Permit •
'
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00114
�IL I ' 13125 SW Hall Blvd., Tigard, O 972 503 - 639 -4171 DATE ISSUED: 5/16/2005
PARCEL: 25101 DC -04603
SITE ADDRESS: 07405 SW TECH CENTER DR 160 ZONING: I -P
SUBDIVISION: SW COMMERCE CENTER LOT: JURISDICTION: TIG
Project Description: Low voltage. Install voice and data system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WATUMULL PROPERTIES CORP BROADWAY ELECTRIC - COCHRAN INC
307 LEWERS ST #6FLR 626 SE MAIN
HONOLULU, HI 96815 PORTLAND, OR 97214
Phone: Phone: 503 234 - 6564
Reg #: LIC 72942
SUP 3447S
FEES ELE 37 -546C
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/16/2005 $75.00
[TAX] 8% State Surchart 5/16/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 7 001 -0100. You may obtain copies of these rules or direct ques 'ons to OUNC at 503 - 246 -6699.
Issued By: .� _ _ _ mil_ -` Permittee Signature: f / . 7 %,0<u
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.
Electrical Permit A FOR OFFICE USE ONLY
� Receive p� Q
�2S of Tigard Received c / /0/G�5_ •{ 3 Permit No.: Oj - - IVO //
13125 SW Hall Blvd., Tigard, OR 97223 1 Plan Review V E D
Phone: 503.639.4171 Fax: 503.598.1960 MAY Y 1 6 1005 /[ i'` . r.. ' . , I i I'i
A\ d DateBy: Other Permit.
"`
Inspection Line: 503.639.4175 Date Ready/By: hair: ® See Page 2 for
• Internet: www.ci.tigard.or.us CITY OF TIGAR,' Notified/Method: r Supplemental Information
7 ;'r � r. ',� - , ft „r rrsx. T/• y R - .yr,r�r".�^y 7• -•.1 " +- ^ -'.r# , o.:- it.'J'�i' - �° I �
7G� r• '2 a.� ...�.,�ti:,,z,z `:,.... ! ,, .t! C,, 47rs ., .4—z. ∎ 1 ,..w. , SO .rt i4'n5... - i •` A -§ • .. . X , d` " ° •; ` s'.' p:
Yi:.= IL7iti rim 1;3
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other OService over 225 amps, comm'l ❑Hazardous location
• 2'• µr:;'� ' _ a ` , w ap ._ _ n ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
a
'.( „ (x7„ (,61, o ; -K4o �"A iru � it- i =• •Yz% of 1- and 2-family dwellings 4 or more new residential
-4 -- _ '6t,v .: -S•: ..- r' _.ey.._'` :..:c..a -.,.. Y"e"t c.,_7, ,%."i::" Y
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi - family 0 Master builder 0 Other:
_ ['Occupant load over 99 persons ['Manufactured structures or
72 irc , ti;1 a . X j * �' `y RV park
r . ILL C5 _�t;r�- _'cs-_ , )� ` ..,... T _, -- , : , ?.?!-•1 .. ❑Egress /li g ht ing p lan p
Job no.: bc 7S 7`TVI i Job site address:' 74 `.�, Si �) � ❑Health - care facility ❑Other:
J Se I CCU, t da I Submit 2 sets of plans with any of the above.
City /State/ZIP: ; r Q The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 4 (no I Project name: lit de4/ V, RA b1 i ` � '' ' `: "
Description 1 Qty. I Fee. I Total i .
Cross street/directions to job site: New residential single -or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no Limited energy, residential 75.00 2
`z: , Y+� nrz Limited energy, non - residential 75.00 2
L y t ' . � - r ;r ,b L y * ° a.. t 3 r ' �,,( . *r _ .. "R - - Each manufactured or modular
.� F!•ffsl__•. -. !'J..: . -.5 -�. zR: tr • . sa.
I y !� V 1 __ I , 1 D 5 \Oe-yr\ dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
+a r ;' � ^ .,` W z _ - w- - =. t �.a , 201 amps to 400 amps 106.85 2
402 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I 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 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
"I- �"' 7 ' , 9 � `l °,4y.r . ;r '� w" m f , ..F .-? 1 7+ ^�' `n
i . iy-:car�'�. _ a S �:^ :.s 4 : . - , e-'_ 2 . ' , i X 9�3?' . a t ;,: A. Fee for branch circuits with
}�,� service or feeder fee, each 6.65 2
Business name: Br-Lad l l • a e(2_ i Y 1 C., branch circuit
Contact name: ✓Oim (, O d B. Fee for branch circuits
-� without service or feeder fee, 46.85 2
� a , e , �„ - r each branch circuit
Address: j ( ,I
u • Each add'1 branch circuit 6.65 2
City/State/ZIP: � n CI V Cl r(2 l Miscellaneous (service or feeder not included)
Phone: (513 234 (Otto LI I Fax: : (`b / 2.--C Ze , Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2 '
E -mail: ... ' 0 , Cr teal," •Y� , C ( sY)" Signal circuit(s) or limited-
. 3 ,... _ j ' y -'""_r,7,�' . 'r. ;:m .lt ' k !, ,,m4 i` y am, ,;, -''z i ' ." v;. "'rte energy panel, alteration, or
F -;= " i ;,, . l ���`19. rr z ip l y . �_....: •saw: e„� r- extension. Describe: / Page 2 7S 2
Business name: ( c ri „„ ). . 0 s CI. OI Ica
Address: l Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) //0/0/ Fax. ( ) Industrial plant per hour 73.75
CCB Lic.: 12 Electrical Lic.: 37 Qc Suprv. Lic.: 3` E��S Subtotal i fs`
Suprv. Electrician signature, required: l Plan review (25% of permit fee)
Print name: k e. 4\4_1(\r\. \� Date: 5 4 i�'"--- State surcharge (8% of permit fee) &
TOTAL PERMIT FEE g./
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board
• • Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PermitApp.doc 12/03 440-46 1 ST(10/02/COM/WEB