Permit r '
;■ CITY OF ®R ® ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00479
D; DATE ISSUED: 12/26/2007
TIGAR
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102A6 04800
SITE ADDRESS: 12454 SW MAIN ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: COMMAND CENTER STAFFING
Project Description: Low voltage protective signal.
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
CAPISTRANO, NICOLAS N + CHRISTIN BRINKS HOME SECURITY
6646 SW 35TH AVE 8080 SW CIRRUS DR
PORTLAND, OR 97221 BEAVERTON, OR 97008
Phone: Contact #: PRI 503 - 641 -0287
FAX 503 -641 -0960
Reg #: ELE 34- I66CLE
FEES LIC 44421
Description Date Amount SUP 3213LEA
[ELPRMT] ELR Permit 12/26/2007 $75.00
[TAX] 8% State Surcha 12/26/2007 $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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 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'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.
-- 12/25/20 07 23:22 5036410960 BRINKS HOME SECURITY PAGE 01/03
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Electrical Permit Applicati 1 3 EGENET)i ; ''' �, r r3R of i 1cE i usr OiNI 1 ti . ; _ --
City of Ti and Received /
�J g nn re ll3 : /� / Permit No. // — D �r
n 13125 SW Hall Blvd., Tigard, OR 97223 2 6 2 �'�'
nn Plan Review
''' ° . :;'... i Phone: 50 3.6 39.417 1 Fax: 50 3.598.1969)EC Other Permit:
Date/By: Ins Ctipn l.inc: 503.639.4175 � �( Y Q
Inte t '�' l�,tc Ready/By' ,torts: I ® See Page 2 far
TIGn, Internet! www,tigard- or.gov WY /�, t � ! ®- Notified/Method: tP -
\71DtpR� Su t {emen infnrmntinn
4 fit i t n ' ;y; P jL1 t i I U1 t ,, • 11' . >19/1,,i; r i)Cl 1�1CC';y i,•, „r• , • • .. 1 �} . )g r 1 i'it,1 ...., y� ypp i 3 7{rp ( 7 t o j i d g1 , :
,. n11:10 (ij 1 v i f ;(; OtIt �i 1, p�4 , {tl , , " I , a 1 i , t j ' ,'� yy I, nSU� tit �f1i r i '',�Sil d , 'fh4h R 1'1 1 I i f !`F �, �+ A � rvrl Vin' 1 N 4ll �I I y ��i;l+:1tiE,
kr &c'l'inic`'' i . , , f t1,Hjlr ,,., 1! ; yi,�Iliif:
7MLY , � , 4.,.., .,...,.. ,;,, !.,, � ,i' a�7N 6 'l .! .. 4' h t ”I) , }h - II + �11 9, �tN � . 1 ,,! ',., IIJ,1 ") 1 Li rl
Please check all that apply ( <nhmft 2 acts of plans w /items checked below):
® New construction El Addition /alteration /rcplaccsment
['Service or fccdcr 400 amps or more I] Buildintt over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
� I r>n 1
i a ,', , 1l `" 7 °' i w t ;:• J� i i` 1'J ' 'ti' `" cxccce 10.000 amps ai 150 volts or Floating buildings.
f ;. : ''. i :; ' aG . , .. 1 l i d , - ,,, i 1., IE , • ∎ -5 ' 5 " r ,.(" 5 , fir. 1 „•tla d
: + I tll n a s.
s
' � - 1ccv to gmund, or cxcccde 74.ann ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder p Other: ❑ Fire pinup. ❑ installation of 75 KvA or
.l #61j t8#t � ji91 1 t'4i ' {� "'1 ”" I" I Ji7iF1P 1111 4r '`.: },;ar:� Additi system,
I largerseparate y derive ..system.
�..- , �t k1i' l+l tiv ., 1':ti i drip r ,e-n— (;�rRi.. �Rw l,,ji,,; z; : tvil∎rz all, ,. � ,. 1 4 1:01 � 5; �, I5 1 , I ry: 51 i 1:1 /tddltian of new motor Iond of A „ 4, .. 2 . 3 . ;
Tob no.: 71244210 Job site address: 12454 SW Main Street toolrP or more. ❑ occupancy.
❑ Six or more msidential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ FTcalth -care incimics. ❑ Supply voltage for more the,
❑ Hormrdnns jncnlions. 600 volts nominal.
Suite/bldg. /apt:. no.: ' Project name: e = ❑ Service or fccdcr 600 amps or more.
41.i... 41.i... ;t.. - - '- - -. ,P,ii I 'P1t 11 ;tit { ..,.' 4 Ai • m 1 1'inli l i I i O',`l 'l1', n! rl.
Cross street/directions t(1,lob site: Description Qty. Pre Tidal "
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.11. or portion 33.40 1
Tax rnap /parcel no.: Limited energy, residential
i o 44i1fl Ii nH �i;tili I! J� 11` I n(t6Y "G•tS,�;1a1 '7� y�.yry *10)Jb A i (1 Ii '4r i '"i�t ryil/i • (with above B . ft• 75.00 2
it ilk;tla� C,'T!h?_ er,_illi {,f_ _ fir _11'1�S "t1 W __ __ lf�ff > ,`1f 4ii �`4!`c11 ati r.+W, N i i It•.�•,T.,E
;ii,,. ire• t; r a�� w , r r ut it is { 9 )
i V Alarm installation Limited energy. multi - family 75.00 2
residential (with above an. R,)
Services or feeders installation alteration. and /or relocation
200 amps or less 80.30 2
iw' }Y� II �:c v I" i "''i�41; it "d9a ft' n;� It' urvrtucn:d`YI`ttiiY !E' ; I
• t,�f;4 m' „Mtn' 1 " ".1 r,v,1 Is t 1 a Gi" I v�� , n' a 'n,1 I f j� ��,. 201 a s 10 400 amps 106.85 2
, 1 '; 1 , a d,,, f,,..,,.,.,ItIF fi ', 1 Q.. I L ,� 0„.3.,4,',!7...". 1 ,I.I.iF, llii;4f i4 . Y 4 i P p
Name: 401 amps to 600 amps 160.60 2
601 amps to L000 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 l
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
g A, Fcc for branch circuits with
11 rt� i+ 'tt t c i. r I ` I 1 �l iiTt ill{` �jb d 31 " �'10 �¢ A I �i {niP'� above service or fccdcr fce, t i'
IGf'S14it �,1ll , t, -1hi 3i 1 1 Hii,ht,_I sla�t;lin,� ,.4 F n, 1 .f1sY .t �, Ml�huty. {�, , 6.65 2
each branch circuit
Business name: Tigard Command Center Office B. Fcc for branch circuits
Contact name: Ben Klecker
without service or feeder fce 46.85 2
first branch circuit
Address: Each add'l branch circuit J 6.65 2
Miaccllnncmta (service or feeder not included)
City/State /ZIP: Bach manufactured or modular 90.90 2
503 691 -8555 Fax: ; dwelling, service and /or feeder
Phone:
(503) ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
019;1,M!ilsl{ign tj"l sMrtilintla sl l R.,4C'�V'. h. 1'!C 'OCk ? .,stilIie iNWli ;;1� �r%I f y V4 sign or outline lighting 53.40 2
Signal circuit(s) or limited-
Business name: Brinks Home Security
energy panel, alteration, or
Address: 8080 SW Cirrus Drive extension, Describe; 1 Page 2 75.1)0 2
City/State/ZIP: Beaverton, OR 97008 Each additional inspection over allowable in any of the above
�[ Per inspection 62.50
Phone: (503) 641 -0287 W D Fax: (503) 641 -0960 Investigation per hoar (1 hr min) 62,50
CCB Lic.: 044421 l ' •1 . Electrical Lic.: 34 -166CL Suprv, Lic.: 3213LEA Industrial plant per hour 73 75
ql • , i1i i F a i , I ' • . t . ..
` 11 i k x 7'`1 3$°f ) 1
dal) ,�,�91: Y'S�4, , . . 3 aiU'ah7i ...
Suprv. Electrician signature, required; Subtotal: 75.00
Print name: Kevin Tucker Date: 12/26/07 Plan review (25% of permit fee):
State surcharge (8% of permit fcc): 6.00
Authorized signature: TOTAL PERMIT FEE: 81.00
This permit application expires If a permit is not obtained within itt
Print name: Jackie McKcc Date: 12/26/07 days after it ham been accepted an complete,
• Number of inspections nilowcd per permit.
1 :1RuildinglPcrmltal- C•PantItAOp tine 05/23/05 44n A6t 5T(11 /05 /coM tvaa