Permit ,, CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00241
TIGAR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 185
Project: Cricket Communications Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: Low voltage for HVAC
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES LP
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 233 -6911 PHONE:
FAX: 503 - 238 -9767
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/30/2011 $75.00
12% State Surcharge - Electrical 11/30/2011 $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■ . • -.:. law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 t ou • h OAR 95 101-1!• I. ou • ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /� � .
� llst! � _ f Permittee Signature: _ � �... _ d
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.
Electrical Permit ApplicationECDED FOR OFFICE USE ONLY
City of Tigard Received If 2
Date/B : II 67° IIIIMMI Permit No.: fa,
1114 *I 13125 SW Hall Blvd., Tigard, OR 9722
' . r' • • ' V 0 2011 Plan Review Phone: 503.718.2439 Fax: 503.598.19.■
i I 3
Date/B : Other Permit ilee oft- 5 .-- A,
Inspection Line: 503.639.4175 .. ' Date Ready/By: lulls: Ed See Page 2 for
TIGARD
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
• i
\''IWiLiikl6p,,,,,',51i,QIN,GZIVISICia: '''':::VZ'V;*4. .''. -. 'IPZ:':":11:nNerk•Pir4lOcifW.:06,:;:iv-,, .,.;:t'"„"1,.!, •
0 New construction Addition/alteration/replacement
Please check alt that apply (submit 2 sets of plans w/items checked below):
Z
PService or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
t Y , 717 , k7:7.1A : IPIAw , 5 ,- air G exceeds 10,000 amps at 150 volts or 0 Floating buildings.
' less to ground, or exceeds 14.000 0 Commercial-use agricultural
El 1- and 2-fatinly dwelling Z Commercial/industrial El Accessory building amps for all other installations. buildings.
El Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
0 Emergency system, larger separately derived system.
A4 tcrail+4':''f'N"liiirjEA".‘ =
: 1-;- : , ;q;',,, „,„,j iT ,,, , ,,, ,4,.. . ,. .., ' ,. x
.,,.6 , .- - A :,••;.;mtlEV S Aifil. 0 Addition of new motor load of 0 "A". "E". "1-2", "1-3",
Job no.: 3216 Job site address: 7007 SW Cardinal Ln 100HP or more. occupancy.
ID Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard OR 97224 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg/apt. no.: /85 Project name: Cricket Communication 0 Service or feeder 600 amps or more.
71410;-,,,OEr4PLT.17,rtiati,4,;'':..:'''''
Cross street/directions to job site: Description I Qtv. 1 Fee. I Total 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. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
75.00 /
11S , ' i -f1.7'.4itg*(0,j1j7711:catoz* Ass.,,,*:-:- (with above sq. ft.)
Limited energy, multi-family
75.00 2
Relocate thermostat & wire residential (with above sq. ft.)
' Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
77X:ilittt * ' - !-- ,.!, I-P1Minriri:j 17 , 201 amps to 400 amps 133.56 2
401 amps 10 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address:. Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps 10 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
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
Apv.220,.:**T08N1 immt73,4'.:k.E11.-cOls,d8071rascfliktf::,,.:';: above rsaenrcvhiceciorcrufieet feeder fee' 7.42 2
'Business name: Protemp Associates B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: Bruce Butner branch circuit
Each add'l branch circuit 7.42 2
Address: 9788 SE 17 Ave Miscellaneous ,(service or feeder not included)
Each manufactured or modular
City/State/ZIP: Portland Oregon 97222 67.8 2
dwelling, service and/or feeder
Phone: (503) 519 Fax: : (503 238 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E bruce@protmp.com
Sign or outline lighting 67.84 2
Signal circuit(s) or limited-energy 75e
Business name: Same as above panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr mm) 66.25/ hr •
City/State/ZIP: .
Industrial plant (1 hr min) 78.18/hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
90.00/ hr
specifically listed (1/4 hr min)
CCB Lie.: 38868 Electrical Lie.: 26 Suprv. Lie.: 2613leb :ItVii,f.,,s
Subtotal:
Suprv. Electrician signature, required: rn ....
Print name: Monty Schroeder Date: 11/3011 Plan review (25% of permit fee): ...■---
State surcharge (12% of permit fee): C./ .a6
TOTAL PERMIT FEE: gt-i,
Authorized signature: .?5...zZ This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: Bruce Butner Date: 11/30/11 * Number of inspections allowed per pennit.
1: \ Building \Pennits\ ELC-PermitApp.doe 07/01/10 440 I 1/05/COM/WEB