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Permit
a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT •• 2 .. COMMUNITY DEVELOPMENT Permit #: ELR2012 -00039 • T F G A.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/29/2012 Parcel: 2S101AB00100 Jurisdiction: TIGARD Site address: 12005 SW 70TH AVE Project: Meridian Acupuncture Clinic Subdivision: 1996 -024 PARTITION PLAT Lot: 2 Project Description: Data, audio and security systems. Contractor: T & L COMMUNICATIONS INC Owner: RED ROCK BUSINESS ASSOCIATES LLC PO BOX 87387 23077 SW NEWLAND RD VANCOUVER, WA 98687 -7387 WILSONVILLE, OR 97070 PHONE: 360 - 737 -9725 PHONE: FAX: 360 - 737 -9648 FEES Description Date Amount Specifics: Restricted Energy Permit 02/29/2012 $225.00 12% State Surcharge - Electrical 02/29/2012 $27.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 3 Audio & Stereo: Y 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: Y Other: N Total $252.00 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 - - s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: (=P----4,116:1:"-- 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' 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. 02/28/2012 09:27 FAX 360 737 9648 O T &L Communications 11j0001 /0002 • Electrical Permit Au lica r tion , �� , l,:1 I• i lc 1: t . ( ) \ 1.1 , a �D �`1, F: /] % ,, PeN0. ( O n 13125 Sw Hall Blvd.. 'Tigard, OR e • r �® .ew ` r 11 • Phone: 503.639.4171 Fax 503' • . t �Q. � • q ty: • • Other Permit See Page 2 for I . i ,` i r) Ins Line: 50175 � �,� di ( Cr et : . . 7 /, 1 Su p�ental Information Internet www.tig�d- or.god- ar.gov ' i . ' ', c wt :' i 7 ,' """a A_ •.*A r,, _ - 4" , ' . -: 7 , . X77, 4: -„ S - . , '� F, r ^LT3' - 1 . - p:'n 4 ?! . -74: . .,_. __.0 . ... _ . Y,:+ w.. _s.> -b^Y+ ... - S.l .__ 3,th,u.f.. _ `•tr t. ... r I.°.Iw. `i ! - ,r ] ndEiL C__r — ati...L�. ❑ New construction ® Addition/alterati' . •4' t i. ,, t rheum chef' all t apply (submit hem of plans Whams ruems c (crow): 4 ❑ Service or feeder 400 amps or room Qeurlding over three stories. ❑ Demolition ❑ Other where the available fault current 0 Marina and boatyards. k''''1 ::::",',1-: � V.A lax , c 1 A .7-k Utr 1x;, fi..- exceeds 10:000 amps at 150 volts or ❑ Ploabog bulldings. sa.. . - ✓ 3 : .._ i . ^ ac _ .: : -L. _∎. .. _ v..a . t , D .1..1 _ x _x.. -. x , * ,... , . - 5, _.w, . 91 x . .: lea to snood, or exceeds 14.000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling © Commer©alfindustrial ❑ Accessory building amps for all other installations. buildings. ❑ CI � Multi ❑ Master builder ❑ Other. ❑ Fun pump. ❑ Installation of 75 KVA or r `. ', vi ' t e Nr y i .ie x " “E -.V s 56V4 > ' ncy system. larger separately derived system. ? _. a r r5 __44 _ . _. . _.. ,11. .lw.t. . _ _k ts'^?` ._ :; ikee ":. rt tibt d4 _ „__ :i?i - A,t `i~ frrt: _= ❑ Addition of new motor load of ❑ "A ", "E". "1 -2 ". "1 -3 ". Job no.: Job site address: 12005 SW 70th Ave occupancy. ❑ Six sa o or r or errs' more residential Trolls. ❑ Recreational vehicle parks. City /State/ZIP: Tigard, OR ❑ Healthcare facilities. ❑ Supply voltage for more than O Hazardous locations. 600 volts nominal. Suite/bldg./apt no.: Project name: Meridian Acupuncture 0 Service or feeder 600 amps or more. v �. "e t ,, .hp d q, i , . H if :A W 11'..t 2tlL�7. Cross street/directions to job site: �' e i . 1-• u -.. .. __ t a1 .,'11:.?;-?.4t, Desmrptlm 04y Fee. .. 7b1 • New residential single- or mold - family dwelling unit. Includes attached garage. Subdivision: • Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/ pared no.: Ea. add'1500 sq. ft. or portion 33.40 1 �P P Limited energy, residential r 75.00 2 ms 's a � rr I �' S+ 'z'R; k• 'n ' - ` 7 j n : `F oaa' " '� w a yr r - ee a , (with above sq. R) 1k..:414 .4. F�fit ,._ -? 1ss ,._1 ..xF.uLa::a�.:i»nc9lrtY?„ 5'Bi- k7_We-r?m N`RiXibd_ _ ,.: energy, multi- family • Run Cat6 data drops, cable for phone, speaker & security systems residential (with above sq. R) 75'00 2 Services or feeders Installs alteration, and/or relocation Mr AT ! f �/� Q 200 amps or less 80.30 2 p�. ��rr.. _ .e 4'' `.Y < §; '; 'n. _ -_ 71 R :'#' 51 } +'ih � V€"M , j. .ett=�,7,f• R C .:M! 201 !� §"�'� .at• amps to 400 amps 106.85 2 F✓.° ��^.. . iar _r.K.rs��q:.cr.�:d ,k �_otit;.,.1!fu`. ..1�..<':i._:•ei._. .Xvu .�...�. �_�:".r+,... - .. Name: «,., 401 amps to 600 amps 160.60 2 Address: Over 1.000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation,elteiadon, and/or _ w ' 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 amp 10030 2 intended for sale, l ease, 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, panel Owner signature: Date: _ gn A. Fee for branch circuits with "�`� , 'lid ', � ` r < s e d K 'A , . r above service OI fender fee. ft .._.. ;"iM1L.:..., : ur &. 4 ..i.,:iii4es:: : :: ::n:,ot aKi:_1 .1.- - ?1.1' . .. as nie L _ vn v :ry ,vv a . . . ; 6.65 2 each branch circuit Business name: T &L Communications, Inc. B. Fee for branch circuits without service or f" ' 46.85 2 Contact name: Ross Bushaw first branch circuit Address: PO Box 87387 Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: Vancouver, WA 98687 Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( 360) 737 -9725 Fax: : ( 360) 737 -9648 Reconnect only 66.85 2 E -mail: Office ®tl- communications.com Pump or irrigation circle 53.40 2 r £r,�A tg,' 4 % v . � L w-a'n. to ri ! ` i. .: '' .�Y� 'k'},'?._4-"'k q " : : ' " Sign ar outline lighting 53.40 2 G�'��= v7a.Ca�,: ^�,�s^�. t..�... ,.. +a�3:':(:`:w { .... v_�:,,�:�Ss� Business name: T &L Communications, Inc. viral caen by Pei,(al teration, or extension. Describe: Address: PO Box 87387 NP , City/StateIZiP• Vancouver, WA 98687 Each additional inspection over allowable in .1 of the above Per inspection 62-50 Phone: ( 360) 737 -9725 Fax: ( 360) 737 -9648 Investigation per hour Cl br min) 62.50 CCB Lic.: 67787 Electrical Lic.: 7- 428CLE Su 'Iv. Lic.: 6841.F• Industrial plant per hour _ 73.75 Suprv. Electrician signature, required: 41,111Will 111M1111111 Subtotal , (k..) Print name: / Date: 02/272012 Plan review (25% of permit fee): — Bushaw State surcharge (8% of permit fee): 7 Oc) Authorized signature: ''� TOTAL PERMIT FEE ot5 2 E� P rint name: Larry :.. � • Date: 02/272012 This it expires if &permit accepted �s��mWal within 180 • Number of inspections allowed per permit ' t :lBoadlag'PermWisdePemmitAppdoe 05/23106 44p4615r(lia tCOM WEB 02/29/2012 09:22 FAX 360 737 9648 T &L Communications Ii0001 /0001 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: t ,�a+csa � �n�w 1 .k r s n ) [ ;, a t -, Me 9e a SHE. , x- Y �.� , 1 1 f -.. VAS 3k .;. x.c %ti....,�, i ce.. - _. w.nwa.ncz,� r++ w:;. 1'� ... ' .. �. � :. Fee fo ; ,au residential systems combined ... $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. :::7:C:'.'2;:17, �" ' - �. 9 �^� T m �''� * —s `- . ,. l.Ta�'S'1�� _ v s ,> t .J g +,max vA 1' h 'lfr? Fee for each commercial $75.00 system (SEE OAR 918 -309 -0000) Check Type of Work Involved: ,,.. _ A udio and Stereo Systems ❑ Boiler Controls • , . _. ❑ Clock Systems yQ Data Telecommunication Installation ! ❑ l Fire Alarm Installation ❑ HVAC ❑ Instrumentation (,{ ❑ Intercom and Paging Systems `° ❑ Landscape Irrigation Control* , n0 ❑ Medical L . El Nurse Calls ❑ Outdoor Landscape Lighting* U' Protective Signaling ' Seck ❑ Other 444 Total number of commercial systems: *No licenses are required. Licenses are required for all other installations t\a,saineermit,W arennivisp mrotno