Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
=" COMMUNITY DEVELOPMENT Permit #: ELR2009 -00284
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/03/2009
TIGARD Parcel: 2S112DC01400
Jurisdiction: Tigard
Site address: 15865 SW 74TH AVE 105
Subdivision: CREEKVIEW INDUSTRIAL PARK Lot: 4
Project: Cognex Corporation
Project Description: Install intrusion alarm system.
FEES
Owner:
JDS LLC & Description Date Amount
CRITERION CREEKVIEW LLC, PO BOX 6525 Restricted Energy Permit 09/03/2009 $75.00
BEAVERTON, OR 97007 12% State Surcharge - Electrical 09/03/2009 $9.00
PHONE:
Contractor:
ARONSON SECURITY GROUP
8089 SW CIRRUS DR
BEAVERTON, OR 97008
PHONE: 503 - 639 -9988
FAX: 503 - 684 -4357
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N 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
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: Y
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 0 952- 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: 9A/ ,0Gr(°�7%O,V
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 ' L�ppllCatlO F OFFICE USE ONLY
City of Tigard �������
- y g R eceived Q t / n Q
, 11 '%/ Permit :tilt: doo ' — AO 45d
13125 SW Hal] Blvd., Tigard, OR 97223
II
Phone: 503.639.4171 Fax: 503.598. i 9� P Date /B ` [r
® � 2009 P lan
Other mi
Da[eB Revie
TIGARD Inspection Line: 503.639.4175 Date Ready /By: ® See Page 2 for
Internet: www.ti and - or. ov CITY OF TIGARD Notified/Method: Supplemental g g Su lemen[allnformation
SIOI�
TYPE O PLAN, REVIEW'f,
❑ 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
0 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 ® 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 ", "1 -2 ", "1 -3 ",
Job no.: i( -i Job site address: 15865 SW 74 AVE 100HP or more. occupancy.
CI
or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 105 Project name: COGNEX CORPORATION ❑ Service or feeder 600 amps or more.
—
-: {,FE SCHEDULE . _ _
Cross street/directions to Job site: Description I Qty. ] Fee. I 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
reside ntial with above sq. ft.) 75.00 2
'►ns},,ll 'e>�-Yl.�sin alYr�n Sys ( q�
Services or feeders installation, alteration, and/or relocation
' 200 amps or less 80.30 2
'❑_ PROPERTY' OWNER ' 'ID„ 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 amp 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" " , f 0 CONTACT, PERSON ` above service or feeder fee, 6.65 2
each branch circuit
Business name: B, Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 I 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: ARONSON SECURITY GROUP energy panel, alteration, or
Address: 8089 SW CIRRUS DR extension. Describe: 1 Page 2 75.00 2
City /State /ZIP: BEAVRTON OR 97008 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 639 -9988 1' Fax: (503) 684 -4357
Investigation per hour (1 hr min) 62.50
CCB Lic.: 185024 9,15 Electrical Lic.: 26 -497CL /] I uprv. Lic.: 974LEA Industrial plant per hour 73.75
i ELECTRICAL PERMIT 'FEES
Suprv. Electrician signature, required: Subtotal: 75.00
Print name: JIM LEPPER Date: 8/25/09
Plan review (25% of permit fee):
State surcharge (12% of permit fee): 9.00
Authorized signature: TOTAL PERMIT FEE: 84.00 ✓ `
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(11/05/COM /WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDEN .TIAL 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 Aix Conditioning System*
❑ Vacuum Systems*
Other:
CONIMERGIAL WORK ONLY: . .
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
M Other Intrusion Alarm Systerm
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
1: \Building \Permits \ELC- PermitApp.doc 03/23/06