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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ii `' 7 * , . COMMUNITY DEVELOPMENT Permit #: ELR2011 -00100 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/05/2011 Parcel: 2S112DD00200 Jurisdiction: Tigard Site address: 15862 SW 72ND AVE 150 Project: Immunology Subdivision: PACIFIC CORPORATE CENTER Lot: 0 Project Description: Low voltage for (2) systems including: voice, data, security, access control, and video. Contractor: SUPERIOR CONTRACTORS INC Owner: PACIFIC REALTY ASSOCIATES PO BOX 72 15350 SW SEQUOIA PKWY #300 MCMINNVILLE, OR 97128 PORTLAND, OR 97224 PHONE: 503 - 435 -0782 PHONE: 503 - 624 -6300 FAX: 503 - 472 -2473 FEES Description Date Amount Specifics: Restricted Energy Permit 05/05/2011 $150.00 12% State Surcharge - Electrical 05/05/2011 $18.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 2 Audio & Stereo: N Boiler Controls: N CCTV: Y 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: Y Other: Y Total $168.00 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 m- - • «.• - the ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. q. Issued By: _ _ -i Permittee Signature: : � 1-� — __LA. _I 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. May. 4. 2011 1:39PM Superior No.0307 P. 1 Electrical Permit Application RECEIVED iJ eceid City of Tigard - Pernik .p�a. yt / �.d i[J 11 s r I h � 1:3125 SW Hall Hivd., Tigard, OR 97223 MAY 4 2011 tita, ae ve S "' r/ �� rmit view III lA ' Phone: 503.718.2439 Fax: 5(1:3.59,1960 hat&Jny: Other v ll ---,( SS` I I t :.„,1, r, Inspection Lune: 503.639.4175 CITY OF TIGARD Date Rcad Turk. � 0 Scc p age 2 for Jntcrnct: www.tigard - or.gov a I ,1 Notified/Method: . T"- - et Supplemental Information u mmN 1 dj� +idly I Il iI� iiII'VI �V�Iiili I I II I;I' jl � Il il l i il l i i li ,I FII i . Print manic: ] iii ,1 . i il i u. 1 � I J�liJ!JJ f , J • New construction :A Addition/alteration /replacement El Ucmol itiotn El Other: ' ;I I I VI} `'i F . PLAN REVIEW " 1 p � tl .I Irte we 0.,.,.:k 0 thd apply ( subm 2 sets of plans it w/items checked below) ifw, I I !il ���1' �ill� ''foa l i �i, rtF OkY OF (4$111111 1 11 � � ������ ' ,� 1 111 , :q �. + ❑Sernce or feeder 41)11 amp or more 11 Building over three 1 - and 2 family dwelling idai Commercial /industrial Accessory building where the available fault cutlollt stories. ❑ Multi - fain I �I�� El builder El Other: exceeds 10,000 amps at 150 volts or ❑ Marinas and boatyards. /ik l l� h Irr �, :r y 1: II V ,u y o l oi'I i llglu ti 1 , Il i : IevxIn yrnund,urexceed :514,1100 ❑ Floating buildings l�l,� k ! I �'o'9�I� hl .1 ,I iNFOIR 4. ', A,+ I u , Ili ,ul . h�iul`i�(.,, r amps f or all other installations. ❑ B . 1 / a t� Lnmmcrcial -use Job no.: inn Siff address; !J Fl ' 24R AID aim pump. agricultural ❑EI erge,cy system. buildings. City /Stair /ZIP: ,c, gr . ,..9 N D, 0 /1 9. `^2j c ❑Addl[I ,, Ilf Flew motor load or ❑ Ti itallatinn of 75 KVA Suite /bldg. /apt.no,; Prujeetname: /►71 / 0 + /k 100I1P ormore. nr �� �i/j c \/ �' �,�1/ f � ❑ larger separately derived system. / r Six or more residential units. Cross street /directions to job site: ❑ Hcal[h -cart facilities. occulr,,ucy. ❑ Ha2ar dons locations. I1 1• •I Itecreiiltnnist vehicle ❑ Service ur feeder 600 parks. Subdivision: I Lot no.: ionp5 yr more ❑ Supply voltage for . Tax map /parcel no.; more than l i } i'3p "" 110.4!':'"... 6110 volts cuminal. d � ull. i t ilia , Fit l ill l� I I- I i'�I lu, , ,Z OW 1/ LE - Vt... /''�� E, � 1 ���i 'III 1i 11 � l l 21 .1:4 � Tr7 � i rt, I y. 4 eti Description lip Qry Fee. Total New residential single or multi family dwelling unit. 0 ti ' a ' ♦ Includes attached garage. 1 Il l > ' FRO 7t t � �,, Avila ¢ 1 11 l " {��lh l l< I I� G ' p I " — b0 ,,„ . , di .:V C 1 1 I'I : NA N "L" 1 ,000 sq. ft, or legs 165 54 4. Ntnne: M iw (live 4E4 y NS w 4THKT,s L A Q� d4 Q y La. tldl'15oo sit. ft. or portion 33.92 1 d energy. residential 75.00 1 Address: R (with above sq. ft.) '� � � � / � Limited energy, multi- family City /Stale /ZIP: PoR'n „9„ ©i ' 97,22 U residential (with above sq. ft.) 75.00 2 T Services or feeders installation, alteration, and /or relocation Phone: ( ) I Fax: ( ) 200 amps or less 100.70 2 Owner installation: This installation is being made on property that I own whii:Jt is not 201 amps la 400 amps 133.56 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 200.34 _ 2 Owner signature: Uatti: 601 amps to 1,000 amps 301.04 2 iy�l h Ld1II' �� p ° m a III i t II ' 11111 p � � h Over 1,000 amps Or volts 552.26 2 ��l i'llnu i I� ?�iii�kdulll ,11111,1i,:11 �!'I Illu �ll� Ill i�1 �� II 1, II Id I �IiIdhI'!' L, C a .ti� i1 7 � u 1 1 6 I l em poraty services or f eeders i nstallat i on, alte and/or Iusiness name : - c 4.40 y Co ALS v‘ A t 4 a - reoeation ^ 200 amps or loss 59.36 1 Contact name: jah ice'sL . 201 alnips to 400 amps 125.08 2 Address: I 401 turps lu 549 amps 168.54 2 ' S �. ?, �v1a H �-J / Rranch circuits - new, alteration, or extension, per panel City /State /ill'; p r � J � A. Fee for branch circuits let /h ��� !S trlxrvc sc,viCe or feeder fee, Phone: ( 5 o 3 ) 5 ..., ERG 7 [ l a x : : i(501) 5 / is f each branch circuit 7 2 E B Pee for branch circuits without E service or feeder lee, first i p�� i y '„ y;: it �' 56.18 2 ;i1�ul li g� 11Ili11��i V�I)11II11 u , CONTRACTOR l� �� l 4i ; 11111I0I�Ubi ' branch i � � .a. u i it b � , I. , Business name: l7 ,r� Each atld'I bruu:h circuit 7.42 2 Vf el �t /� l 'p /111 re Remits. ;�J1i Miscellaneous (service or feeder not included) Address: 7 pp Each manutacttncd nr nmdplar 6,7,54 2 - r � �x ,2.2 ���) . 7_ l L3, G' � f/ I� p. drvcllil� service and/or feeder City /State /Z.IP; M � v �� • 0 o ki 1 2 /.2. e Reconnect only 67.PA 2 - ' i V w Pump or irrigation circle 67.84 2 Phone: (5 3) t/33 - 07: a Fax (�,rc,3) /i 2 - Sign or outline lighting _ 67.84 2 CCBLie.: 3 a ElectricalLic.' Suprv, Signal circuil(s) orlimited-energy � i r ry _ r panel, alteration, or extension. Page 2 , 2 Suprv, Electrician signature, required: _ 0 .4.......< r Each additional in pection over allowahlc in any of the above ■ .6,---del- Additional inspection (1 hr min) 60.25/ hr Print name: 0t9 v' .L/ ,Q , VD R$0 ,,,/ I )ate: ... 57,/771 - 7/ Investigation (1 hr min) 66.25 / In Industrial plant (1 hr min) 78.18/ hr Authorized signature: It1SpCG1W215 for which nV fee is 90.00/ hr specifically listed Ch hi mill) I.\ Buildui ;U'urnutslELC- PernutApp.doc 07/01/10 440- 4nlvl'(I1 /05 /('.1)M/W Ma 4. 2011 1:39PM Superior No.0307 P. 3 ,1 '��i� i i i i II[111 i;lii l+ ii1I ..I4 Y_ cAL PERNEil11 ftwe 177 Subtotal d 00 Plan review (25% of pcnnit fee): State surcharge (12% of permit fee); / 5 0, 0 O TOTAL PERMIT PEE: >t g 00 Ilia permit application espirea it a permit is not obtained within 18o don alter• it ha■ lieea accepted as complete. • Number of inspections allowed per permit Hililtling\Perrnita 07/01/10 May. 4. 2011 1:39PM SuPerIor No.0307 P. 2 Electrical Permit Application - City of Tigard Page 2 - Supplemental information )4 Data Telecommunication Installation ❑ Fire Alarm Installation LIMITED ENERGY PERMIT FEES: ❑ 1 -IVAC I � I�il� 141' ,� I � , I i�,ioiii� 1,I��l „ll E 1' �i at WORK ���1 I II��wI���I�Gi�l�l�� l r r„ ❑ Instrumentation Fee fur all residential systems combined,., $75.00 ❑ Intercom and Paging Systems • Check Type of Work involved: ❑ Landscape Irrigation Control* El Audio and Stereo Systems* ❑ Medical ❑ Burglar Alarm El Nurse Calls [2 Garage Door Opener* l l Outdoor Landscape Lighting* ❑ Heating, Ventilation and Air Conditioning System* Protective Signaling_ , ❑ Vacuum Systems* Other G e 1 ' teeSSLINIR ❑ Other: Total number of commercial systems: °tOlVIMERCIA L V iK0SitY: *Nu licenses ace other are required. lu Licenses arc rcquire4 for Fcc for each commercial system $75.00 (SEE OAR 918- 309 -0000) Check Type of Work involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems l \H4,iodin vi (\I.i.C-PwiailAyp. iv 07 ov