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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2011 -00203 T 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2011 Parcel: 1 S126BC01506 Jurisdiction: Tigard Site address: 9020 SW WASHINGTON SQUARE RD 450 Project: River City Travel Subdivision: Lot: Project Description: Low voltage for HVAC Contractor: PROTEMP ASSOCIATES INC Owner: WISCO REAL ESTATE EQUITY FUND I 9788 SE 17TH AVE 1501 SW TAYLOR ST STE 100 PORTLAND, OR 97222 PORTLAND, OR 97205 PHONE: 503 - 233 -6911 PHONE FAX: 503 - 238 -9767 FEES Description Date Amount Specifics: Restricted Energy Permit 09/13/2011 $75.00 12% State Surcharge - Electrical 09/13/2011 $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 N Fire Alarm N HVAC: y 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 ATTENTIO■ - s• law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952 - 001 -0010 rough OAR 95 6 1 -00• • You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 Issued /At/ ■IL - -A . 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. CaII 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. Electrical Permit Applicatio�n RECEIVED FOR OFFICE USE ONLY • Cl of Tigard RECEIVED Received 'M�n t No , ' ..-.40, ' - `J g Date /By � � Permit f' 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review Phone. 503 639.4171 Fax 13 2011 Date /B Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready /By furls RI See Page 2 for Internet: www ttgard or.gov C�T'Y OF TIGARD Notified /Method Supplemental Su lementallnformati on y ° ;t y "r: t . °` �1 - �' " ry ' s„ , PL V , . 0 = F. TYI'E�� a NI�1V�k:r ;;,r � r ; AN. °- ;�, ,,;:, .,, - .,, _ � �, TS F�� >v� dry,_., .,,, .,..;�.ia.', ..� . - .��;dc, +," , .., ": /" bay ,�, r . , .. . ; "s ❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below)• ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards "'s exceeds 10,000 amps 150 volts or ❑ Floating buildings ...? :',, : ., " `CATEGORY OI CONSTRUCTIO 1,.: ': =%' & *`..a p g s g - '"• " "•' ,- "' `� less to ground, or exceeds 14,000 ❑ Commercial -use agricultuial ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ installation of 75 KVA or EA ION tCND3 4 " 4 ,:4444-- r, Emergency system larger separately derived system 111 .,, 7° JOB "'SIT INFORMA ,,, LOCATt > , Addition of new motor load of Job no.: 3150 Job site address: 9020 SW Washington Square Rd 1001-I or more occupancy. ❑ 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.: £1i50 Project name: River City Travel ❑ Service or feeder 600 amps or more 3:t% ,>C`,EE_SCME1JU,1.'E - /;1 .> .. Cross street/directions to job site: Description I Qty. 1 Fee. 1 Total I New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.. 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. fl. or portion 33 40 1 Tax map /parcel no.: Lunited energy, residential 75.00 2 l ,, DESCRIPT N1 IO W WORK; (with above sq. ft ) Limited energy, multi- family THERMOSTATS & Wire \ residential (with above sq ft ) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 II, ' ! PROP.ERT1' OWNER;; - a j _ A •TENANT ,.' 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240 60 2 Address: Over 1,000 amps or volts 454 65 2 City /State /ZiP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ;,®s'AP PL IC „ a' __, - ® C ©NTA ' �PTRsQN �r : above service or feeder fee, 6 65 2 each branch circuit Business name: PROTEMP ASSOCIATES B Fee for branch circuits Contact name: BRUCE BUTNER without service or feeder fee 46.85 2 first branch circuit Address: 9788 SE 17 AVE Each add'I branch circuit 6 65 2 Miscellaneous (service or feeder not included) City /State /ZIP: PORTLAND OR 97222 Each manufactured or modular 90 90 2 dwelling, service and /or feeder Phone: (503) 519 - 6199 Fax: : (503 - ) 238 - 9767 Reconnect only on y Recoly 66 85 2 E -mail: Pump or imgatlon circle 53.40 2 w - , j r ., ,, c'CONTRACTOR. {'' , Sign or outline lighting 53 40 2 Business name: SAME AS ABOVE Signal circuit(s) or limited - energy panel, alteration, or qr+C19 Address: extension Describe• 1 Page 2 1- ,7' 2 THERMOSTAT &WIRING City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62 50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr mm) 62.50 CCB Lic.: 38868 Electrical Lic. • 261036CR Suprv. Lic.: 2613LEB industnal plant per hour 73.75 `f' °' : id t TI 'AL RMIT FE ' = " Suprv. Electrician signature, required: C P .,.. ES` - p g 9 0� 4 g L Subtotal: 75-°° Plan review (25% of permit fee): — Print name: MONTY SCHROEDER /� e� Date: 9/12/11 State surcharge (12% of permit fee) y, Cho /3,2 Authorized signature: , . —P , „� k TOTAL PERMIT FEE: g� Print name: BRUCE BUTNER � Date: 9/12/11 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. * Number of inspections allowed per permit 1 \ Building \Permits \ELC- PermiApp doc 05/23/06 440- 4615T(11 /05 /COM/WEB