Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111 COMMUNITY DEVELOPMENT Permit #: ELR2012 -00096
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2012
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 380
Project: Duggal Visual Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: Voice /Data Cabling
Contractor: TECHNOCOM INC Owner: PACIFIC REALTY ASSOCIATES
7929 SW BURNS WAY SUITE 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 05/15/2012 $75.00
12% State Surcharge - Electrical 05/15/2012 $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 0 52 -001- 090. You m y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: A:( 1! Permittee Signature: t' `t Lic r -n o&
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 Application R E c C'I�
Ci of Tigard I t L L , t�=Ivca Permit No.: p
1.11,
h' g Date/By: t 1 8- 49.0/47%._ 017
" 13125 SW Hall Blvd., Tigard, OR 97223 MAY 15 2012 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit;
Inspection Linc: 503,639.4175 Uaie Ready/By: : El See Page 2 for
T I GA r n Internet: www.tigard- or.gov CIT OF TIGARD Notified/Method: i p Supplemental Information
4.D • v. - ': ..: . - . ..:.. ... ..: .... ...:.' ::• PEtiN' : fZEVIEW
❑ New construction ® Add ition /alteration/replacement Please check all that apply (submit a sets of plans w /items checked below):
❑ Service a} feeder 400 amps or more ❑ Building over three stance.
❑ Demolition ❑ Other: where the available fault current 1:1 Marines and boatyards.
; ; . : ...:..
..... ,...: -: ..:.. ...• •• C�cTEGt7>�tt ..... ; CONSTRUC117 . .
•• exceeds PO 000 amps nt 150 volts Or Floating buildings.
y
.. ......... ... ......:. . ...
less to grdund, or exceeds 14,000 ❑Commercial -use agricultural
0 1 - and 2 dwelling ®Commercial /industrial 0 Accessory building amps for all otherinstallations, buildings.
0 Multi family • ❑ Master builder 0 Other: In Fire pump, ❑ Installation of 75 KVA or
: .,.... ..: .: ......... cr n system. system.
.. ,,. ,..... ,. ........ :...... :. .3bg:. ; i bRMA1 iO'M:; AND - LOCATION motor load of
larger separately Y
Job no.: 124042 • Job site address: 15350 SW SEQUOIA PARKWAY toorrP u< .,,ore. a a
❑ Six or m Recreational vehicle parks,
City/State /ZIP: PORTLAND, OR 97224 ❑ Health -cue facilities. ❑ Supply voltage for more than
❑ Hnrnrdrnls Incatinns. 600 volts nominal.
Suitc/bldg. /apt. no.: 3W I Project name: DUGGAL VISUAL 124042 ['Service of feeder 600 amps or more.
,.:. , ....: ; ::1 ..:..::::::.: !:FEE :5PHED,. ULE .
Cross street/directionsto job site Nu __ ••__ __ Qts_ F� f Total I •
New residential single- or maid-family dwelling unit.
includes a4tached garage.
Snhrlivisinn• T.nt no.: 1,000 sq. Nor less 168.54 4
- Ea. add'I 500 sq. R or portion 33.92 1
Tax map /parcel no,: Limited energy, residential 75.00 2
' ;1; . 'DtSCR1PTION OF. WORK . .. . .... . (with above sq. ft.)
Limited energy, multi - tinnily 75.00 2
VOICE/DATA CABLING eisidentlhl (with above sq. R.)
I Services or feeders installation, alteratton, and /or relocation
200 amps of leas 100.70 2
: !:' El : -PROPERTY::OWNER ::. ;1 ; :: I .:' : L]' •TENANT .: . : 201 amps td 400 omps 133.56 2
401 amps td 600 amps 200.34 2
Name. 601 amps td 1,000 amps 301,04 2
Address: • Over 1,0001srmps or volts 552.26 2
Cary /SIatGLIP: e mpempo a services or feeders installation, alteration, and /or
Phone: ( ) • Fax: ( ) 200 amps of leas 59.36 1
201 amps td 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps tO 599 amps 168,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, nr cxtensiorb tur janel
Owner signature: ' ,_Date: _.••.• • • • . A. Fee for branch circuits with
� above service or feeder f tie,
: _.:? ®: APPLiCANT .:. ' ... • :. ®' CONT 'PERSON 7.42 2
• each bra circuit
Business name: TECHNOCOM INC B. Fee for branch circuits without
y ervirc trr tt•eder nX, nrst
56.18 2
Contact name: LESLIE PARSONS brunch circuit
Each add'I branch circuit 7,42 2
Address: 7929 SW:BURNS WAY. SUITE, F Miscellaneous (service or feeder not included)
City/State/ZIP: PORTLAND, OR 97224 dwelling, rvice der 67.84 2
Phone: (503) 682 -4195 Fax: : (503 -) 682 -2781 Reconnect Only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: I,parsonsca gotechnocom.com • Sign or outline lighting 67.84 2
::.;:;::,.;?: :;;:.:...1: :;, :': ? ::....:::::.::::.:•,....:::.:. NTRA O :
R::' .. • .......... • • Sigtaleireuit(c)
Business name: TECHNOCOM INC panel, alt or m extension. 1 Page 2 75 2
Each additional Ins . ection over allowable In an of the abov
Address: 7929 SW: BURNS WAY, SUITE F • Additinnal inspection (1 hr min) 66.25/ hr
City/ State/ZIP: PORTLAND, OR 97224 Invesligatioh (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
--
Phone: (503) 682 -4195 Fax: (503) 682 - 2781 inspections for which no fcc is 90.00/ hr
, specificatlyhisted ('h hr min)
CCB . Lie.: 73872 Electrical Lie.: 34 269C4 J Suprv. Lie.: 2861LEA :..:k ELECTRiCAL'.PERMIT •FEES: ':::::':....:.:
i S
Suprv. Electrician signature, required: j Subtotal:. 75
Plan review (25% of permit it f fee);
Print name: SCOTT BERKEY Date: 05/14/12 State surcharge (12% of permit fcc): 9
X TOTAL PERMIT FEE: 84
Authorized signstru e: T hLe permit application expires if a permit is not obtained within 180
Print nAmc: SCOTT BERKEY D 0 5/]4/12 days after It has ores accepted as complete.
Data:
• Number Of tnspccnons allowed per permit.
I: Tulding \PermikAAEtC PermitADp. 07/01 /IO 440.4615111.1/051c0M/WE8
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Hcating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
. .... .... .
CCO1V M)E"R A ;WORK 01� LY:. • . .. . .
•
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
�] Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
p Landscape Irrigation Control*
[� Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
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