Permit -. q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
,;_, COMMUNITY DEVELOPMENT Permit #: ELR2009 -00364
;TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 12/31/2009
Parcel: 2S112ACO2800
Jurisdiction: Tigard
Site address: 14865 SW 74TH AVE 280
Subdivision: METRO PART/MLP2002 -00007 Lot: 1
Project: Securetech Company
Project Description: Install restricted energy for security system.
FEES
Owner:
FANNO CREEK ACRES LLC Description Date Amount
14865 SW 74TH STE 300 Restricted Energy Permit 12/31/2009 $67.84
TIGARD, OR 97223 12% State Surcharge - Electrical 12/31/2009 $8.14
PHONE:
Contractor:
BROADVIEW SECURITY INC
8080 SW CIRRUS DR
BEAVERTON, OR 97008
PHONE: 503 - 641 -0287
FAX: 503- 641 -0960
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: e l AS 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' _0_
cep\ c n4 i nn 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.
y — ■
12/30/2009 19:48 503641096 n �, BRINKS HOME SECURITY PAGE 01/03
• Electrical Permit Applicatio FOR OFFICE USE ONLY
1. O Tigard Received I 0 •
II �' g D 31 2009 Date/13y: l.. Permit No. . _
° 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Review
;cw �� , � y
Phone: 543.639,4171 Fax: 503.598.1960 DaiciThy: Other Pcrm;Permit: 1
p CITY OF TIGARD is Rcady/By i C A r. n fns cction Line 503.639.4175 uses ady/Bv rnr;r,{ See Page 2 for
Internet: www,tigard or,gov BUILDING DIVISION Notified/Method; (.1 Supplemental information
❑ New construction ❑ Addition /alteration /replacement Please cheek all that apply (submit a sets of plans w/itcms checked below):
❑ Service nr feeder 400 amps or more ❑ Budding over three stnriee,
❑ Demolition Q Other: where the mmilnblc fault current ID Marinas and boatyards.
I tA11 ' exc eeds 10,000 am
.._ li l ' bi� CbIVS'1'EtUC'1hT�i1V' • ' I _ a pat 150 volts or ❑ Floating M1ildinRa,
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 0 Fire pump. ❑ installation of 75 KVA nr
Cl Emer rte system,
+ Be Y Y larger separately 4en.ed system.
t011 5fJ"t 1?<1 C1R II(S < A i:p�ATr�1N
, ' ❑ Addition of new motor load of ❑ "A" "F" M.7,", "1 �3 ",
Job no.: 91263350 Job site address: 14865 SW 74th 100HP or more. occupancy,
0 Six or more residential snits, ❑ Recreational vehicle parks.
City/State /ZTP: Tigard, Oregon 97224 ❑ f lenith.cate fncilitica. ❑ Supply voltage for more than
❑ tda7,ardoes locations. 600 volts nominal,
Suite /bldg. /apt. no.: 280 Project name: Securetech Company ❑ Service or feeder 600 amps 0? more,
Cross street/directions to 1"EE''5C1l LE1 '
o job site: Bonita
Dercriptlnn 1 Qtv 1 pee I • „T^rnl
Ncw residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: i,.ot no.: 1.000 sq. R. or less 168.54 14
Ea. add'l 500 sq. 1t. or portion 33,92 1
Tax map /parcel no.: Limited energy. residential
C'RP.111 �', JF' �YORiTt g} 2
fES
(with abov sq, R 6 7 .84
Limited energy, multi - family
Tow Voltage security system install residential (with above sq. ft) 67.84 2
- Services or feeders installation. Alteration, and /or relocation
„ p or less 200 amps 100,70 . 2
❑ P R t P F . 1 1 * T Y ' 0 0 ; 0 1 ,,j N,1ANT 201 amps to 400 amps 133,56 2
Name: James Koenig 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301,04 2
Address: 14865 SW 74 Suite 280
Over 1,000 amps or volts 552.26 � 2
City /State /ZTP: Tigard, Oregon 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)453 -4440 Fax: ( ) 200 amps or less 59.36 i I
Owner installation: This installation is being made on property that T own 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 599 amps I 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date. A. Fcc for branch circuits with
1: : ra APPf tCANT, . •;4 • ' • • •CONTlt,'CT .1'ERSO , above service or feeder fee,
each branch circuit 7.42 2
Business name: Broadview Security -
13. Fec for branch circuits
Contact name; Delta Danielson
without service or feeder rec. 56.18 2
first branch circuit
Address: 8080 SW Cirrus Drive • Each add'I branch circuit 7,42 2
Miscellaneous (.service or feeder not included)
City /State /ZIP: Beaverton, Oregon 97008 Each manufactured or modular
dwelling. service and /or feeder 67.84 2
Phone: (503) 641 -0287 Fax_ : (503) 641 -0960 Reconnect only 67.84 2
E-mail: delta. danicison@broadviewsecurity -com Pump or irrigation circle 67.84 2
' CONTRACTOR , ' � J �• -; ._., Si
• :_ Sign or outline lighting 67.84 2
Business name: Broadview Security Signal circuit(s) or limited-
energy panel, alteration. or
Address: 8080 SW Cirrus Drive cxtcnsion. Describe: 1 Page 2 G7.84 2
City/State /ZIP: Beaverton, Oregon 97008 Each additional inpection over allowable in any of the above
- Phone: (503) 641-0287 Per inspection 66.25
( ) Fax: (503) 641 -0960 investigation per hour (1 hr min) 66.25
CCB Lie.: 44421 _ I Electrical Lic.: 34 -166 Suprv. Lie.: 3213LEA industrial plant per hour 78.18 �
I`: ELECTRICAL ,YI• R8IIT f'FErS r • '
Suprv. Electrician signature. required: eir _/" w Subtotal:
Print name: Gary Kevin Tucker D /Z _,5 /.- / Plan review (25 %ofpermit fcc);
■ State surcharge (12% of permit fee): 8,14
Authorized signature: TOTAL PERMIT FEE; 75.98
Print name: I Date' This permit application expires if a permit Is not obtained within 180
days after it has been acrepted as complete.
Number of inspections allowed per permit,
r ;lRutidln a \Permitl\6LC•Pernirnpp,dnc 10101 /09
4 a 0 - afliT( /nc /C011N✓iiD
tQ\#Q secs n