Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
13 fix COMMUNITY DEVELOPMENT Permit #: ELR2009 -00336
Date Issued: 10/23/2009
4,1GA•U 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
rxrr� Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15895 SW 72ND AVE 200
Subdivision: OREGON BUSINESS PARK III' Lot: 40
Project: CIDA
Project Description: Fire alarm.
FEES •
Owner:
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 10/23/2009 $67.84
PORTLAND, OR 97224 12% State Surcharge - Electrical 10/23/2009 $8.14
PHONE: 503 - 624 -6300
Contractor:
STANLEY SECURITY SOLUTIONS
15495 SW SEQUOIA PKWY #100
PORTLAND, OR 97224
PHONE: 503 - 968 -3353
FAX: 503 - 968 -3398
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 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, 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. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente . Those rule set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6 or 1.800. .2344.
Issued By: / 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.
CaII 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.
t �: „,;ii �, N n t,; ' " • , 0 d4 t4 P" e. �u : :i(� a r'
Electrical Permit Application c� (, . : m I � 1. FOR O S O a : u w
City w l-I Tigard, OR 9,7223, O CT �i � ZOOS Dat B a /6 2 . t 9 ;' Pe ' 8Zi2 , 9 40,154
l l aa Permit No.
" ° Phone: 503.639.4171 Fax: 503.598.19 1 OF TIGARD DateBy; taw Other Permit:
Inspection Line: 503.639.4175 .PS� Oo /C/
4, 1 ,6,.:6, ns
; BUILDING DIVISION Date Juris: ® SeePage2 -for
));k , ,! , v9& Internet: www.tigard- or.gov Notified/Method: 77e- Supplemental Information
.. r oc ' ,a? � : , � TYP OF WORK ._ , • _ �E iw x „ r.m � . a ` . • , PLAN REVIEW , ?, =' , ... E . •
❑ 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 stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
4 s # C A TEGORY OFC ON3TRUCTION ,x p � , a 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
❑ Emergency Addition of syste new
m tor load of larger separately derived system.
G '� t JOBB, SITEt?1NFORATION ND LOCATION w . x ❑ o ❑
Job no.: Job site address: 15875 SW SEQi4OIA,PARKW-A-V 100l-IP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 97224 ',a 4- C ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous' locations. 600 volts nominal.
Suite/bldg. /apt. no.: 202 Project name: CIDA ❑ Service or feeder 600 amps or more
`t ' " ilW ' iFEE SCHEDUEZA'ESS �:* �..
Cross street/directions to job site: Description 1 Qt I Fee. 1 'Total
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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no
Limited energy, residential
"" 1 ' ,t fDESCRIPTIONLOFiWORK 7, h x - `h' A (with above sq. ft.) 75.00 2
Limited energy, multi - family - 75.00 2
INSTALL FIVE HORNSTROBES AND.POWER BOOSTER ON EXISTING residential (with above sq. ft.)
FIRE SYSTEM Services or feeders installation, alteration, and/or relocation
200 amps or Tess 80.30 2
' 'r ®" PROPERTY OWNERS . � t O ' . A 'r NA t £r r 4 201 amps to 400 amps 106.85 2
Name: PACIFIC REALITY ASSOSCIATES 401 amps -to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 15350 SW SEQUOIA PARKWAY Over 1,000 amps or volts 454.65 2
City/State /ZIP: PORTLAND, OR 97224 Temporary services or feeders installation, alteration, and /or
relocation •
Phone: (503)624 -6300 Fax: (503)624 -7755 200 amps or less 66.85 1
'Owner installation: This installation is being made on property that 1 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, pet-panel
Owner signature: Date: A. Fee for branch circuits with
x r ® APPLICAN T u, gw `" S P - w ®CONTA'CT PERSON w WIZ above service or feeder fee, 6.65 2
each branch circuit
Business name: STANLEY SECURITY SOLUTIONS B. Fee for branch circuits
Contact name: GARY TAUSCHER wi l t bra service or feeder fee, 46.85 2
first branch' circuit
Address: 15495 SW SEQUOIA PARKWAY, SUITE 100 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: PORTLAND, OR 97224 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 968-3355 Fax: : (503) 968 -3398 Reconnect only 66.85 2
E -mail: • Pump irrigation circle 53.40 2
Fv Mi ° r t a,.ur "'',,,CONTRACTQR; ; ;,;r , ; h ' 'r ia ,a e t? Sign or outline lighting , 53.40 2
Business name: STANLEY SECURITY SOLUTIONS Signal circuit(s) r
limited-
energy panel, alteeration, , or
Address: 15495 SW SEQUOIA PARKWAY, SUITE 100 extension. Describe: / /
Page 2 C7. RI 2
City /State /ZIP: PORTLAND, OR 97224 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 968 -3355 Fax: (503)- 968 -3398 Investigation per hour (1 hr min) 62.50
CCB Lic.: 161567 Electrical Lic.: 37 -1054 Suprv. Lic.: Industrial plant per hour 73.75
it J , w , x ELECTRICAL PERMIT FEES,` ' " y g a / ii
Suprv. Electrician signature, requ � �' Subtotal: �, i • p
Print name: STEVE MOREHOUSE Date: 10/22/2009 Plan review (25% of permit fee):
State surcharge (12% of permit fee): / y
Authorized signature: TOTAL PERMIT FEE: 5 2 ,
•
S ( This permit application expires if a permit not obtained within 180
Print name: 1 jl Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I: \ BuildinglPermits \ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB