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Permit - n CITY OF TIGA ELECTRICAL R ESTRICTED ENERGY PERMIT : � , '� g '- COMMUNITY DEVELOPMENT Permit #: ELR201200240 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/25/2012 Parcel: 25101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 310 Project: Cascade Management Subdivision: VARNS ACRES Lot: 9 Project Description: Low voltage for fire alarm Contractor: T & L COMMUNICATIONS INC Owner: GK TRIANGLE CORPORATE PARK III L PO BOX 87387 BY THOMSON REUTERS INC VANCOUVER, WA 98687 -7387 ATTN: MEGAN DOWLING PO BOX 130174 CARLSBAD, CA 92013 PHONE: 360 - 737 -9725 PHONE: • FAX: 360 - 737 -9648 FEES . Description Date Amount Specifics:, Restricted Energy Permit 10/25/2012 $75.00 • 12% State Surcharge - Electrical 10/25/2012 $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: N Fire Alarm: Y 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. ATTENTI• L • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR ' 952 - 001 -00 : through OA' 952 -001 -' %- I. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344 Iss I =d By: ■ , K Permittee Signature: IC ,,/ . 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 FOR OFFICE USE ONLY Rev ie City of Tigard a ived Permit No.: e /J 2 t IIII 1 3125 SW Hall Blvd., Tigard, OR 97223 RECElVE ate/ y: Other Permit: /O i8 /, Phone: 503.639.4171 Fax: 503.598.1960 �oW �eg DDi, T I G A R D Inspection Line: 503.639.4175 Date Ready/By: 7 lar s: See Page 2 for Internet: www.tigard- or.gov OCT 18 2012 Notified thod 10 ZS /L �'/ I� 7/ H (� Supplemental Information TYPE OF WORK CITY4FTIGARD / PLAN REVIEW ❑ New construction ® Addition/alterationatMON6 DIVISION Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling © Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION El Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A "E ", "l -2 ", "I -3 ", 21 SW 68th Parkway 100 or or o more. R occupancy. r Job no.: Job site address: 132 on _ 0 or more residential units. 0 vehicle parks. City /State/ZIP: Tigard, OR 97223 I3t2' ❑ Healthcare facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Cascade Management ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 fire alarm tenant improvement residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: T &L Communications, Inc. B. Fee for branch circuits without service or feeder fee, 46.85 2 Contact name: Larry Bushaw first branch circuit Each add'I branch circuit 6.65 2 Address: p0 Box 87387 Miscellaneous (service or feeder not included) _ City / State/ZIP: Vancouver, WA 98687 Each manufactured or modular 90.90 2 dwelling, service and/or feeder 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 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: T &L Communications, Inc. energy panel, alteration, or Address: PO Box 87387 exte sion. Describe: Page 2 ,� d 2 2>E 9G A��'9 City /State /ZIP: Vancouver, WA 98687 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( 360 ) 737 -9725 I Fax: ( 360 ) 737 -9648 Investigation per hour (1 hr min) 62.50 CCB Lic.: 67787 f l fl Electrical Lic.: 7- 428CLE I Suprv. Lic.: 684LEA Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: • Subtotal: 75`pO Larry Bushaw Print name: D a te: 1 -I , /2_ P lan review (25% of permit fee): State surcharge (8% of permit fee): q .. Authorized signature: / TOTAL PERMIT FEE: pO _ �• f Z Print name: Larry Bushai Date: /0/ This p ermit application expires if a permit is not obtained within 180 days after it has been accepted as complete. / * Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(II /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental 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* El Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems H Landscape Irrigation Control* ❑ Medical El Nurse Calls H Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations IABuildingTermitsELC-PermitApp.doc 03/23/06