Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMTI"
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00425
TIGARD DATE ISSUED: 11/15/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113AC - 00102
SITE ADDRESS: 07250 SW DURHAM RD BLDG J - 900 ZONING: I -
SUBDIVISION: PACIFIC BUSINESS CENTER LOT: 025 JURISDICTION: TIG
PROJECT: STASH TEA CO
Project Description: Low voltage for access controls. Job No. P070277
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER:, CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: ACCESS CNT X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES SONITROL PACIFIC
15350 SW SEQUOIA PKWY #300 -WMI 8220 N. INTERSTATE AVE.
PORTLAND, OR 97224 PORTLAND, OR 97217
Phone: Contact #: PRI 503- 223 -5822
FAX 503- 973 -7773
FEES Reg #: ELE 26- 370CLE
LIC 53535
Description Date Amount SUP 3567LEA
[ELPRMT] ELR Permit 11/15/2007 $75.00
[TAX] 8% State Surchar€ 11/15/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 re_t ban 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a t forth in OAR95 :!1 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503. 46.6699 or 1.800.3' 344
Iss ed By: 0(e ` t/ Permittee Sig -ture:
OWNER INSTALLATION ONL
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'N: 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 Application FOR OFFICE USE ONLY
1,1 City of Tigard 9 CEI VED Received permit No.: j e(��"� a . ° 13125 SW Hail Blvd., Ti a rd, OR Plan Re : /� IS O I g Plan Review
' Phone: 503.639.4171 Fax: 503.598MI I yy 6 Ili / Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready /By: J— RI See Page 2 for
Internet: www.tigard - or.gov Q � CITY 01- I - ' /_AV ® Notified/Method: (Ca: Supplemental Information
TYPE O1MlNGDIUI. PLAN REVIEW
❑ 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.
CATEGORY OF CONSTRUCTION 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: P070277 Job site address: 7250 SW Durham Road 1 00HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: S 9e1D Project name: Stash Tea Co. ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Description I Qty. I Fee. I 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
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
Installation of Access Control residential (with above sq. a.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
'fir PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
I 401 amps to 600 amps 160.60 2
Name: C E! 2C2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: (513 ) 62e./.45.00 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
m A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
___ first branch circuit
Address: Each add'I branch circuit I I 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Sonitrol Pacific Signal circuit(s) or limited -
energy panel, alteration, or
Address: 8220 North Interstate Avenue extension. Describe: 1 Page 2 75 2
City /State /ZIP: Portland, OR 97217 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 223 - 5822 Fax: (503) 973 4773 Investigation per hour (I hr min) 62.50
CCB Lic.: 53535 Electrical Lic.: 26 -370 C Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 1 Subtotal: $75.00
Print name: 1 y Jj ( s a Date \ >..t__7 Plan review (25% of permit fee):
State surcharge (8% of permit fee): $6.00
Authorized signature: TOTAL PERMIT FEE: $81.00
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
1. \ Building \Permits \ELC- PermitApp. doc 05/23/06 440- 4615T(I l /05 /COM/WEB