Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00187
TtGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
Parcel: 25101 DB00104
Jurisdiction: Tigard
Site address: 7300 SW HUNZIKER RD 200
Project: MD's Subdivision: Lot:
Project Description: Data telecommunications system.
Contractor: AF TECHNOLOGIES Owner: HILLTOP BUSINESS CENTER LLC
PO BOX 6551 HUNZIKER LLC
BEAVERTON, OR 97005 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 466 -2900 PHONE:
FAX: 503 - 466 -2922
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/05/2011 $75.00
12% State Surcharge - Electrical 08/05/2011 $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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By Permittee Signature:
—
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.
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Aug. 4. 2011 4:37PM�- ,
1 L .. ErlRoFFici: 2858: P. 3
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10 all Blvd Tigard, OR 97223 A U G 0 5 2 01 1 p a , R ! i Permit No.:
Phone; 503,718.2439 Fax: 503,598.1960 P1aa Rov;ew L � j— 7
i ci ,\ R T Inspection Line: 503.639.4175 Date/BY; Other Permit:
Internet www tigard -0r gov CITY OF TBGA R ii p t .ea y y
• I r itl11(' nigrlc ti• od;
EMI ®Seep �2 for
ri ✓ ` . :. , N s �s n apple: i titration
/II New construction M a, ^;" r a , k a`�^' : : .� r �,�� r �, r G a ow e : � r ,• ,
❑ A dition/alterat' on/replacement Please check apply , ,.,,;. k that a ,..:, a � j sets of ? ' c :: F „. cs„
pp ly (submit , "` ".
I)emo1i oI1 d Other ❑ Service or feeder 400 am s or more plans Building over three t below):
u : r a !' , , ? where the available fault current ❑ Building ova oat stories.
a.,.. a..: K t r ❑ Marinas and boatyards.
. "v l w :. •..,,,: ' r ,... r . r ' ! ai Zxceeds 10 000 amps at 150 vole or ❑ P atiag buildings.
1 / Commercial/industrial ❑ Accessory building toes to r 41 other exceeds 14 4 Commeteiat -use agricultural
❑ I- and 2- family dwelling
❑ Multi-family y
ID Master builder ❑ Other: awes for an other installations. CI in installation
er ❑fire pump.
.,.., e Emer C lnsraAetio of 75 KVA or
Job no.. „ 4„ Y larger separately derived system. •
I Z • J ob Site address. 50 (rf ❑Addition of new motor lead of ❑ "A" '�° ,.1 2•' 'y-3 „ ,
S u nz l' r ¢j tror:ormore o a 8 t il i c o n
* q 5 ""i c ❑ Six or :ore residential units. ❑ Supply io voltage vehicle petits,
f S 7 2 ' l Q Healthcare facilities. ❑ Supply voltage for:ore than
S Project '�, ❑Hazardou locations. 600 volts nominal.
Suite/bldg./apt no.:
• / % J Ct miller Of ‘• T1 A(i nC) ( h, ❑. , o . feeder 6 00 p
Cross Street/directions t0 am s or more
_lob site: ,
Daces , eon - ^ .
New residential single- or multi-family dwelling un i t. 7oa1
Subdivision: Includes a ttached garage.
Lot no.: 1,004 sq. R. Mims 168.54
Tax map /parcel no > a ada'1500 sq.
r portion 33.92
',muted energy, •
Tft. ) onti8l
r ., >, (with abov sc ft. 75,00 2
>
l •1 . Limited energy, multi - family — —
residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteratio n, and/or relocation
200
„ M.,,. 1 '' F , amps or less 100.70 2
r t 1 , , . 201 amp to 4 5
Name: � 133.56 2
2
�` 401 amps to 600 !nips. 200.34
Address 601 amps to 1,000 amps 301 2
Over 1,000 amps or volts 552.26
City /State/ZIP; Temporary services or feeders installation, alteration, and /or 2
Phone! ( ) �— relocation Fax: ( ) 200 amps or less 59.36
Owner instapation: This iASta(]ation is being made on pr 201 am to amps 1
intended for sale lease, r exchange, °per' flat I own Which is not 125 2
ent, or exchan a according to ORS 447, 449, 670, and 701 4 01 , E 400 amps 168.s4
Owner signature _Branch circuits l 2 • Date li ra - new a teraflon or extension
i a A. Pee for branch circuits with ,
a SBYV 0r feed fe e,
Business name: each branch crrcnit 7.42
2
13. Fee f or branch Circuits without
Contact name: service or feeder fee, first
branch circuit 56 18 2
Address: Each add'1 branch circu 7 42
1►recellaneoas (service or feeder not indaded) 2
City/State/ZIP:
Each manufactured or modular
dwellin servi andlor {cede 67.$4
Phone: ( ) 2
Fax:: ( ) Reconnect only
E-mail: — 2
-
a l Pump or im on cnc 2
' sari le 67.84
Si g» or outline ligh
' ” : :r Signal circuit(s) or limited-energy ' 2
Business name: �_� gy —
�h d S _ C Panel, alteration, or extension. Page 2 2
Address: T Each additional inseeetion over allowable in an of the above
4.23,01. Additional inspection (1 hr min) Mil 66.25! hr
(1 MEM
City /State/ZIP " dk v 014 p dr a O , 7 Investigation ( h r min)
4� 66.25/ hi
Phone: e03) e. /7 .' (� k Industrial plant (1 hr min) r 78.18/ hr
L__` 603) 4 . • - �' Inspections for which no fee is MIM
CCB Lie: t)(701 s • elficall listed 'h hr mm 9000 /hr
St[prv. Lic,: tI D ;, r
pp p Electrician Signature, required: , jr.
r i �" c ��"
Uu rV. �:.. :, ,... :,,. 1...,;�,..r^.�. Y s e �,, 1 ^ h,,.. F i ..- �,
Subtotal: ���
Print name: Plan review (25% of permit fee):
s , O on R Date: `a State surcharge (12% of permit fee):
Authorized Signature: TOTAL PERMIT FEE:
Print name .01 t " Thi permit application expires if a permit is hot obtained within 180
� � �� Date: d ays after it has been accepied as corn lete, . INMAI Number of irrs allowed P
:\BYildln 8 C- 1App \PenneealF7. Pecmi .doc 07/01/10
per
44 0 -46197(1 /osicomfwffi
Aug, 4. 2011 4:37PM No. 2858 P. 4
Electrical rermit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined , .. f $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other' -
Fee for etch commercial �._ ...
$75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Ir�seallado
❑ Fire Alarm Installation
❑ HVAc
❑ 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
] Tui ldi0E\Pefmiu\aLC- PermitApp.doc 07/01/10
"`''Aug. 4. 2011' 4: 37PM`''''' ,__I ur 1 i laarL No. 2858 P. 2 '_.
City of Tigard II
13125 SW Hall Blvd. = _
• Tigard, OR 97223 , r ..
Phone: 503 - 639 -4171
T VGA
FAX TRANSMITTAL
Date A 4t 4, 2011
Number of pages including cower keel _ 1
To: A Tcchnolo ies From: Brandep TaR
Co: Co: City of Tigard
Fax #: 503-466,22. Fax #: L0-598 -1960
Ph #: 503-J18-2449
SUBJECT: World Financial Permit 7300 SW Hunziker Suite 200
MESSAGE:
Ikllo,
•
I. just learned that your electrical license is expired. So, unfortunately I want be able to issue the World
Financial permit until your .license is activated. Regarding the tenant at this address, we currently have
recent permits at Suite 200 for the tenant MD's, Please con 6rm if the low voltage work will beat Suite
200 for MD's.
The reason I'm sending you this fax is because I can't seem to contact you when I call your phone
number, When I call (503) 466 -2900 there is an unusual scrambled digital sound. If you have any
questions, feel free to let me know. "
'T hanks, 0 •
-17 , “1
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•
•
Aug. 4. 2011 4:37PM No. 2858 P. 1
A I Technologies
503 - 466 - 2900 Office • 503 -466 -2922 Fax
PO Box 6551 • Beaverton, OR 97007
regina @aftinc.biz
www.aftinc.biz
Fax
To: City of Tigard FFO Regina Vandecoevering
Fax: Pages: 5 pages attached
Phone: Date: August 4, 2011
Re: cc:
❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
• Comments:
Attached you will find a copy of your fax that you sent to us. Thank you!!! We have been having a problem with
our voice mail, and it is still unresolved. We moved our office a couple months back & the license renewal was
sent to the old address. We made the payment online today, and attached is a copy of the receipt. We would
like to have the permit pulled as soon as possible, Attached is all of the paperwork completed again.
If you need something additional or have any questions, please call me at 503 -820 -1109.
Thank you!
" A u g . 4. 2 0 1 1 " 4 : 37 P■' "" .l id UL 1I1uss s'-' 1uip, :„ iiumbasaruirc.dcbs.oregon_0 o , 2 8 5 Sense P. 6prise/Payment...
OREGON
•
•
Department of Consumer and Business Services -
Building Codes Division
Licensing Home.Page Payment Receipt
Logout
Thank You!
Your payment has been successfully received.
• Please print and retain this page as your receipt.
• Your request will be processed in the order in which it was
received.
• To Speed processing of your request, please make sure to
complete any items that could not be completed online and
mail them to the division.
Licensee: AF TECHNOLOGIES INC
License Number: CLE10
Agency: OR DCBS
Process: Renew License
Authorization Code: 010996
Received Amount: $375.00
Received Date: 8/4/2011 4:28:45 PM
Transaction ID: EC176299
Credit Card Number: X)OO( )000( XXX)( )000(
Print Receipt
1 of 1
8/4/2011 4:29 PM