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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2012 -00001 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2012 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 333 Project: Anchor QEA Subdivision: 1996 -048 PARTITION PLAT Lot: 2 Project Description: Data telecommunications system. Contractor: TECHNOCOM INC Owner: PACIFIC REALTY ASSOCIATES 7929 SW BURNS WAY STE. F ATTN: N PIVEN WILSONVILLE, OR 97070 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 682 -4195 PHONE: FAX: 503 -682 -2781 FEES Description Date Amount Specifics: Restricted Energy Permit 01/04/2012 $75.00 12% State Surcharge - Electrical 01/04/2012 $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 ' $84.00 Other Desc: Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a c.'V11 rules or . • -ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: _ Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. i Electrical Iermit A,pplicatia E IVED FOR OFFICE USE ONLY Cit r of Tigard Receiver Permit N o.: J AN 0 3 2012 Dat /By: r _ r F al„.0 ) ie— ercxxXx, N. - n [312 SW Hall Blvd., Tig OR 9722 Plan Rcvi • _ Phone: 503.718.2439 Fax: 503.598.1 p Other Permit; TiGARD inspection Line: 503.639.4175 Idly O TiGARD Date Ready/By; Ark; Er Sec Page for Interret: www.tigard- or.gov BUILDING DIVISION . Noti °d: Supplemental information TYPE OF'WORK PLAN RIWI$W Please check I all that apply (submit 2 sets of plans w /itms checked below) III New constructi ® Addition /alteration /replacement tlr 0 Service feeder 400 amps or more ❑ Building over three stories. 0 Demolition ❑ Other: where the available ra„tl c„Mant © M a r nsc I n t l bontyardc, CATEGORY OF CONSTRUCTION exceeds i 0,000 amps at 150 volts or ❑ Floating building& loss to grbtmd, or exceeds 14.000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ® Commerciai /industrial ❑ Accessory building amps rot other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑Fire puml 0 installation of 75 KVA or JOB SITE INFORMATION AND LOCATION © Emergcnby system. larger separately derived system. ❑ Additionl °f new motor load of 0 "A" ^E" "1-2", "1 -3" Job no.: 124001 Job site address: 6650 SW REDWOOD LANE 10011P a morn. occupancy. Cl Sis or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: PORTLAND, OR 97224 ❑ Hcalth - care facilities. ❑ Supply voltage for more than 0 14n,nrdni`c lnectinnc 600 volts nominal. Suite /bldg. /apt. no.: 333 1 Project name: ANCHOR QEA ❑ Service dr feeder 600 amps or more FEE scken Cross street /directions to job site: nnserlpt;on I i Qty. I Fcc. I Total _ .I New residential single- or multi- family dwelling unit. Includes n`ttached garage. Subdivision: Lot no.: 1,000 sq. ft or less __ 168.54 4 Ea. add' 15 0 sq. ft. or portion 33.92 1 Tax map /parcel no Limited energy, residential DESCRIPTION OF WORK ..: (with abbvc sq ft.) 75.00 2 Limited energy, multi - family VOICE /DATA CABLING residentibi (with above sq. ft.) 75.00 2 Services of feeders installation, alteration, and /or relocation 200 an 1132, ul lass 100.70 2 [] PROPERTY OWNER • ❑ TENANT 201 amps td 400 amps 133.56 2 _, 401 snips id 600 amps 200,34 2 Name: 601 amps td 1,000 amps 301,04 2 Address: Over 1,000Iamps or volts 552.26 - 2 City /State /ZIP: Temporary services or feeders Instailatlon. alteration, and /or relocation) Phone: ( ) F ax: ( ) 200 amps 0' less 59,36 1 201 amps td 400 amps 125.08 2- Owner installsttiv t This Instailatlon is being made on property that I own which is not 401 amps td 599 amps 168.54 2 intended for sale, base. rent, or exchange, according to ORS 447. 449. 670, and 701. Branch circuits new, alteration, or extension, per panel Owner signature :j Date: A. Fee for branch circuits lri/h ®' A PLiCANT ' . . • f CONTACII' I'L;ILSON above seiice or feeder fec, - " each brad ch circuit 7,42 2 Business name: A CHO.R QEA 13. Fcc for blanch circuits without - service o' feeder lbe, first 56.18 2 Contact name: LE LIE PARSONS branch circuit Each add'l 0ranch circuit 7,42 2 Address: 6650 SW REDWOOD LANE. SUITE 333 Miscellaneous (service or feeder not - included) City /State/ZIP: PO TLAND, OR 97224 Ea manufbetured or modular 67,84 2 dwelling advise and /or feeder - Phone: (503) 6S2 -4195 Fax:: (503 -) 682-2751 Reconnect dnly G7 R4 2 Pump or irrigation circle 67,84 2 E mail: I.parsonstgotechnocom.corrt S ign or nut1M lighting 67.84 R 2 CONTRACTOR Signal cireuf or limited energy Business name: TECHNOCOM, INC panel, alteration, or extension, 1 Page 2 75 2 Each additional inspection over allowable in any of the abov Address; 7929 SW BURNS WAY, STF. F Addition :11 ilicprrtinn (r hr min) 66.25/ hr Investigation (1 hr min) 66,25/ hr City /State /ZIP: WI,SONVILLE, OR 97070 _ industrial pt{tnt (I hr min) 78,1$/ hr Phone: (503) 682 5 fax; (503) 082 -2781 inspections for which no fee Is 90.00 / hr specifically listed (' /e hr min) GCB Lie` 7 Electrical Lie.: 34 - 269 - 1 Suprv. Lic.: 22811 LEA ELECTRICAL PERMIT FEES t l r , y S 75 Suprv. Electrician sign , aired: I U / /� / Plan review (25% of permit fee): Print name: JEFF c ANI,ONER Date: 01/03/12 State surcharge (12% of permit fee): 9 TOTAL PERMIT FEE: 84 Authorized signature: r bfs Dcrmit application expires if fl permit is not obtained within 180 Print name.: JEFF SANDNER Date: 01/03/12 days after it has been accepted as complete. Numbcr o tnspecuons allowed per permit, l;tanildina \PcrmitelF,l,C -Perml App,dnc 07/6070 44t1 4515T(II /nSICOM/wea Electrical II ermit Application - City of Tigard Page 2 - SupOlemcntal Information LIMITED ENERGY PERMIT FEES: • RESIDENTIAL WORK .ONLY: Fee for all residential systems combined $75.00 Check Type of Work involved: ❑ Audio and Stereo Systems* E. Burglar Alarm ❑ Garage i]oor Opener* ❑ I-Ieating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* • n Other: COMMERCI WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 9 =8- 309 -0000) Check Type of Work Involved: ❑ Audio a d Stereo Systems ❑ Boiler C ntrols ❑ Clock Sy §tems 13'6ata Telecommunication Installation ❑ Fire AIartn Installation n HVAC n Instrumentation n Intercom and Paging Systems 7 Landscape Irrigation Control* ❑ Medical n Nurse Cal s n Outdoor Landscape Lighting* n Protcctiv Signaling O Total number of, commercial systems: 1 *No licenses a e required. Licenses are required for all other installations I:( BUildingTernIfts1ELC- Porrrf Apo ,doc 07/01(10