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Permit
• - CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT Ilp ' ; °. COMMUNITY DEVELOPMENT Permit #: ELR2009-00093 T I G A R b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/27/2009 Parcel: 1 S 135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST Subdivision: Lot: 0 Project: Plaza West Project Description: Low voltage for fire alarm system. Owner: FEES PLAZA WEST LLC Description Date Amount BY NORRIS BEGGS & SIMPSON, 121 SW Restricted Energy Permit 03/27/2009 $75.00 MORRISON ST STE 200 12% State Surcharge - Restricted Energy 03/27/2009 $9.00 PHONE: Contractor: WESTERN STATES FIRE PROTECTION 13896 FIR ST STE B OREGON CITY, OR 97045 PHONE: 503 - 657 -5155 AX: 503 - 657 -5182 0 111. Type of Use: COM Class of Work: ALT • Total Number of Systems: 1 . Er illie udio & Stereo: Boiler Controls: CCTV: Clock Systems: Data & Telecommunications: Fire Alarm: Y HVAC: Instrumentation: Total $84.00 Intercom /Paging: Landscape /Irrigation: Landscape Lighting: Required Items and Reports (Conditions) 0 6 9 Nurse Calls: Medical: Protective Signal: Security Alarm: Other: 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: 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. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT inl g_. COMMUNITY DEVELOPMENT Permit #: ELR2009 -00093 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/27/2009 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST Subdivision: Lot: 0 Project: Plaza West Project Description: Low voltage for fire alarm system. • Owner: FEES PLAZA WEST LLC Description Date Amount BY NORRIS BEGGS & SIMPSON, 121 SW Restricted Energy Permit 03/27/2009 $75.00 MORRISON ST STE 200 12% State Surcharge - Restricted Energy 03/27/2009 $9.00 PHONE: Contractor: WESTERN STATES FIRE PROTECTION • 13896 FIR ST STE B OREGON CITY, OR 97045 PHONE: 503 -657 -5155 FAX: 503 -657 -5182 • Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: Boiler Controls: CCTV: Clock Systems: Data & Telecommunications: Fire Alarm: Y HVAC: Instrumentation: Total $84.00 Intercom /Paging: Landscape /Irrigation: Landscape Lighting: Medical: Required Items and Reports (Conditions) Nurse Calls: Protective Signal: Security Alarm: Other: • 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 d. • = in acco • • with ap• .• - d plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 18• days. ATTENTION: • • law e. • s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 -0010 through OAR 952 • . 10 o - y obtain a copy of t' e rules or direct questions to OUNC by calling 503.246.6699 or 1.800. 32.2344. ' f J Issue• By: , __ _∎ l 1 ■i& / / 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. EIiettrical Permit Application FOR OFFICE USE ONLY Daceived a,7�9 F3 City of Tigard Date/13y: 7 q Permit No.: f 13125 SW Hall Blvd., Tigard, OR • . " Plan Review C Phone: 503.639.4171 Fax: 503. - • 1 ' P t LIVE Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Buis: ® See Page 2 for Internet: www.tigard - or.gov MAR 2 7 200 Notified/Method: ' Co„ Supplemental Information TYPE OF WORK Ti , PLAN REVIEW ❑ New construction Additional l Ii Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: BUI C D \ ON ❑ Service or feeder 400 amps or more ❑ Building over three stories. 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 ,2Commercial/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 ", "1 -2 ", "1 -3 ", 60 3 7 Job site address: ©/ �1 �) /� I OOHP or more. occupancy. Job no. (9 4 Vo 5,W W. l /i4 k Sk ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: F 0474.441 6 q 7 Z Z,� ❑ Health -care facilities. ❑ Supply voltage for more than 't - / ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: (A Z .4- lAie it ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: S • w / '� E � � Description I qty. I Fee. I Total I • C j "42 J New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) / / Limited energy multi - family 75.00 2 a p ,1 S' Ito/ �.wc.t°i # 'S s r ; / a Lc.r !d! n� residential (with above sq. ft.) / v / ✓ Services or feeders installation, alteration, and/or relocation F OZP, X4/4 Alit C.,,,f' .4••.•- .. 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 I 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 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, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee 46.85 2 • first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: esre 2N ST.¢7GS' Ff26. 4,(. po_0 • 01 I energy panel, alteration, or Address: Ano? c Fir - � #�T n A 4Ofe extension. Describe: I Page 2 2 ct City/State /ZIP: 0 a � a 7 C Q / ) 4 • 7Q T r Each additional inspection over allowable in any of the above - Per inspection 62.50 Phone: j3) V Fax: (Sa3) Investigation per hour (I hr min) 62.50 CCB Lic.: /6 T 5-7 O Electrical Lic.: cit /0 81 Suprv. Lic.: ,t , 6) f Industrial plant per hour 73.75 -47 l O 1 • ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: • I • u t P Sn 9 � Su Print name: //� ,/f� mate: Plan review (25% of permit fee): 'KrQ, ' "" `� 1 a r �7c= State surcharge (12% of permit fee): Authorized signature: / TOTAL PERMIT FEE: 8. 06 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I :\ Building \Permits\ELC- PermitApp.doc 05/23/06 440-4615T( I I/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 ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ire Alarm Installation ❑ HVAC ❑ Instrumentation El Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PermitApp.doc 03/23/06