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Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2010-00026 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/09/2010 Parcel: 2S115BA02500 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY X Subdivision: Lot: 0 Project: Marshalls Project Description: Install restricted energy for voice/data. FEES Owner: SN PROPERTIES PARTNERSHIP Description Date Amount 1121 SW SALMON ST Restricted Energy Permit 02/09/2010 $67.84 PORTLAND, OR 97205 12% State Surcharge - Electrical 02/09/2010 $8.14 PHONE: Contractor: NETVERSANT SOLUTIONS III LLC 9740 SW NIMBUS AVE BEAVERTON, OR 97008 PHONE: 503-646-0533 FAX: 503-641-6613 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 Total $75,98 Intercom/Paging: N Landscape/Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Other Desc: This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stale 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 CAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or l 800.332.2344. r t Issued By: p ~nl ~-'u l K Permittee Signature: 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 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. f FEB-04-2010(THU) 21:53 NETUER5ANT CASCADES INC P.001/003 Electrical Permit A lien CEWED MR OFFICE USE ONLY, City of Tigard Raceturd PemdtNo,: " 131.5 SW Hall Mvd., Tigard, OR TS O 5 201 llalcluv: Plnn Review Phone: 503.639,4171 Pax; $03,5 , t r0 t7nlcrBu other Pcrndl: Imincetion Line $03,639,417.5 (sate Itaa4Ytny: r ' 0 seePage2lar Internet: unvw.tigard•ur,gov CITY OF TIGARD NatlncdrMethodt Supplemental lnformatlan ,n.~',~.ri+ .I°~.. Cl',~7 .r. '~I';7"i alp. ..I', ,I vl.~lr ~Gl ,'tr1 7W ud.ii;,..n,ilm^;;;Ib.:ia„III.~.I I,., .'1'-•:.l`I~i an 7:!~" i:'I:'i, 11 I '4,(•;*,r:y lf1611",,M°I~S~~}+y~I~~I^U~I:y1I~V IB LIII II ..1 ..u,.......,l. ~ii;tltdlilal,,;; .,III ,I:,• l,l arq i~RE ` wll ,:r {F;, .I III, NewconNtruCtion 'AtldEliun/ultcrtttionlrcplaeement t`lanaecheck a{Ithal a Apply (cuteill; mit11rtiluhRwritamathtskedbclow):' CI Service or fecdcr,to0 otttpa nr mutts ❑ ddilding over tltrce stories, © Demolition D Other: Where Uie avuflahla 113013 current Meritua and ho2lyar4a. I ilallnl;; , ~,I, i, ~ ipyll, III i „ !C• C:taTl„Cl?itY AF • CQ I ,°;I I L, Iji I cacuads 111,0110 atrrya at t SO volts or 0 Floathtµ hufldinp. ire ;dll'r•,, less to 1rmund.orexccedoI4icc0 ❑ Cammcrcinbttustp ituintral [J I -and 2-family dwelling CommerciaUinduan ia1 [J Accessory building amps for 411 other IlleWlludrnta buHdlnttl. [f Multi-faml ly ❑ Master builder C) Other: Nirt pulnp. 0 Inatallatiun u0: KVA nr .°I fl irl+;~•.'i;lig il9 'fi. ::a'P,: I ~rq,. l~, ~~~I. _ ,i, ,•I'I "~I I,',eG QHmargrncysymem• IorµurnapurrmlydarlueJ ystem. a L7..11; 41I ~AdditionornewtuolurluaJur Job no,, Job site addres•B; lcazao ~ plc ~Fe E~-1w lull)-U'urularo, morpuncy. C Si- nr morn milidcnthil units. 0 Recreational vcllble park, City/State/zII,: d, d ie 2.7 ?,Z 0 tlcolth.enrc rhe)))um 0 Supply upltage Ibr lilmo Ilion © Hazardous localiona. 6110 vnita notrilml, Swite/Uidg,/dpi,no,: Proicctname: 1:1Sctviccarfuodar60pumnsor rmm 1,1 i14111''rN;II"'hlfSIICiH.H» ~I: CM n[1Uk1i~°lh ~ i'''"Ilia l" li I'•'. ~dol:.fl"'''I'~.IrP' . I ~ 'r(, I. a' ":gllllll~lli Eti.'.4'r Cr= slreeUdireciions tcjob site. n= a v. New rctidantlai a Pe TOM btgle-ur rnuld-farnily dwell Ing 11 lilt, Ittchpdcsl attached t;arat;e, Subdivision; Lot no,: 1,UOU 04. IL or less 16954 4 Tax rnap pare no.., -r a. add'1500 tut, IL or portlon 33.92 1 I r , I. I Limited energy, resideaual 11. nlhi~°,i~1(;!1i11r~..+'.I!I'dl'~,,:'.. '.Ii,till)i~1~Siu~aC~t~trsi4.►tWra>I'ili~~ilq'':~'•;~,~'ill!,la~i4i;~," lllll~,i'~,If f ',III I L , ' wlth above a q. fL 67,84 I Limited eneruy, multifamily U L repldcntial (with abavc s . 0 6", R•i 2 Services or fccdcr, IMatallatinti, alierutluit. and/or rdocation 200 am a or Iota tUn,70 2 r I ,ill f Ir„p,ugufill u' p,ROP 1FR(Y O I~ III U,1sl!IIIS . Itl ~a-V, I . I IIII I .I, tt,F ANTilll > I kh „ 201 am+s to 400 a il' • ~ L '•1 l~E.I 171 I lu I , i I, II'.. mpa 133 56 Narnc; 401 umpa to 600 amps 200,34 601 amps to 1,000 ampit 301.D4 Address: Over 1,000 umpa or volts 552 26 2 City/StatdrlP; Temporary servlem or rcedcrs Inotallalinp, Mlterltttap, and/or relacutlon Yholie; ( ) Cux; ( ) 200 umpa or IcaR $13,36 I Owner installatinit: This inNialltttion is being made on property that I own which is not .01 ant s to 400 umpa 125,08 2 intended for r4 c, Ieuhc, Fell 1, or exchange, accord Ing to M 447, 449, 670, and 701. 401 ampR to 599 amps 16&54 Brunch circulto- new alteruiluu or extension -per panel wrtcr Nlbnuturt. Owe: I I Jl~~,ill III !I!I~III , f . II~ I it i• 0• A',I!. , ,nl r1;CAN 1':'li ll i.l r i l y.l.ii'II I' ifl;tl , L I .i A. PGC for brunch CttCldi3 lrrl 05 LY liaa,j "i O(1N t }1CRII;I•I4}C50N .ii ,ll rpl pbnvC RClviCe or reader fee, melt brunch cireult 7'42 2 13usinc4t: name: B. Tee fur branch circuits Cuniact nume: withnnt service or fecder fee, 56.18 2 Ilia bnineh circuit AtJllrcns: Mich ttd01 brunch circa)) 7,42 2 Mlocellattcollr service or feerlerlint locludcd City/Stall:/7113: Each rmnufarwird or modular 67,8n 2 -dwelling, uevice and/or fecder Phone: (Leoannect only 67.84 r-moil: Pump or irrigation circle 67.94 2 „e` d.. CON(t11tr1'Gt OR,.I;I' SIRn or nulline lighting 67,84 2 130 .inecr name: ETV G ZS f T Sigrtul eirCUtt(a) or umitcd= f~r1 t~ cncrKy panel, allcrnliun, or V 1. Address: 'I / L_p 5k)J V1 41t jA5 Av4e n U tn:1pun. cacrlbe: Page 2 2 Giry/StateJGIA:~~f(U~f)-•~•~ Q~ tal~po Each addilintial11161cctlonoverattowahlaIII filly Ur file nbo%re Pcr {ne cmion 66.25 phone: 60 ) 614 CO. Or 7" lax: ("'Z3 G (41 . Ce (e ~ Inyeatigulion per hour (i hr min) 662$ CCr3Lic.:1glp2_2, glec(riculLic,: Suprv.Lic.:71OLP19 Induntriat )nit ethaur 79.18 Suprv. Electrician signature, required: ~L, subtnutl; 41.9 )after nume: Date: Plan review (25% orpermit fcry SlateSurcharge (12%ofpcrmll rce): Authorized 5inaturc: i g To'i'nt. PERMIT FFF: ZS. °l`d 7i Title perudl applleutlr)n rspirm If a penoil Is not uuluiued within till) Print name: bole: t {3,~L~1 1 days after II llos liven agrrptell as celltplele. /7 - Nurtther of inapeetlana allowed {rep panhh. l:InuOdurutrermh.tG~cpre„uann,eM luruuuu aan»u;l5tlnlnsrconvwaa