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Permit
CITY OF 'TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2010 -00030 TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010 Parcel: 2 S 101 AC00900 Jurisdiction: Tigard Site address: 7128 SW GONZAGA ST 100 Subdivision: Lot: 0 Project: Holmes & Co Project Description: Relocate alarm panel. Owner: FEES BARMASS LLC Description Date Amount PO BOX 69409 Restricted Energy Permit 02/12/2010 $67.84 PORTLAND, OR 97239 12% State Surcharge - Electrical 02/12/2010 $8.14 PHONE: Contractor: TECHNOCOM INC 7929 SW BURNS WAY STE. F WILSONVILLE, OR 97070 PHONE: 503 - 682 -4195 FAX: 503 - 682 -2781 • 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: 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: Y 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 Center. Those rules are 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 503.246.6699 or 1.800.332.2344. Issued By: / I Permittee Signature: Qom\ P &� 'ei / 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. • Electrical Permit A licati.'" ECEIVED a :� 4 ; . � � 3 � :t: # z, ,' a F t)I If I l ti 1111, tr 'e. `:' " City of Tigard 2� B 77 E Received aA !r EZ/e,20 /0 _,,,,,, 3 0 ' • 13125 SW Hall Blvd., Tigard, OR 97 2 L Date/B /0 (. , • Pt tt,;e 1JU,; Plan Review _ W Phone: 503.639.4171 Fax: 503.5 0 Other Permit r Y OF TIGARD Dar` /Ra _ i 1ir`ta" inspection Line: $03,639,4175 irate Rawly/Ay t, *i•' 21 See Page 2 for i1 tu1t Internet: www.ti and- r ov wt L Notified/method: 1 i i & m li� t�>�;�`r,'�i� t'r<u °�'r� �.�� l eg ' � y f BUILD BUILDING DIVISION ad ;i l�."�''xr,�} i � „�,:,,P r `; - + . ,;, , a , �' , „ .,. � Supplemental Information . i . � �;., " e t a: niti rilii,X'Y.a,.�i ,4 . , m., ; ,ally..,,.;:,1,!. Inl:�l �1t �ilAtFS ” a 1 .: � 11ti 1J, a ' x . *. {! Y?ll.� fi t 1 1 r. � � a2°,I Please check all that avnly (sabmrt a sets of plates w /iWrlts chucked below): ❑ New construction ❑ Addition/alteration/replacement ❑ Demolition [lr6ther: YYI ❑ Service or feeder 400 amps of more ❑ Building over three stories, r b �1�o-�r = , , tubers the available fault eunenr r:1 Marinas and boatyards. (�f, r i .�� " "' ^ f y i ' 4 ^ i , e nn xceedls 10,000 i at 150 volts or 1 1 +� . C��,�i ^ ... 4 .f. w. x � i . , ������rt",'9�"4.� 1 �1"v!1 rxJ� ",'$ � �I��: -�'9a: ' �+r°".� ps . Q FlOaling buildings. les; to ground, or exceeds 14,000 ❑ Coaccocial -use agricultural ❑ 1- and 2- family dwelling G Commercial /industrial ❑ Accessory building ;apps for all other installations. buildings. ' ❑ Mulrt fami ly ❑ Master builder ❑ Other: 17 Fire nuulp. ❑ roilellation of75 KVA or 15 o yl �l e � aY ' t' �' 8 1 p ..a , y 1 4 1 + p F n 0 ' + i5'1 '0 ', ❑ Emergency system. larger separately derived system. �, xttt t '' #l •, , 1.:„1 t. 1 h.. t I . �'' I lvl IC 1! Ott ii sliw'r,.' +: fe ' ,, ,. ., ,. ,. , ;iii,;r,l IC ❑ Addition ufnew motor load of © "A ","1;", 'y 2 ", "1 - ", Job no. 2,317S4 Job site address: 7 1,20 b w 94 Q �Q Six or or ore m. occunancy. l ❑Six ur rrturu residential units. ❑ Recreational vehicle parks. City /State /Z1 P: �j /t /r jo / ' f ,CL CI 7 ['Health-care facilities, ❑ Supply voltage for more than + '`'`/� !/vl• u ! a v locations, M6� ox ' ' ,a1 1 Y �i 60) ohs ¢Otmnal, Su itz/151dg. /apl. no.: Project name: / S � Orix yV• o or f 600 ¢m ¢ of mote. R ,. t + ,. ,. r , , ,Tie :4 ieil lxd, . 1o;''' Cross street/directions to job site: `fi i v R'� ® ®4 New residential single nr multi - fancily dwelling unit. includes attached garage, Subdivision: Lot no.: 1,000 sq. ft. or 1e55 168.54 4 Tax map /parcel no ton why' 4()11 xq, ft. or portion 33.92 1 ,' x, map/ parcel r o X , ,- MITI P `k t s t, Limited energy, residential 7 rY 1 " v�, Y t e.,, r if p1nm, g MI :s `„ i ' i 1t! ( a 'h+w I t 7 !a: ° ,' to' 5 (with above s.. ft.) 67,84 2 1 L1 id 090 ) �j, � J Limited energy, multifamily 6/.84 2 V .Yl p I / • ` l residential (with above so, ft.) Services or feeders installation, alteration, and/or relocation X { A o r a 3 u i.+ s 6l p, e a - r 1 r x. tarp ro 2 amp or Less 100,70 UU Q ' ,,,.,i , „ ,., _, g �,, l 5a igy �i ! , , , a . 2 01 amps to 400 amps MI 133,56 1E11 Name: 401 amps to 600 amps _ 200.34 2 601 amp:: to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/VP: Temporary services or feeders installation. alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that 1 ot4n which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to a99 amps 168.54 2 Branch circuits — new, alteration, or ex_ tension, per panel Owner signature: Date: A. Fee for brunch circuits with r ,� . `' 1' above service or focde, fee, r „� � y �!�� gg ai7t y„.11i:,ti ' 0., �',, er ,ran+ gdlll °,i t :1 ^eR',.r. 16dk, ' k 7,42 2 each branch circuit Business name: i pizzoi/) ,N'f B. Fee for branch circuits Contact name: .../�� N+ rst Irhn anch servcice ircuui it feeder fee, 56.18 2 � ✓✓TJ . ' fi b r Address: /gig � cL) / ` (yl Z f 4 Each add'1 branch circuit 7.42 2 `7 1/0, ^ Vt ! , Mixrellnnenus (service rir feeder not included) City/State /Z1P: IISt� 7 V/ / be aYe) 707 0 ' Each manufactured or modular 67.84 2 // r dwellin •, service and/or feeder Phone: ( 1 � f� £ '7 / / F ax:: 6 , ; , 41 / Reconnect only 67.84 E-mail: / a /10 ' r' n • ,MAI r 0 eon Qp� Pump or irrigation circle 67.84 ® i�Ii rr1V'vc w, rt li` ytt:1,z xir tb.' : i "tm e ri . t k i, .' l a 7. 1 :1".110.01 li} r l ,�irl,i{ ig : i.Iiu Sign or outline lighting 67.84 Business name: —r ` � � /7 , crg pan al te i.(ar ration , or r o jl 0 � r ,-t � /9 L , / etler$y pn Address: / _...e a.) ' / / ,$ , extension. escribe: /m 01/11 Page 2 1 �/ � City/State /ZIP: l 1 / z ap I SM Vi ei / Q,0 Each ad ' itional ins r ection over allowable iu any of the above ) (/ / Per inspection 66,25 _. ( Phone: 0 / elitM• ✓ .Investi per hour (1 he mi„) -- CCI3 Lic.: / Electrical Lic.. -fi . e sup,. Lic, fr . Lfq Indubtnal plant per hour 78.18 1 #t MI ' � � �t�, { - t C' 1 1 y i���!F�� ti'�,tr� M. • Si t, `d�tl�'e N "yl: �JR�. � r r� lr Suprv. Electrician signature, required; J •S --4--J subtotal: (i, 1! Print name: (San d '1 i 1 Date: 4. 7_ 71,,Q Plan review (25% of permit tee): Illrelin State surcharge (I?% of permit fee): WarEll Authorized sigma e: '1.4....-. 1 / .4 TOTAL PERMIT FEE: 5 / . ', t ' This permit application expires if a permit is not obtained within 1: r Print name /� . alb h , -�, Date: Q r,7 1 10 dugs ufh-r it has hrrn urrwprnri art rnmplara C 1 / • Number of inspections allowed per permit, . I:\Building\PermitslELC- Per.,it •p.doc 10/01/09 440- 715T(11 /05 /C0M /WEB IQ_ Z10 -c) av Electrical Permit Application - City of Tig rd Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: i r n; * 4 .'MMONEM"' 1' t 1PIE Fee for residential systems combined ... $67.84 Cheek Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air ConditioningSycrem* ❑ Vacuum Systems* ❑ Other: Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: H Audio and Stereo Systems n Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ire Alarm Installation C V,,1 Q v�,� • ❑ I -IVAC 111111 ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irri Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling • ❑ Other • Total number of commercial systems: t *No licenses arc required. Licenses arc required for all other installations ii tuildic011PermilaLc- PnrmiiAOU.duc 10/01/09