Permit --- CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2009 -00091
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2009
Parcel: 2S 102 DA00401
Jurisdiction: Tigard
Site address: 13125",SW HALL-BLVD PERMITS
Subdivision: Lot: 0
Project: City of Tigard- Permit Center
Project Description: Install data cabling. Job No, 73454
Owner: FEES
TIGARD, CITY OF Description Date Amount
13125 SW HALL BLVD Restricted Energy Permit 03/19/2009 $75.00
TIGARD, OR 97223 12% State Surcharge - Restricted Energy 03/19/2009 $9.00
PHONE:
Contractor:
E C COMPANY
PO BOX 10286
PORTLAND, OR 97296
PHONE: 503 - 224 -3511
FAX: 503 - 295 -3512
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
•
Audio & Stereo: Boiler Controls:
CCTV: Clock Systems:
Data & Telecommunications: Y Fire Alarm:
HVAC: Instrumentation: Total $84.00
Intercom /Paging: Landscape /Irrigation: -
Landscape Lighting: Medical: Required Items and Reports (Conditions)
Nurse Calls: Protective Signal:
Security Alarm: Other:
Other Desc:
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 thr•, gh 0' ' •52 -001 % 00. •u may obtain a copy of the rules or direct questions to OUNC by calling 503. • - 6699 or 1.800.332.2344.
Issued By: 00.
Permittee Signature: �j■1. ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.. . —..Nar.18. 2009 1:41PM RECEIVED \o.4265 P. 1
, Electrical Permit Application
1 009 i ,„ ed
,. ',. City of Tigard 1;9 Permit No.:
- ei_49,0E-X07/
" 13125 SW Hall Blvd ' ' • ' Ti MAR 8 2
gard OR 0722trry F TIGARD tie —
II --' p 1r /19
Phone; 503.639.4171 Fax 503 598 1 O Date/By: Other Perini':
T A R
- InSPectilM OM 503,639.4175 BUILDING DIVISION. Date Ready/By:
bids B See Page 2 fur ---
I u
Internet: www.tigard-orgov Nuritied/Method: .1 ...- Supplemental I nrOrmation
::'.,: .',:..:'::,.,„; -,.' •! 111 1T 't ' ..::Pi :' ':,;',..:',; :.!:::::::::.;
0 Ncw Construction 0 Addition/alteralion/replacement Ple.1$e ,heci.. ail that apply (56,„,,45.. of plans w/itcms checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
D Demol Won 0 Other: where the available fault current 0 Marinas and boatyards. ■
adibelti.,..p .: 4 7 .0 (42,..,1,,: !!!1: ;...: ;;-'1: '. exceeds 10,000 amps at 150 volts or 0 Floating buildings .
less to ground, or exceeds 14,000 0 Commercial aitriculttaal
0 1 - and 2 dwelling [I Commercial/industrial D Accessory building amps for all other installations. buildings.
111 Multi-family El Master builder 0 Other: 0 Fire pump. 0 Installation of 75 K VA or
larger separately derived system. i
' 7 1 q# ; ,M;T:; E i:;p i T e pw. v yg9,$.;A19).„ ; : i WC1ON . : . " j ' . : ,,,.• : . ':': , '. f .' , ::P"?‘ ,, ...:Y‘. • ':'' ,.: ' 0 Addition of new motax load of 0 "A", - 2" : , "1.3"
Job no.: 73454 Job site address: 13125 SW Hall Blvd 1001 Of More. occupancy.
0 Six or more residential units. 0 kevrtalitrad vehicle parks. 1
City/State/ZIP: Tigard, OR 97223 0 Health facilities 0 Supply voltage for more than
. 0 Harardous locations. 600 volts nominal
Suite/bldg./apt. no.: p (4_3 Project name: Permit Center / r IEHIBI= 0 Service or feeder 600 amps or more.
..i?Et
Cross street/directions to job site: Description I 0 1 FeL I refill 1 • i
. — New residential single- or multi-family dwelling unit. 1
Includes attached garage.
' ----
Subdivision: Lot no.: 1,000 sq. ft. or less
145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1 I
fax map/parcel no.:
. , , . . Limited energy, residential 2 , 1
cM 11?1 ;' ..‘ ': 14 M 1 ; ,' :i : $11:lbS 1 S 1 c 1 tEPT,IONil*:;' WORK . . 1 i. 1 ::13:$;' ) ,g)::: ] V,:l..;.:::F::. 1 ,.' , :i . i , •....::: , ;,; _ vith ahovcaftj________ 75-00
Limited energy, multi-family
Install Voice & Data Cabling 75.00 2 i
residential (with abovcsalt) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 1
1
::• , .o . **iv;,:•::.. :,,.:::,:,..:;;:....{..,,y,,,f,::;,,itroiii„11;e,,,i,5!,..,;.:,::;„.:::,,,..::%„, 201 v amps to 400 amps 106.85 2
— _
Name: City of Tigard 401 amps to 600 amps 160.60 2
. 601 amps to 1,000 amps 240.60 2
Address: 13125 SW Hall Blvd . Over 1,000 amps or volts 454.65 I I 2
City/State/ZIP: Tigard, OR 97223 Temperazy services or feeders installation, alteration, and/or
.— . relocation
. _
Phone: (503)372-7459 Fax: ( ) 200 amps or less 66.85 1 I
_ ,
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 1
*'1*isK;' :.'';' f7VeoktattiiikSijil,.'M,? above service or feeder fee,
6.65 2
each branch circuit
Business name: EC Company ____, R. Pee Air branch circuits -.
without service or feeder fee,
Contact name: Gary Cawley 46.85 2 .
first branch circuit i
Address: 2121 NW Thurman st Each add'l branch circuit 6.65 2
—,--. Miscellaneous (service or feeder not Included)
— 1
City/Stale/ZIP: Portland, OR 97210 Each manufactured or modular
dwelling,
90.90 2
service and/or feeder
Phone: (503) 220-5319 Fax: : (503) 224-3480 Reconnect only 66.85 2 .'
E-mail: gitraye!v-e-ve.Gem ';1<c?,t‘r a -C.-r-0,..t,S.Cnira.r_r_ Pump or irrigation circle 53.40 2
-.,
:j% .:.,:•'.:;•:.'„, (x1Nrit*,*.:,70"1:;:;:':',y :::.7,: Sign or outline lighting 53A0 2
Si circuit( or limited
Business name: EC Company
energy panel, alteration, or
— 1PIP:05
Address: PO Box 10286 extension, Describe: le Page 2 2 .1
Data Telecom
City/State/ZIP: Portland, OR 97296 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 224-3511 Fax: (503) 295-3512 —
Investigation per hour (11w min) 62.50
GCB Lie.: 49737 1 i,. to Electrical Lie.: g4. _'" Suprv. Lie,: 3 ..)_ gs Industrial plant per hour -
1,gelltiCAVtit.SIM FOES
Suprv. Electrician signature, required: "- Subtotal. _ i.. i .1 -7,„
— —
Plan review (25% of permit fee):
Print name: Sl. 6 Date: ,R , ig-, 4 ,,,
State surcharge (12% of permit fee): 1.810tr"' . f-1 _
Authorized signature' la. .
'DOTAL PERMIT PFE:
-.-_.
Print name: Andrea Stinger Date: 3/18/2009
This permit appliostion lespirftt it n permit mit obtained within 180"
days after it hil s }teen accepted vs compiete.
• Number of inspections allowed per p
Wirt5Rina1PrrrnitcVPI C-PArmitAnn elnr 5k77151,■ AAA,AlcrrIlmvrnummn
'•Mar.18. 2009 1:44PM 1\o.4265 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage boor Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial $75.00
system
(Sll�: OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Ste:rco Systems
❑ Boiler Controls
❑ Clock Systems
S Data Telecommunication Installation
❑ Fire Alarm Installation
❑ IIVAC
❑ Instrumentation
Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other.
Total number of commercial systems: 2
*No licenses are requited. Licenses are required
for all other installations