Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
a,.. COMMUNITY DEVELOPMENT Permit #: ELR2013 -00049
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued: 03/11/2013
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 220
Project: Southwest Business Corp Subdivision:E CONDO, THE SUPPLEMENTAL PLAT Lot: 25 -4
Project Description: Low voltage for data
Contractor: BRY -COM Owner: WISCO REAL ESTATE EQUITY FUND I
14244 SE BUSH 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97236 PORTLAND, OR 97205
PHONE: 503 - 761 -5156 PHONE:
FAX: 503 - 760 -7501
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/11/2013 $75.00
12% State Surcharge - Electrical 03/11/2013 $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 r more the 180
days ATTE ON: on law requires you to follow the rules adopted by the Oregon Utility Notification Center ose rules aret fort /n OAR
952 - 001 -00 0 through OAR 52 -001 9 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987,6 :00 33.'44
Issued Permittee Signature: i ` _� AI
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 ApplicatiRECE VED FOR OFFICE USE ONLY
City of Tigard Received 5,13 Permit No a pip /3 -00Q`7 9
° 13125 SW Hall Blvd., Tigard,OR 9722MAR 1 1 2013 Plan Review
Phone 503.718 2439 Fax• 503 598 1960 Date/By Other Permit
T I GA RD Inspection Line. 503 639 4175 CITY TIGARD Not Re a h od runs See Page 2 for
Internet www tigard- or.gov BUILDING DIVISION PP merit 1 Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ 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 ❑ Emergency system larger separately derived system
❑ Addmon of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 962,6 �(� s �`6 �� 100 or or occupancy
❑
❑ Six or more re a residenhal units Recreational vehicle parks
City /State /ZIP: TI Oi G' ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: _� Project name: ), (A 1 ❑ 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 168 54 4
Ea add'I 500 sq ft or portion 33 92 1
Tax map /parcel no.: Limited energy, residential
D CRIPTION OF WORK (with above sq ft) 75 00 2
_j_-a c0 j ,cirAT/ 1
Limited energy, multi-family
sq 75 00 2
L , / c � / q / / V � residential (with above sq ft )
(M
AL t A Services or feeders installation, alteration, and/or relocation
( 200 amps or less 100 70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2
401 amps to 600 amps 200 34 2
Name: 601 amps to 1,000 amps 301 04 2
Address: Over 1,000 amps or volts 552 26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59 36 1
201 amps to 400 amps 125 08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 54 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, 7 42 2
each branch circuit
Business name: B Fee for branch circuits without
service or feeder fee, first 56 18 2
Contact name: branch circuit
Each add'I branch circuit 7 42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84 2
Y dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67 84 2
Pump or irrigation circle 67 84 2
E -mail: Sign or outline lighting 67 84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: it it .. ��1 panel, alteration, or extension I Page 2 2
/' Each additional inspection over allowable in any of the above
Address: Lj2 t'f S ' , WW'(- SM Additional inspection (1 hr min) 66 25/ hr
City /State /ZIP: % / i ai7232 Investigation (I hr mm) 66 25/ hr
r.� ` Industrial plant (1 hr mm) 78 18/ hr
Phone: (5 �� / ���� Fax: (S(�3) 1 , 0 - / � 3 3 g Inspections for which no fee is 90 00/ hr
Y specifically listed (Y2 hr mm)
CCB Lic.:l2/ 2- 8-5 t` Electrical Lic.:7Co li�r uprv. Lic.:( ELECTRICAL PERMIT FEES
� ` � r
Suprv. Elec ician signature, required: ` .4
/0 / l/ Subtotal
a
i � Plan review (25 /u of permit fee).
Print name: y/ 1 S j A • at : 3 -0 r/3 State surcharge (12% of permit fee)
� TOTAL PERMIT FEE
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
N um b er of inspections allowed per permit
1 \Building\Permits\ELC- PermitApp doc 07/01/10 440- 46I5T(11/05 /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*
❑ 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- 309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nursc Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 \Building\Pennus\ELC- PermitApp doc 07/01/10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9020 SW WASHINGTON SQUARE RD 220,
TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
03/29/2013 00:00
ELR2013-00049
PASS - No C of O
Violation Summary:
Inspector Contractor