Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111 0 COMMUNITY DEVELOPMENT Permit #: ELR2010 -00245
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2010
Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: University of Phoenix
Project Description: Low voltage for installation of wireless routers.
Owner: FEES
GK TRIANGLE CORPORATE PARK 111 L Description Date Amount
PO BOX 2096 Restricted Energy Permit 11/05/2010 $75.00
WARREN, MI 48090 12% State Surcharge - Electrical 11/05/2010 $9.00
PHONE:
Contractor:
IES COMMERCIAL INC
16135 SW 74TH AVE
TIGARD, OR 97224
PHONE: 503 - 648 -1900
FAX: 503 - 670 -9572
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 permit ' 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 n accordance with approv : • : ns. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. TTENTION: Oregon law requires • to follow the rules adopted by the Oregon Utility Notificatio• "-nter. Those rules are set forth in OAR
952- 1 -0010 thr• ugh OAR 952 -'' 1100. Y ' ay obtain a copy of the rules or direct questions to OUNC by callin • 6699 or 1.800.332.2344.
1 7 4 00 '
//
Iss ed By: � / 6 ' �` i. / / r Permittee Sign. e: �i. 4. 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.
11/04/2010 14:21 5036709572 NEW TECH ELECTRIC PAGE 01/03
Electrical Permit nn i
.A,pplicatiot � FOR OFFICE. I.15F ONLY
1t� 1 V R eceived //t
City 0 igalyd Permit No.: fc�2£9 c ,2 S
a 13125 SW Hall Blvd., Tigard, OR 97223 F y O
Finn Review
Q. -' Phone: 503.718.2439 Fair: 503,598.196140 4 2010 Date:/By OtherPcmdt:
r 1 c n r•. n inapcction Linc: 503.639.4175 Dnte Rendy/By; wr(s � See Page 2 for
lInternet: tv
ct: ww.tigard- or.gov OF T]GARD Notified/Mothnd: I pJ Supplemental Information
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❑ Ncw construction ® Addit ion /alteration/replacement Plcece check all that apply (.submit /sets of plans w /items oheeltcd below):
❑ Service or feeder 400 moo or more O Building over three stories,
❑ Demolition ❑ Other:
where thc available fault current 0 Marinas and boatyards.
or ❑ Floating buildin
y 4i7,,i :, wi ' ! a` if �i }ii t�¢ 1 77 c ' r ni's.r . h l; + R`•. r 1 111 3 1 'f 1 1,1,; �a ,fd)n �1(' .-rile .,, ,o '1, i exceeds 10.000 amps at 150 volts gs.
i4 X 11; � . 111! 1 i:t''.4..;;-:.1.41'..-`t l , 4 1 } D
CI 1- and 2-family dwelling Tess to ground, or exceeds t4,000 ❑ Commaeial -uso agrlcutturat
y g ®Commercial /industrial �]Accessorybuilding amps for all otherin$tafations. buildings,
❑ Multifamily ❑ Master builder ❑ Other ❑ Fire pump. ❑ inatnllntikm of 75 TCVA or
T T p 2 1t '.'{ ,m a*� � r(L t4 i H h/l I , ,b li� ,
t w u . : `J G ^ , j t ate I t n I i , (p ^ n y � j rya r p. p n'm a y 1 �6tq�' , l iU i r ❑ Etnergoncy system. larger st umotely derived system.
Wit4at11iiA,, )i.
ri:+ig1 ,D,.r''? ?NOR 0 l7Tnr �tl ttt
1nitr,`te n tiIh�'4 k ''' . e `' s,d A
❑dd iti onof inew.motortMdof 0 "A ", "F.". "1- 7 ",..1 -3 -,
Job no.: 53113 Job site address: 13221 SW 6S Parkway tome or more. occupancy,
0 Six or morc residential units. ❑ Recreational vehicle parks.
City/State/ZJP• Tigard, OR ❑ Health -swore l:£cilit;ec• ❑ Supply voltage for morc than
❑ Tiu'Irdortt locations 600 volts nominal,
Suite/bldg. /apt. no.: 500 1 Project name: University of Phoenix l 0 Service or feeder 6 amps or more. +.ww, �'+ {lK } jay 11t1�a
P h . i ; 77 ..,y ./i,r 0"1:Ii‘P`)? r : • �t j l riii
Cross street/directions to job site: , 1on
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 aq._ft. or less 168.54 ' 4
Tax map /parcel no.: Ea, add'l 500 sq. ft, or portion 33.92 1
i V 4 j r � Jd , ;• i,� i l itlip lA a �'P ( ° C . ;�„ S k 1 , a - r r r. ; qi. �;x ; i•'' L, residential 75,00 2
l t y m1 de
Mi.lf1j��tlt4w., t;ti$.4i. ?g1dE iilC. ill lg,,. iu „ hrn>»n intc l 'st.tiillcii !1..#- yy .Bail ilhl i1 ,0 4 i,/ts.1... Limited energy, multifamily
S .i t tfla W 11r #U.SS y�(.. - residential (with above sq. R 75,00
) 2
✓f Services or feeders installation, alteration and /o_r relocation
200 amps or lees 100,70 2
l �lrrl�i L �� 76 V I � �'F K l 7 l� v, 1 l hri`r 7`y 1 ,' a rt . ? F.1 t Ii` 4�7Y., 0!C ",, , ry1 r p1,f t ,.? . j , r
ilia,i�l`r �, e l jt,t.�t � bit a-�r t UN ''c 'toV1'';�l(sfi 4 ' er+ l rtbt fl ' li ll' 201 am t0 4 °0 amps 133,56 1
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 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State/Z1P:
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I t
Owner installation: This installation is being made on property that J 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 amps 168.54 2
Branch circuit -- new, alteration, or e per and
Owner signature: ii}} gg Date: A. Fee fbt branch circnitee with
'ti ll f� ,(1,i �1 t , Lt ?fltal i<i+ t�fi4,l I i(til>if tit, i'ill il�llif is S�ttc tI tie a i'(W,k t1all. : , tM c�. a r >r t AVO ' . s ,. .., tF 4 t service or feeder fee, 7.42 2
each bench circuit
Fusiness name: B. Fee for branch circuits without
service or feeder fee. first 56.18 2
Contact name: Jorge Algeciras branch circuit
Each add'- brunch circuit 7A2 _ 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84 2
dwelling, scrvicc and/or feeder
P. hone: (503) 577 - 6966 j Fax: : ( ) Reconnect only - 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
r mm ^ Sign or outline lighting 67.84 2
A!i4if: r;:.bh11:t!1uil,1..atiii 1;�;!> o! 1, t{ fii,,: l�lif�i� ;Itsn`�tnmrtSifi,R'at»»4�, ° �td ,L,�lYi�,'l tiiai:61t� dlil G 1' G PP. lei .�ai#Itt1I Signal circuit(s) or limited-energy r
Business name: TES Commercial, Inc. panel, alteration, or extension. 1 Pa e 2 75 2
Each additional inspection over allowable in any of thc abov
Address: 16135 SW 74 Ave r Additional inspection (1 hr min) 66,25/ hr
City/State/ZIP: Tigard, OR 97224 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 M min) 78.18/ hr
P one: (503) 648-1900 I Fax: (503) 670 -9572 inspections for which no fee is '
V
/ s � specifically listed (%z hr min) 90.001 hr
CCB Lic.: 182452 1 Electrical Lic.: C448 I Suprv. l.ic.: 491 i ' ”, � I I L ;�� �tE;4;rt' ki$, t. „ ',,,,,s4 1 t t„� il , ^'?f+, r 'NCI
/ V i �t' ��c,..� � �� ,1 . ,....4.dxw�l�kai,a.cp:i i.lF N'
1��
Suprv. Electrician signature, required: Subtotal; 75
Plan review (25% of permit fee):
Print name: Corey Baysinger Date: 11-4-10 Sic surcharge (12% of permit fec): 9.00
Authorized signature: �;
TOTAL PERMIT MB: $4,00
This permit application expires if o permit it not nbtainrrl within 1
/ days after It has been accepted ns complete.
Print name: I Date: • Number of inspections allowed per permit,
r:1Buildingiperm1r lFl.C.PermitApp. 07/01/10 4411 4M ST(II/n5 /COM/w5R
11/04/2010 14:21 5036709572 NEW TECH ELECTRIC PAGE 02/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
cl r� �� �r Cy�'f tr»f6 1�i� {( I ;ayu��r�r {r t�l- , fib�,,�f {'1{; �r
I � m�l!'i0.1 'MfIRa. tilrl/*ax `I0.riJ!.. X�, l'� .�I Ali �kAl K ,1'�l351111�ltri.rvil� trwA.0 G.�:y4R 6
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm.
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
❑
Other:
r �" •'6 i t t n �.� �. I rt�, �1 �..,�r Ti f � �t 4�s R i� 1t1ni �J�,�1S � 1 { t r7��! i.�
, ,�i.1,,t�ta: ig �a Yi i �t ��I lx� ,r� ,
Fee for each commercial $75.00
system
(SEE OAR 913 - 309 -0000)
Check Type of Work Involved:
❑ Audio ana Stereo Systems
❑ Boiler Controls
❑
Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrunaentadon
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor, Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems: b
*Ni, licenses are required. Licenses are required
for all other installations
is Ulltdidloi0Ponoli it FT,C-PnrontAryp .aoc 07rov10