Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
t m ; C COMMUNITY DEVELOPMENT Permit #: ELR2009 -00349
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/02/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9502 SW WASHINGTON SQUARE RD J03
Subdivision: Lot: 0
Project: AT & T
Project Description: Install low voltage for CCTV & security.
FEES
Owner:
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O Restricted Energy Permit 12/02/2009 $135.68
CARLSBAD, CA 92008 12% State Surcharge - Electrical 12/02/2009 $16.28
PHONE:
Contractor:
SECURITY PROFESSIONALS
911 MAIN ST, SUITE 101
VANCOUVER, WA 98660
PHONE: 360- 574 -5329
FAX: 360- 571 -8715
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: N Boiler Controls: N
CCTV: Y Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $151.96
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
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. ATTENT • • •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0. • through OA' • 52 -01 • 100. You may obtain a co.y of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued =y: 4 rd�� Permittee Signature: I ° 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 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.
•-..,,,
- Dec 02 09 08:40a Security Professionals 360-571-8715 P-1
Electrical Permit Application RECEIVE is -1..,..,. r..:.'•!,,,FORO.F.FIE USF.ONL,l'.."„iA 4 ,?; :; . q?
. -..... '''•ff S.:e. , ..1 L ' I' .; . : • .1 -.. ,' . '.1 *,,-.' ,- 0 .' . -'., ,;.'...... - • ..r, --. ., - ..
Tigard
iiii0. 1* • 13125 SW Hall 131vd., Tigard. OR 972
1
- :---', : Phone: 503.639.4171 Fax: 503.598.1960 DEC 0 2 2009
. Received ,,,,, ,0 / _ • rerm N,,, #0 7 60 y.... _ e:::4 o jie?
Plan Review
Dale/By: Othet Permit:
I nspection Line: 503.639.4175 CITY OF TIGAR By: D
Date Ready/ JUllS: fil See Page 2 tor
• g; i l l . 6 2 . Vi.j.ILI Internet: www.tigard-or.00v BUILDING DIVISIOKifireMethod: Supplemental information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 F.c(s of plans %Own:5 checked below):
0 New construction n Addition/alteration/replacement
- 0 Service or feeder 400 amps or more 0 Building over three stories
. ,
D DCMOlill011 El Other: ; /1'3/."../ // -.--* • - ,,, :1'1 : ;4 r ji •' ,/,', 8,,,./ ,vhere the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTREJ If ION ,...4 .....), exceeds 10,000 amps at 150 volLs or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commemiakise agricultural
0 1 - and 2 dwelling cgt Commercial/industrial El Accessory building amps fur all other installations. buildings.
0 Multi 0 Master builder D Other: 0 Fu e mum,. 0 Installation of 75 KVA or
0 Emergency system larger separately derived system.
.10B SITE INFORMATION AND LOCATION 0 Addition of new motor load of
1001 or more. occupancy
i .5 s tob no.: Job site address: t c,, ,:::.,. t . , - . • Sr S', /2d.
i /t c.ii - , ED Six or mon: residential units. 0 Recreational vehicle paiks.
01 lealth-carc facilities. 0 Supply voltage for more
' than
City/State/ZIP: 77 e c , 1 . - ? ../ / r X. ( s i• 7 .,.. J :3 0,1a m
vardous locations. 600 volts nonial.
,
Suite/bldg./apt. no.: Project name: 14 T Le:7-- 0 SerViCe of feeder 600 amps or more.
' FEE SCHEDULE
Cross street/directions to job site: S .7„...„ 1. ../77,) ;LL% Description o. Fee. Total i •
/
New residential single- or multi-family dwelling unit.
i . 1.
<--- - , 4
(.... f•-• i'; I, t,I ,(,1 r....,,H . -- T: c ) '77-,/ ; ) ( j ) 77 7 .,. ! ; . ; :,-.), , y7 -,,,-, . _P /.7 ( /1, ' 1 includes attached garage.
. r
Subdivision . 168.54 4
'? •'2 ' / ' Lot no.: 1,000 sq. ft. or less -
Ea. adcfl 500 sq. ft. or portion 33.92
Tax map/parcel no.: Limited energy, residential 67.84 1
DESCRIPTION OF WORK (with above sq. 0.)
1,imited energy. multi-family 67.84 2
Trq t I .c. '' s i 1 , .1; ,- - ./ ' r : 11 : ,-/2,-';, residential (with above sq. ft
,, .)
/ Services or feeders installation. alters ion, and/or relocation
..
200 amps or leas 100.70 2
.. -
8PROPERTY OWNER 0 TENANT 201 amps to 400 amps 133.56 2
--- ' 4 '. // ----- i• 401 amps to 600 amps 200.34 2
Name: 7 ,.-: / i ; ; L " __.t /", .1 ) r' ok
-- 601 amps to 1,000 amps 301.04 2
,
Address: ti s -- t 71 3 4..., L , /,,, __(. / . 1.. S ,,, ,.. i , ). 4 . / e .( Ovcr 1.000 amps or volts 552.26 -,
-
' 2 ', Temporary services or feeders installation, alteration, and/or
City/Statc/ZIP: T ., ,, ,,,/ ck j 7 , , : d..2 7,
I. ' _ relocation
Phone: Fax: ( ) 200 amps or less 59.36 I
amps to 400 amps 125.08 2
Owner installation: "Ibis 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 l'or branch circuits with
VI APPLICANT 1 C] CONTACT PERSON above service or feeder lee, 7.42 -
each branch circuit
.--', -
B m
usiness une: ... 1 , 7(: ,,, , ,_ , / ,.., ; ,.;., ;,, , 715 I3. Fee fig hrtinch circuits
i without service or feeder fix, 56.18 ,
,.
Contact namc• " ' ' /./ first branch circuit -
z.:, Each addl branch circuit 7.4 2
Address: 9 / 4,1 / , ,, 7 S' i - ; ,/ r i c / y y
Miscellaneous (service or feedc nol included)
City/State/ZIP: t ( //7.) ( i,e, ,,-..7 (-;,,(,. Each manufactured or modular 67.84 2
dwelling, service and/or feeder ,
Phone: (3, ) 5 . 79 - __ - Fax: :(3 ::, 7/ _,, 7/ 5--- Reconnect only 67.84 2 _
Pump or irrigation circle 67.84 2
E-mail: 23 et/. ti 4 s :: /.,.../ 1 ,... '' f,:,---,4- , ,,-/- ./),--,:!' _____
co 'TRACTOR Sign or outline lighting 67.84 2
. .,.. Signal circuit(s) or limited-
I3usincss name: C... ; -J!-- p / .„ ) ,( 1 , s , f .,.., 40 1 , energy panel, alteration. or
'-`. / . extensio9. Pc:scribe: 2 Page 2 2
Address: 7/ / .. .4 ' i ,, ,--,) c,/, ./,, /6 ( abli 4 P-id-.
.
Each additional inspection over allow: hle in any of thc above
Cit y/State/ZIP: /,',.. 1. 7 , ),; „-.. / 4 c /.1 `7 ill,. (,',..' C;)
Per inspection 66.25
Phone: ( 2 ,0( 2 ) s 7 ey - 4; 3 )' I Fax: Qk.c.) ) 5 2/ -- 7/ 5--- _ Investigation per hour (1 fir min) 66.25
78.18
\ ‘k CCB Lie.: i'2 3 cii (. Electrical Lie:37.339001 Suprv. Lic.:33y ir/j . Industrial plant per hour -
IT FEES
- ELECTRICAL PERM
Suprv. Electrician signatur suire
e. ci: "_, i 7',.• ,,,,.'.•('-.1;. Subtotal: I j
.. _
i , , ,, r /,... , ,
Print name: --- -- rc , / : ? 1 , .. ,, , •/ ,... i Date: i /.. .,) :,,-,,
it" ( ,: / • ,.. //
Plan review (25% o1 permit fee):
State surcharge (12% of permit fcc):
-
Authorized signature : .4r Awe& ,' "FOT AI_ l' ER M Ft FEE: ( ''c,,•'. •',7&
- linguic ,
' • - - ' . This permit application expires if a permit is not obtained within Iso
Print name: r (..-).-Kt-f-L.i.:.- i Date: 1 2_( 76)7 _____ days after it has been accepted as complete.
CI- • Number of inspections allowed per penult.
430-41, t sTi 1 unSicom
I: \Building\ Pei rnitsTI.C.PermitApo duc 10101/09
-Dec 4 02 09 09:54a Security Professionals 360 - 571 -8715 P.3
Electrical Permit Application - City of Tigard �j 3�
Page 2 - Supplemental Information // / 2-C / J
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined........ $67.84
Check Type of Work Involved:
\udo and Stereo Systems*
I [ Burglar Alarm
I I Garage Door Opener*
I Heating, eating, \"cntilation and Air Conditioning System*
I I Vacuum Systems*
[ 1 Other:
COMMERCIAL WORK ONLY:
Fee for each commercial S67.84
system
(SEE OAR 918- 309 -O((t )
Check Type of Work Involved:
[ Audio and Stereo Systems
1 I Boiler Controls
7 (,lock Systems
Fl Data Telecommunication Installation
I I Fire .Alarm Installation
MAC
I 1 Instrumentation
I Intercom and Paging Systems
I Landscape Irricat.ion Control*
I 1 Medical
I 1 Nurse Calls
[ Outdoor Landscape Lighting*
Protective Signaling
[ Other C CTt .
Total number or commercial systems: •?�
*No licenses are required. Licenses are required
for all other installations
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