Permit e p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'`1 • COMMUNITY DEVELOPMENT Permit#: ELR201500116
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2015
T&C�A)LL� Parcel: 25101 DC04603
Jurisdiction: Tigard
Site address: 7405 SW TECH CENTER DR 144
Project: African New Life Ministry Subdivision: TECH CENTER BUSINESS PARK Lot: 2
Project Description: Data telecommunications system.
Contractor: ALLPHIN COMMUNICATIONS INC Owner: WPC TIGARD LLC
23220 SW BOSKY DELL LANE 307 LEWERS ST 6TH FL
WEST LINN, OR 97068 HONOLULU, HI 96815
PHONE: 503-638-9000 PHONE:
FAX: 503-638-9100
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/28/2015 $75.00
12%State Surcharge-Electrical 04/28/2015 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 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 is.uance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notif ati•n Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by callin i 5•.y 232.1987 or 1.:00 .2344.
i / / .
Issued By: �� �,�, Permittee Signature: �� . _i
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
City of Tigard Received
Tigard Date/B : S ..1-•J. Permit#: , L ,_,i ) 6tO /O
II il 13125 SW Hall Blvd.,Tigard,OR 97223_ 503 V 1`' Plan Review
ED Phone: 503.718.2439 Fax: .59 CE 1�D Date/B : Related Permit#:
Inspection Line: 503.639.4175 ' Ready Date/By: Surfs: ® See Page 2 for
T I(' \R 1) Internet: www.tigard-or.gov .1.015 Notified/Method: "------C.•"------C.• Supplemental Information
TYPE OF WOR10141 ��D PLAN REVIEW
El New construction al Addition/alteratio tirm�tt ON Please check all that apply(submit 2 sets of plans w/items checked):
❑ G" G 01\ AS% ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF COCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling pi CommerciaUindustrial ❑Accessory building
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family in Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: C�q5-0 / O�SW r e� ❑100H Addition of new motor load of system.
Job site address: Y L°�,,,(�-,�,�,Q,�; 100I-IP or more. ❑"A","E","1-2",°t-3",
Ci /State/ZIP: ❑Six or more residential units. occupancy.
ty �G 4. a. S 7 2.2.3 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: /yy� Project name: ^ 1 ,/(y,,,,, L,k nt�/`' ardous locations. ❑Supply voltage for more than
I w�- ❑Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
YO(c.e a l Cu / a (with above sq.tt.)
�r SQL- Limited energy,muhi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
❑ APPLICANT I ❑ CONTACT PERSON
Branch circuits—new,alteration,or extension,per panel
0044114 A.Fee for branch circuits with
Business name: l/pi&a,J 4N;e_c"..f'o.✓,c `�'nJ L above service or feeder fee, 7 42 2
""T'p ,^ l^ each branch circuit
Contact name: J C.. 1 .�'e�,`,J B.Fee for branch circuits without
Address: 2-3 a v S,) 6 eskc( o5(L lid branch or feeder fee,first
branch circuit 56.18 2
t City/State/ZIP: �cf �'I r!! ✓ q-)0 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: 0 ) 6 ,' OO(0 I Fax::(03 ) G 3 Q ( f Each manufactured or modular 67 84 2
/f� r r dwelling,service and/or feeder --Email: `� L 4- (.y;vG o,',. , Cor-1 Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
�n 1P eij ��ne .
Signal cterati(s)or limited-energy Page 2 � 2
Address: panel,alteration or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) I Fax:( ) Investigation(1 hr min) 66.25/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
`01. specifically listed(Y.hr min)
CCB Lic.: 6 I Electric c.:3-N/ . / Surv.Lic.: 2�� ELECTRICAL PERMIT FEES _+�+
JSuprv.Electrician signature,required. J Subtotal: �7 '.
Print name: g n Date: 1/42:7/r S� ❑Plan Review Required(25%of permit fee):
(� 111 State surcharge(12%ofpermit fee): 9
� ,�/ �e
Authorized signature: ` TOTAL PERMIT FEE:
Thu permit application expires if a permit is not obtained within 180
Print name:0 ri`Li , p Date: a 1(i ' days after it has been accepted as complete.
Number of inspections allowed per permit.
L1Building\Permi ts\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 440.4615T(I1/05/COM/WEB
Location:
Record Type:
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Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7405 SW TECH CENTER DR 144, TIGARD, OR,
97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2015-00116
Jeff Grove
Violation Summary:
Inspector Contractor