Permit 71 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00124
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2011
Parcel: 25101 AD03100
Jurisdiction: Tigard
Site address: 6950 SW HAMPTON ST 160
Project: PCC Hampton Square Subdivision: WEST PORTLAND HEIGHTS Lot: PTS 1 -8
Project Description: Low voltage for voice /data cabling.
r
Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: WESTON INVESTMENT CO
1709 SE 3RD AVE 2154 NE BROADWAY
PORTLAND, OR 97124 PORTLAND, OR 97232
PHONE: 503 - 234 -9900 PHONE:
FAX: 503 - 234 -1001
FEES
Description Date Amount
•
Specifics: Restricted Energy Permit 06/07/2011 $75.00
12% State Surcharge - Electrical 06/07/2011 $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. ATTENTI ^k egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 through OA' 952-.: 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 59,'i232.1987 or 1.800.332 2344.
Issue By: � � Permittee Signatu
t ls�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' c �1 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.
( 1 z- L-4 SQ /too
Electrical Permit Application FoR OFF USE ONLY •
P { �, Of Tigard fl E ly Received � �� /
II 't 13125 SW Hall Blvd., Tigard, OR 9 281 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 p Date /B Other Permit:
:it GARD Inspection Line: 503.639.4175 JUN 1 2011 Date Ready /By: ® H See Page 2 for
_ . Internet: www.tigard or.gov Notified /Method, Supplemental Information
t 1 Z I I U I IVI l Please cheek ail that apply (submit 2 sets ked of plans wfitems chec below): W.
_
❑ New construction ® Addition /'•tf�il�t4�i
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Manias and boatya,ds.
`:' . '':.: C ATEGORY . OF` CONSTRUCTION ). • •' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all outer installations, buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' -- � - - Emergency system. larger separately derived system.
JOB SITE 'INFORMATION AND LOCATION 0 Additton of new motor lad of ❑ "A" "C" "1 -2" "i -3 ',
tooHP or more. occupancy.
Job no.: 570I3 -110 ( Job site address: 6950 SW Hampton St _ —
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: STE 160 Project name: FCC Hampton Square ❑ Service or feeder 600 amps or more.
.. ' SCHEDULE .' .
Cross street /directions to job site: Description I Qty. ( Fee. I - rotas j
j ), 6 i ° New residential single- or multi - family dwelling unit.
l0 includes attached garage.
Subdivision: . - r Lot no.: 1,000 sq. ft. or less 168,54 4
i ( Ea, add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: . — 5 Limited energy, residential
_._._ .............
nergy, res
Lit id 67.84 2
DESGitIPTION OF WORIti ; (with above sq. tt.)
Limited energy, multi- family
Voice /Data Cabling residential (with above sq. ft.) 67 84 7
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2 • •
' : ❑ 'PROPERTY OWNER :. •• - • . ❑ TENANT ' . . . 201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 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
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
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 panel
Owner signature: Date:
A. Fee for branch circuits with • .: :.❑ APPLICANT ...® CONTACT -PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: e: �_ `c) L.v._ B. Fee for branch circuits
without service or feeder fee,
Contact name: � `! 6 \ cite- c -,- C' --3 first branch circuit 56.18 2
Address: x i Each add') branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E - mail: V - , - ,tp r 4---f t�}Q, ®re SovN - e v e .. n C'+n -.,_ Pump or irrigation circle 67.84 2 • . t'ONTRACTO . Sign or outline lighting 67.84 2
Signal circuit(s) or limited- 7
Business name: Oregon Electric Construction, Inc _ energy panel, alteration, or
Address: 1709 SE 3rd Ave extension. Describe: 1 Page 2 f 2
Data Teleconun
City /State /ZIP: Portland, OR 97214 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 234 - 9900 Fax (503) 234 4001 Investigation per hour (1 hr min) 66 25
CCB Lie.: 203 tr ical Licf 26 -95 uprv. Lie..1'4818, " -* Industrial plant per hour 78.18 1 co
' ' r E LECT RI C AL P FEE • ` Subtotal:
Plan review (25 %ofpetmit fee):
Print name: Mark Weft + r - d Date: tbl /11 CO
� � � t � 1 � State surcharge (12% of permit fee): ,�!I" -1^
Authorized signature i 7 f ' mg,' T TOTAL PERMIT FEE: 'r---
This permit application expires if a permit is not obtained within 180
Print name: Mark Weiri•ender Date: 6/1/11 days after it has been accepted as complete. n ��
* Number of inspections allowed per permit. X
I: \Builuina \Penults \ELC- Per,usApp.doc 10/01/0g 4.10 -461 MI 1!05 /COM/WI /I; UUU
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WO1tl( :ONLT':
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Vacuum Systems*
Li Other:
COii�I VrERCIAZ YORK ON. Y:
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
• Boiler Controls
E Clock Systems
r D ata Telecommunication Installation
❑ F ire Alarm Installation
❑ HVAC
— 1 Instrumentation
• Intercom and Paging Systems
L ! Landscape Irrigation Control*
Medical
Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
• for all other installations
l;\[3uildiagPermitssEL.C. P. mitApp.doc 10/01/09