Address: 5573 $ Arctic Dr Each edd'I branch circuit 1 I 6.65 f 2
Miscellaneous (aerviee or feeder not Include1 _ ,
City /State/ZIP: Be verton Or 97005 Bach manufactured or modular 90.90 2
dwelling. service and/or 86eder _
Phone: (503) • 1 732 Fax: : (503) 628 - 6214 Reconnect only 66.85 2
E -mail: phipps@ • snw.com Pump or irrigation circle 53.40 2
.f �i 1. f of ' ; , 1 ....R l y e. ,a 1 , ,�7 r r 1 r v v nrt ,t,r u,m, H,� ln;, �'ki Sign or outiine I 53.40 2
Ni';�'l' :, l?; i�ll��t .�fii1 :•I�F�I!_i >� �':� I ,!: �,.,1 ,:.±,,. �f�1��1t�4�FIr1�t?! fl�ril�,w�Y.ilrri�;a�lgllili't'* �' : t , jj g n lighting
panel, Signal
Business name: Fi e Protedtion Services Inc l a al r limited-
l e
energy p panel, teration, at
Address: 5573 8 Arctic Dr extension. Describe: 1 Paget 7500 2
CityiState21P: Be : verton Or 97005 Eaeb additional inspection over allowable In an of the above
Per inspection 62.50
Phone: (503)590 ' 32 I Fax: (503) 6284214 Investigation per hour (1 ter min) 62.50
CCB Lic.: 1543 J Electrical Lic.: CLE3488 I Suprv. Lio.: 4120LEA Industrial • iant per hour 73.75
I It nl rile lu i 17' , r� ":
t; il 1` I I I
'.li4.t31�!!,17:'!f�'�11 .�J.` :�:�' ?iii';!°;. f. �! i� .l,.:,.`J "'iF�•!_I : l7i.:aA:.nil TE
Suprv. Electrician . ignature, required: Subtotal: 75.00
Print name: Davi. M Phipps , . f!� Date: 09/27/10 Plan review (25% of permit fa):
hPp � _ . State surcharge (12% of permit fee): 9.00
Authorized signs' e: f TOTAL PERMIT FEE: 84,00
PrMt name: Devi • M Phipps / . '/ D ate: 09137!30 Thal permit application expires if a permit is not obtained within ISO
7^ days after it Ioe been accepted as coeeplata.
• Number of inspections allowed per pannit
I BUlldla¢WerTltI a1C.p- • •.dot 05f23/06 44e- .615T11/O5V0MIw®