Permit =y CITY ® ® ELECTRICAL RESTRICTED ENERGY PERMIT
. COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00013
TtGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/17/2008
PARCEL: 2S110AA- CCO5201
SITE ADDRESS: 10831 SW CANTERBURY LN 201 ZONING: R - 12
SUBDIVISION: CANTERBURY CREST CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: WRIGHT PROPERTIES
Project Description: burglar alarm installation
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: BURGLAR AL X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WRIGHT PROPERTIES PROTECTION ONE ALARM MONITORIN
11725 SW QUEEN ELIZABETH 15500 SW 72ND AVE
PORTLAND, OR 97224 STE. 100
PORTLAND, OR 97224
Phone: Contact #: PRI 503- 624 -0244
FAX 1- 866 - 223 -9925
Reg #: ELE 34- 428CLE
FEES LIC 116325
Description Date Amount
[ELPRMT] ELR Permit 1/17/2008 $75.00
[TAX] 12% State Surch 1/17/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: if ,�� ��� �� _ Permittee Signature: X/���
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:
Cali 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.
JAN. 16. 2008 2:52PM NO 306 P 4
Electrical rermit Application � . ,
1 (lit t ■FH( , , I V , i
T' City or Tigard T 0:-14,-VIF:wajaturave! - - 11(0 a j Fcrut No' . ko' Q.0 3 .. 2- 4 13 SW Hall Blvd„ Tigard, OR 9 f :� + , -
P 1anReview Other Permit:
; Phone; 503.639.4171 Fax: 503.59 + 1 V- i OUD Datc/By:
"..,,, 1•t <:1: pecaonLine: 503.639.4175 1 CO DateRendyBy: tax See Page2for
t -::' " Internet: www•tigard- or-gov 3 I• t o ^, Notified/Method; Supplemental Information
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t! - r . , r i 'jl't' 65 ?!It ttl• tlF t ( ,; I ! , t l .• 1" �)ri � q If ill I • nnv n t� ti, t. t FEtIS, , "� 1 ,.�
1
"."''''l it I Ttl:.''6;71'1. l 1 7) 1 i n 'I' i 1 r i il�� 1 Ili ' I • l r� IR`i i,li�n J,
1111 ll� � r, � � 1 .. � , I�f� s ari ilf�li�tlf(���a �� � tgt i ll�ira l �;tlil�� �r t �>,: �Ip 11'It�i'a;.�,�t!i111i {li . r_ iii i . I �� t 1 1V�1 � . ,I � rill .., • •
11 il_1 <<�, ft., -: ,1 a h�`ifll� � f
❑ New construction '4 Addition/alteratno '47; k - t Please check all that apply (submit2 sets of plans w /items ehcakod below
❑ Service or feeder 400 amps or mote ❑ Building over three stories.
❑ Demolition ❑ Other where the available fault current ❑ tvlarinaa and boatyards.
I eIt 1 H nt a nl g a ; l y nt« t I tat`
� ,,,; I , #{ ..,. ,i l t . u' r y . e p, t>i t ill exceeds 10,000 a at 150 volts or Floating buildings.
,(;I I "� ��• . !. ��IIII� I •11 I Il rli 1tHI• �� a �tiFLnLE� in3 iid➢rt tbll•II ?IE}iGt� I 1 1 � ..I f It rt i Icaa to ground, or exceeds 14,000 ❑ Co,nJncrcial•ule agricultural
❑ 1- and 2- family dwelling f! Commercial/industrial ❑ Accessory building amps for an otter installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: Q Fire PUmp• In Installation of 75 KvA or
! la 1•' I, �ryt�t�eH lit +uul i II nr / e�l �t t• n I lttt)s t)3 } aEI [rtPt� # nt�! ttitp lJ , l I! (I' I , • -� - im % ❑ Emergency system. larger acpatatoly derived system.
.. i.. ?E ..,
,,I #,.t i" . IB 4 I „, 1 4 1 ,, 7 t r 1u l i s t l • ., 1 I , ,, ❑ Addition of raw motor load of ❑ , •Ao ugn u1-2", u1-3°
r d I 1 � >f , tigi ,l I i s II ado ! IP a f r !s�u EI U�Uf,tll i t I111 ii
Job no.. Q f • r 0 Job site address: a ; 1ooi or ore mai occupancy.
,�:. ti r_ `.�� =•/ [ � ❑Six or mom rcaidcntisl units. ❑ Recreational vehicle parks.
City /State/Z1P: �W�� C� Hcalth- ❑ Supply voltage for more than
OR - ('] Hazardous locati 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project namenk i1 C AT ` y� Vt e ❑ Scrvico or feeder 600 • s or morn.
1111 lllllf11 flllflilKEy` 'J !!J91!;y11: ID IEM _.:.
Cross street/directions to job site: nes osarn ow. Fee. Twat •
New residential single. or multi•fanilly dwelling unit.
Includes attached . 'rage.
Subdivision: J Lot no.: 1,000 a.. ft. or less 145.15 4
Ha. add'1500 s . . ft. or portion Mil 33.40 1
TeX map/parcel no,:
IIIII1 lliill {! llfl ll 111 llllllll� a i;;;f��,� I!: f lit M I i1 11111111111111111111111111111 (with abo residential 75.00 2
Limited energy, multi - family
;11 �:1r , .1. _. :ti , C � .t= ` - n __ ∎ ' residential (with above sq, R) 75 -00 2
Services or feeders installation„ alteration, and/or relocation
200 amps or less 80,30 2
f I• =:��• y Y II Itlll � I , ! i 3 tlf I i'fl j y 1 201 a
I °4 Jil�lii� {l(, <I. t' . °t l' I tiia EUetii� �i lr 1 . Liiiihl�' Il iIIIII li 1 ,,t„ 5li� iiuial+R, rzilh9l } llf111111 mps to 400 atnps 106.85 2
Name.
t t_i_ r- 19 ! , f�l 1 i_? 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 11 7 5 54) 011 g f) .,e..4 5 77/• Over 1,000 amps or volts 454.65 2 "
City/State/ZIP: /) TLn 0, a 7 ?-2.T Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 55) (Ogg- - / t 2-, r1 ( ) 200 a • is 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 100.90 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: pate: Branch circuits - new or extension, per panel
A. Poo for branch circuits with
,,'v l ! I 1 , ,, 3 It,,,i) , , l 1 t1 . ii �; I . • 1 1 111,7 A ,1 ul li rt 1a t a crd ; I 1 ` 11 . above service or feeder ice, • III 'f illy : 411 1 1 1E111N II I1111 i� ..'„ !I I " 1l ► a l ;1h�lf „I r tfi ��l ,l�,�, l in it each branch circuit
6,65 2
Business name: D. Fee for branch circuits
Contact name: without service o r feeder fcc, 2
- first branch circuit
Address: Bach add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State /ZIP: Bach manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E-mail: Pum. or irrigation circle 53.40 2
lllililllfllill(I1:1! !.i iiillf 111 M(E(I ; „tR, rl,�', �, �MS' ll llllflli ?illl l€ICI@llAl MIVl!111 g iI Ml Sign or outline lighting 53.40 2
Business name: '1 C�, Signal energy p alteration, limited
o -
panel, atcr'a or ,�
2
Address; (r`10. -.. C ' l ∎ l extension. Describe: I Page 2 15°
City/State/ZIP: �� .1 • 11 Each additional inspection over allowable in . , of the above
` ^n � ' � ` � ` '� ' �� ` `` ` " Per inspection 62.50
Phone: (,_3 l.N ! 67_44 . Fax: ( &AO . _ n q . Investi per hour (1 hr min) 62.50
CCB Lic.: ( • -- c . , r;
Electrical Li" p rv; Lie.: Industrial pla �tITV, fX fr,I plant •er hour �t 73.75
- _.± . e 1�J, i} `,,�l; t l
i l :;,;,.. ,
Suprv. Electrician signature, required: �IOr 11111'11
!f I.xIN 0. Subtotal: 1'
Plan review (25% of permit fee)
Print name: � � � + � Date� /Orb,. State surcharge (8% of permit fee): _ it ,✓
Authorized signature: . l i� � ri 4• I _ TOTAL PERMIT FEE. �'
r This permit appAcatlon expires ¢ a permit la not obit w1 In 180
� 1,i +',.i Dad: M . day alter i t ltas been accepted as complete.
Number of inspections allowed per permit
h\BuadIn PcnnastB1.C.PennitApp.doe 05/2306 , 4404615r(i1ro5/COat/wna