Permit 3.4L1 0 Gtadec (t) owj to /( -
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' a COMMUNITY DEVELOPMENT Permit #: ELR2010 -00125
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/20/2010
Parcel: 1S136DC04400
Jurisdiction: Tigard
Site address: 11945 SW 70TH AVE
Subdivision: DARTMOUTH SQUARE Lot: 30
Project: TVF &R Command Center
Project Description: Audio and video. 8/24/10 added (1) audio and video system.
•
Owner: FEES
TUALATIN VALLEY FIRE & RESCUE Description Date Amount
20665 SW BLANTON ST Restricted Energy Permit 07/20/2010 $75.00
ALOHA, OR 97007 12% State Surcharge - Electrical 07/20/2010 $9.00
PHONE: 503 - 649 -8577 Restricted Energy Permit 08/24/2010 $75.00
12% State Surcharge - Electrical 08/24/2010 $9.00
Contractor:
SMARTER SYSTEMS LLC
1237 RIO GLEN DR
EUGENE, OR 97401
PHONE: 503 - 522 -2970
FAX:
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: Y Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $168.00
Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N 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 O • ' 952- 001 -0100. You may obtain a co. • - - or direct questions to OUNC by calling 503.246.6699 or 1.800.3 2.2344. '
I Issued By .. ice_ I s� Permittee Signature:
111
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' 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.
v CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
.e COMMUNITY DEVELOPMENT Permit #: ELR2010 -00125
' ' Date Issued: 07/20/2010
A f Gkikb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S 136 DC04400
Jurisdiction: Tigard
Site address: 11945 SW 70TH AVE
Subdivision: DARTMOUTH SQUARE Lot: 30
Project: TVF &R Command Center
Project Description: Audio and video.
FEES
Owner:
TUALATIN VALLEY FIRE & RESCUE Description Date Amount
20665 SW BLANTON ST Restricted Energy Permit 07/20/2010 $75.00
ALOHA, OR 97007 12% State Surcharge - Electrical 07/20/2010 $9.00
PHONE: 503 - 649 -8577
Contractor:
SMARTER SYSTEMS LLC
1237 RIO GLEN DR
EUGENE, OR 97401
PHONE: 503 - 522 -2970
FAX:
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: y Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $84.00
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: N 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 ma obtain a -- • • o the ru - or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B . /� + 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' 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 uoli.e11 I Ir i.,(isi ,ONl.l -
City of Tigard ���I - Permit No.: lc ,
11111 13125 SW Hall Blvd., Tigard, OR 97223 V an R eview
C Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
1 -1 c i RI) Inspection Line: 503.639.4175 c� A , 1 DAte Ready/By: ® See Page 2 for
• w
Internet: ww.tigard- or.gov 1 :0. . ; 60 L •N13tified/Method: IM Supplemental Information
' TYPE OF WORK - t OF•TIGAR 1 PLAN REVIEW '
C I 1`I Please check all that apply (submit 2 sets of plans w /items checked below):
New construction ❑ Addition /alteration/replape 11fu DIV ISI 400 y ( p ):
tS U ► V ❑ 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.
Tess 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 site address: 1 . I 10OHP or more. occupancy.
Job no.:
l ( � �� Jam+ • 7U� ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: • ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 7- j 1� , ❑ Service or feeder 600 amps or more.
"�" FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 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 168.54 4
Ea. add'1 500 sq. ft. or portion 33.92 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
dot C 1) ek LA01 d h uM S C /� residential (with above sq. ft.)
at y Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State /ZIP: relocation
Phone: ( )
Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I 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 168.54 2
Branch circuits - new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
•
CONTRACTOR . _ Signal circuit(s) or limited- energy
panel, alteration, or extension.
Business name: ,,,�,,, c P age 2 -7 -- 2
/YWt V^ S. Sfrfi'S L G(• Each additional inspection over allowable in any of the above
Address: Additional inspection (I hr min) 66.25/ hr
City/State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr
specifically listed (/2 hr min)
CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: -- cfc�
Plan review (25% of permit fee):
Print name: Date: State surcharge (12% of permit fee): -r t CSU
' TOTAL PERMIT FEE: Si j�� Vd
Authorized signature: This permit application expires if a permit is not obtain within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
I: \ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
• Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
.COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape•Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 07/01/10
err
Electrical Permit Application \,� 1 c)lt till 1(1 til ()NI
1 a ` ; '*' R eceived
City of Tigard .� M - Permit No.: "� • AI a
?c9° Date/B
. ° 13125 SW Hall Blvd., Tigard, 0 ,23, o1� Plan Review
.. Phone: 503.639.4171 Fax: 503. 1960 i % (- Date : Other Permit: j Wl o — 0 v
i i � , 1 . i) Inspection Line: 503.639.4175 0\-- P A Date Ready/By: Juris• ' RI See Page 2 for
Internet: www.tigard - or.gov r - -`.i�kr �q \ Notified/Method: Supplemental Information
/'nl 0' . ‘,f.ACp
'TYPE OF -WOj %\ ' `.) PLAN REVIEW
�A., \iT.
❑ New construction ❑ Addition/alteratlrepl
�' + a cement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more 0 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 ❑ CommerciaUindustrial ❑ 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 ", "1 -2 ", "l -3 ",
Job no.: 3 0 0'7 0 Job site address: 1 i 0, LA 10 7 J 4 40E 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: T / ., 1 -t Q ❑ Health -care facilities. ❑ Supply voltage for more than
ty 1 1 ✓ Alt ` L t L� lL ` z J ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: " T `J ❑ Service or feeder 600 amps or more.
FEE SCHEDULE.
Cross street/directions to job site: z "0 ' O 3 o ✓T(—{ Description 1 Qty. 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 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 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
Al o i 6 - k.) 1 0 ED residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER - ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: "T„ fa tA Tl n j J 1 ..E\ 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: /State /ZIP: Temporary services or feeders installation, alteration, and /or
ty relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: 51,14e1 t-rt s y <'ta'' S L U c — B Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: AvokE� T A(,kj2 branch circuit
Each add'I branch circuit 7.42 2
Address: i z ... 2 ) ') ..1 c.> G- t' N 0 Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State /ZIP: v a-Fti6 ! U 2 1 �� V dw e lling, service and/or feeder 67.84 2
Phone: ( S Z Z Z 91 p Fax: : (5�,) 8 ( 4 4 0 0 8 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: 0 \ ( 1 y g 5✓h 'trie y s rE M S Li, C.. . C U""`
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: � �- panel, alteration, or extension. ` Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr
C specifically listed ( ' /: hr min)
CCB Lic.: , 8�� q Z sy. Electrical
/ t J- ✓ 1Z rv L ic.: 3 7 Z L � ,� ELECTRICA PER MIT 'FEES
arl �idatL / / .;t Subtotal: '7 UU
Suprv. Electrici re, required: Plan review ( 25% of permit fee):
Print name: AN i' Q , C T �� Date: 7 40 _10 State surcharge (12% of permit fee): d ; 00
i �� TOTAL PERMIT FEE: VI n U�
Authorized signature: r, This permit application expires if a permit is not obtained within 180
D days after it has been accepted as complete.
Print name: D R C nip( C C&. Date: t U * Number of inspections allowed per permit.
I: \Building\Permits\ELC- PermitApp.doc 07/01 /10 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: • •
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY: . ,
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check T ork Involved:
Audio and Stereo Systems
n B • oiler Controls
n C • lock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
n P • rotective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building\Permits\ELC- PermitApp.doc 07/01/10