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Permit " CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' COMMUNITY DEVELOPMENT Permit #: ELR2011 -00003 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011 Parcel: 25101 DB00100 Jurisdiction: Tigard Site address: 7320 SW HUNZIKER RD 102 Project: Plaza Home Mortgage Subdivision: Lot: 0 Project Description: Data telecommunications system. Contractor: AF TECHNOLOGIES Owner: HILLTOP BUSINESS CENTER LLC & 1418 HEMLOCK ST. NW HUNZIKER LLC SALEM, OR 97304 9430 NW KAISER RD PORTLAND, OR 97231 PHONE: 503 - 362 -2364 PHONE: FAX: 503 - 362 -2382 FEES Description Date Amount Specifics: Restricted Energy Permit 01/05/2011 $75.00 12% State Surcharge - Electrical 01/05/2011 $9.00 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 Intercom/Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Total $84.00 Other Desc: Required Items and Reports (Conditions) 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 -0090. You ma ob . ii : co. • le rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By - Permittee Signature: 4 /11100 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 the next available inspection date. 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. JAN. 4. 2011 3:26PM 503 - 608 L. I NO. 0851 P. 1 Electrical Permit Application ((,,;; 1.0 R U 1. r i (I . I `t. (n1.1 City of Tigard Received A - Permit No.: r . , rhtre/By: Permit �4 j a„ t (- �a 13125 SW flail Blvd., Tigard, OR 97223 JAN 0 4 Review - Phone: 503.718.2439 Far 503.598.I960 Data/By: other Permit: R1,104 /0 - Vail V- 3 t ILO , - t; n Inspection Line: 503.639.4175 CITY OF TIG ` ' It Dam Ready/By: 7� kris: 13 Sm Page for �C1 Internet; www.tigard- or.gov • t _VISI • A ti6 Z7J. Supplemental information • '1 �4° , 4' - y r 4 1 .a ,, e.•� 7t4✓ti .0 n ra 7;�.' ya ev:! .•,•r 9,'"• ;•/,∎.'ieg.4 ✓ "i" .t P; .d '•,, b 3!L5 ';y;' j. ,d�', e . r .. ` 1 l,1}`�e!.,+1 i l ia (�y �;:�. k.,•1;r+(R�l' •, "t !'n'., P.�.,. ro H o o y' n :, fee!. , ilia ' ' -• �1 �r , . t . # r ; + y". `l 1, . '�- � At � � ,� ^ , J. • `' � � :i4 �i ie� - �I� �R � r 1. • � .Wqa` .�•P,., r r�'. i • l ��by: • : .• ��h 1+ f� .' 7r .' " ., 4 r � 4. ❑ New construction t Addition/aiteration/replacement Please check all that apply (submit 2 acts of plans w /items checked below): ❑ )l7emolition ❑Other• ❑ Service or lbeder 400 amps or more 0 Building over t stories. ,, _ ufiers dic amiable fault current 0 Marinas and boatyards. ni ' # „r 4 y i; exceed 10,000 . s . �t� , r� 1 ' , , �` ;w � y , ��F t 'S' Il� j� "y , i '� / , + ; . , s r ,:�,h ] ., , •i9 , � � 7,.y ° amps at 150voltaor ❑ Floatingbaildings, ' A' % «tst,:t 4 /. , ,�.,••:r ,� , ,4- '. -. , .:.s :.. ,:, ,r..:: -,ln„ 1 11', M;, I, : less to ground, or exceeds 14,000 © ultural ❑ 1 - and 2 welling j Com mercial/industrial Accessory building Ctm d ` Y ❑ rY g amps for all other installations. buildings. ❑ Multi - family 0 Master builder D Other: 0 Fins pip. El Installation of 75 KVA or •.. :'tt• , ! � n + nrm.�x��,rr� -- q cc tps mzb ., ;r , ; • v _, g • O Emergen system. late aeparatc derived system. `', * k,{ • °^ ' n . 15' °�' HFt 1 l i e � t . 1 1v ' 'tl Gr_C e ! e t y �c,,,,�; ± ''('' ❑ ,',...:;•4, c :;',447. .'. u r ,, .; , .., .. M , - ., A. '�S i'i;•9A,Alm , ,o.n'^. 1• t ❑ Add i t i on o f new motor load o r ° A ", ° E", ° 1,2 " " 1.3 " OD l 5W I N i7 u na 16C1 l O2 1001fP or more. oats Job no.: I I D Job sit addr ess: l ❑ Six or morn residential units. occupancy. cy. ❑ Recreational vehicle parks. City /State/ZIP: - to l/`"_ 1(,� yti•I O� q / 2- � � ❑ H� Ihcililie¢ ❑ Supply �ae for room than d� ❑ Hazardous eallhare locations. . 600 volts nvm Service or fccdcr 600 amps or more. Suite/bldgJapk no.: Project name:' q � Q �C)NAC � D� j � p _ ! -' - Q r ig ? i j '.•1 , "1" i ∎R l '�•,'., its` ' s a;,p•'.'i Cross street/directions to job site: ;s Description n . Si l� , 1 E a t ' i ce. I T o t a l "�S i'r e DIY- Pea Tact I New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'1500 sq. ft. or portion 33.92 1 Tax leap /parcel no.: Limited energy, residential 75.00 }' /way" ?�r :1J r �Y!R� [� I'.11 © R B u' 0 d � S. f:m •. ,Yi,;'.', � (with above 9i1. �) +, d 1, b ' ' '' ' Limited energy, multi- family I n5! 11 rt r 7"7{ Ca 7 14L _ _, residential (with above sq. ft.) 75.00 2 - Services or feeders installation, alteration, and/or relocation 200 amps or lees 100.70 2 C 471.31•14.. ra o Via.. ..,t•.,. .$, 1 ■ y J 1P.1 .� ;r'.••,,. ' m � •, 201 amps to 400 amps 133,56 2 .�, ;�i iC +, - . ,,.. . . " � � rkR r.. � ^'¢,rrT •��:� � v., a., ��w �,'..3 ••"k- � ',n a .r 1n q 401 amps to 600 amps 20034 2 Name: -- l a 2 0. p , YY 10 Cl t 601 amps to 1.000 amps 301.04 2 Address: 3 2D SW 4t, '7 I 1 If 02_ Over 1,000 tarps orvolts 552,26 2 City/State/ZIP: r Temporary services or feeders installation, alteration, and/or i D a I • 3 relocation ( 503 ( 77 7 ( ) 200 or less 59.36 1 Phone: Fax: _ amps Owner installation: This installation is being made 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 amps 168.54 2 Branch circuits - new, alteration, or extension, per pastel Owner signature: Date: yy a� A. Foe for branch circuits with x ;:,,,,:?.,70:11 1.� { v e w r� ► jiF' / °q sty + `� 1 •• µ 1P^ above service Or feeder fee, '( ! tin '. h { { '/a•° , r r �' k„' ; h '� ?f: " each branch ciiCtl 7.42 2 Business name: B. Fee rot branch circuits without service or feeder lbe, fast 5618 2 Contact name: branch circuit Each add'1 branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/ar feeder - Phone: ( ) Fax:: ( ) Reconnect only 67.84 2 Pump or orrigation circle 67.84 2 E -mail: or outline lighting ,, - ,. y p t '. .a , 1, + 4 v 'M, i w',•,,,, . , . . . y , n lighting 67.84 2 •l ",°v '', - i� a ro` ^ ,in `, p {�. , ty , ' : rl • , e1 Si ":,: j •lT4'ad ! F i '•'a,:9.!h C;t:lu.a i s4� " 4 "'.:i`.SA� : o I',rl , ", k �'t ;r? : Y..' a Sip1r 1 cirwit(s) or limited-energy • Business name: h C F� N CA--(.71 f panel alteration or extension I Page 2 2 Each additional inspection over allowable in any of the above Address: O "3 CO ) Additional inspection (1 hr min) 66,25/ hr City /State/ZIP: p . �- •'TQ N DC. q 7 op Investigation (1 ht mid) 6625/ hr i Indushial plant (1 hr min) 78.18/lir Phone:( 1.I-176 Z CrOD ( SC5 466-29 '7 Inspections for which no fee is 90,00/ hr 4 r�� spe cifical listed % hr min CCB L 1 10L4 I Elccrzical Lie.: e LE l 7 Suprv. Lic.: 3 ! ✓L IP 1 °b ,,r::% 4 t y , ti' 1, k y, • Suprv. Electrician signature, required: -- Subtotal: Plan review (25% of permit fee): Print name: Ma ( ,J 4l TrDate; l /../ /1 / Statc surcharge (12% ofpermit fee): 1 , Authorized signature: At( PERMIT FEE: ' //, This permit application expires if a permit is not obtained within 180 days after It has been accepted as complete, Print name: Date: • Number of inspections allowed per permit. • JAN. 4.2011 3:26PM 503- 608 -7198 NO. 0851 P. 2 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: . „ 'r'��Miiiitgg r a^ Fee for a ll residential systems combined.,...... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Pleating, Ventilation and Air Conditioning System,* ❑ Vacuum Systems* ❑ Other: i', to ..A : 9 e hh ;�� . Pc �Njy r�” ',? �;1�"'i5•�' ,n ' � Gti �l 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 El Fire Alarm Insrillation ❑ I-IVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* . ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations