Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00329
DATE ISSUED: 8/30/2007
T1 GARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 115AA -00100
SITE ADDRESS: 16194 SW 108TH AVE * ** ZONING: R -25
SUBDIVISION: DURHAM PARK APARTMENTS LOT: 036 JURISDICTION: TIG
PROJECT: BRIGHTWATERS AT REDHAWK
Project Description: Replace fire alarm control panel and devices.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
DURHAM PARK LTD PTNRSHP SIMPLEXGRINNELL
1525 SW PARK AVE SUITE 200 6305 SW ROSEWOOD
PORTLAND, OR 97205 LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 503 - 693 -9000
FEES Reg #: ELE 26- 946CLE
L1C 149921
Description Date Amount
[ELPRMT] ELR Permit 8/30/2007 $75.00
[TAX] 8% State Surcha 8/30/2007 $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 more than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these
rules or direct • . -stions to OUNC at 0..246.6699 or 1.800.332.2344.
MOW -
Issued :y: �f / � Permittee Signature: 6P.
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'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
Received (� , a 5 i a _+ • , 3
City of Tigard Date /B : j1 Permit No.: /
Il ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C, • Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready /By: IM 1Z1 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK 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
❑ I - and 2- family dwelling I 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 LOCATION ❑ Emergency of n em. larger separately derived system.
lD 0 Addition of new w motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no. 1501(42,40 1 Job site address: �� D or
� ' ' 1 OO or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZiP: 0 Q G�2-2_� 600 volts nominal.
❑ H eal[h -care facilities ❑ Supply voltage for more than
i �1
Suite/bldg. /apt. ,. I C q y roject name: ,,,�,4 ,` g 2a� ❑ S e ❑ rvice or H a z ardous feeder 600 locations. amps or more.
�' "� FEE SCHEDULE
Cross street/directions to j0 site: Description 1 Qtr. 1 Fee. 1 Total 1 *
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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
aee. ■e C.iew. f t Pcid..ej residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
De—Ji 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
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: ( ) Fax: ( ) 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, per panel
Owner signature: Date: A. Fee for branch circuits with
g[APPLiCANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
��x����G r 11 branch
Business name: B. Fee e for branch circuits
without service or feeder fee,
Contact name:
C'S G, (: IA vv j i a& first branch circuit 46.85 2
Address: � std..) 2pse _t_....1=10:0 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
ty /State /ZIP: ��� 1 ��� l �� dwelling, service and/or feeder 90.90 2
Phone: ()�'S��� �y Fax: 6�� c,s--2._ Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
l (( Signal panel, or limited -
Business name:
S / C� r zb. �� \ \ energy panel, alteration, or
Address: C� d os Sw Kt�se��oot 5 ,�, extension. Describe: 1 Paget 41-4,„.5% 2
City/State/ZIP: L.c.7.L.,e_ w G Cie Each additional inspection over allowable in any of the above
7 Per inspection 62.50
Phone: ( ) Fax: ( ) investigation per hour (1 hr min) 62.50
CCB Lic.: q ` / g 2 _, Electrical Lic.: A. 7 �0s'Q . upry . Lic.: �Z L�' Industrial plant per hour 73.75
�7
Suprv. Electrician signature, required: �' ELECTRICAL PERMIT FEES Subtotal: St �.r
Print name: .°°' D. te: , Plan review (25% of permit fee):
is] a t ... A �t�A • • • O State surcharge (8% of petmit fee): Jr 6
Authorized signature: TOTAL PERMIT FEE: it S / i
16•_...t
—L r This permit application expires if a permit is not obtained within 180
• Print name: ra_ C� Date: ,� /'7Q /� days after it has been accepted as complete.
` e�e�[/ * Number of inspections allowed per permit.
1: \Building \Permits\ELC - PermitApp.doc 05/23/06 440- 46I5T(I 1/05 /COM/WEB