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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT � '• C OMMUNITY DEVELOPMENT Permit #: ELR2011 00027 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/03/2011 Parcel: 1 S126CA01100 Jurisdiction: Tigard Site address: 9009 SW HALL BLVD 100 Project: Target Subdivision: Lot: 0 Project Description: Access control system. Contractor: STONER ELECTRIC Owner: DAYTON HUDSON CORPORATION 1904 SE OCHOCO BY TARGET CORP T -0345 MILWAUKIE, OR 97222 PROPERTY TAX DEPT/TPN -0950 PO BOX 9456 MINNEAPOLIS, MN 55440 PHONE: 503 -462 -6500 PHONE: 612 -761 -1588 FAX: 503 - 659 -4968 FEES Description Date Amount Specifics: Restricted Energy Permit 02/03/2011 $75.00 12% State Surcharge - Electrical 02/03/2011 $9.00 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 Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: Y Total $84.00 Other Desc: Required Items and Reports (Conditions) 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 -0090. You ma obtain a copy of the s or dire, questions to OUNC by calling 503.232.1987 or 1.800.332.2344. IMP Issued By: it - - 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' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. Feb. 2. 2011 8:43AM Stoner Electric Group No.6526 P. 1 Electrical Permit Applicatio 1 (1P (11 11(1111(1 1 `I i l ■ 1, City of Tigard RECEIVED ®IZI rma _ •• 13I2S SW Hall Blvd., Tigard, OR 97273 ' C Phone: 503.639.4171 Fax: 503.598.1960 IRIIIMIIIIIIIIIIII Olbcr Penn& 1. • a I ` at 1 — ) ■ 1 1 c. A I c1 i Inspection Line: 503.639.4175 a . Internet: www.ligard.or.gov PLAN :REVIEW - Ic . I] New construction O TYPE OF WOR ddition/atieretion/replacoment Please check all MK apply(submit er sea of plare wruema checked bsi fl scovko or feeder 400 amps ormcsc ['Building over thee desks U Demolition ❑ Other where rho available faultctarent ❑Mazvaas arad boatyards • CATEGORY OF CONSTRUCTION . 10,000 amps al 150 voles or ['Flaming buildings. a - leas to ground, or exceeds 14,000 CI Commercial-use agricultural 1 1- and 2-family dwelling iri Commcrciallndustrial ❑ Accessory building amps For all odur'installations. buildings. LI Multi- family ❑Master builder ID Oilier El Fire pump. ❑Inslauuationof7$X.VAor JOB SITE INF ORMATION AND LOCATION ❑Addilro gym' larger separately derived spurn, n of rtewmotor lard of ❑ "A ", "H ". "1 2 ". "l - ". Job no.: j 3003 I Job site address: 9009 £4t) // q.r:,i� El 1001bP or more x Six or more residential ueik ❑Recrationalvehicle City /State/ZIP: 4ygr O� ©lrealthrare ❑ Supply voltage formocc ❑llasardous Locations. 600 volts nominal Suite/bldgJapt. —I Projoctname :7lsaeT ' 0'3 ❑ Seivice or feeder 600 sole or mora- - FEE SCHEDULE' Cross atreet/direotions to job site: nA�bnee ] oar. [Fee. 1 Teat ] • Now residential single- or multi - family dwelling unit. Includes attached garage Subdivision: Vol no.: 1,000 sq. ft or lose 168.54 4 Ea. add'l 500 sq.11. or portion 33.92 1 Tex map/parcel no.: _ Limited energy residenti DESCRIFFION OF WORT[ . (with above eq. B. 75.00 2 pp Limited energy. multifamily 75 - 00 2 T1� CAR i<evPA"'� "TTA 7�a rTi R e 7lrrC residential (with above a.. _ Services or feeders inalalldioh ellerallon, and /or relocation epx/fiitCi C- r3 CO/1%0 i 200 amps or less 1 100,70 2 fl PROPERTY OWNER . NANT - 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301 -04 2 Address: Over 1,000 amps or volts I 552.26 2 City/State/ZIP: /3TateJZlP: Temporary sorylces or feeders Installation, alteration, and/or relocation Phone: ( ) 1 Fax: ( ) 240 amps or Ices 59.36 1 201 amps to 400 amps 125.08 2 Owner installation; This installation is being made on properly 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 — aeW, alteralloo, or extension, per panel Owner signature: Date: A. Fee for branch circuits with above service or feeder fee Q ApPI ICANT ❑ CONTACT PR50N 7.42 2 each branch circuit , Business name: B. Fee for branch circuits without service or feeder fee, first 56 -18 2 ConTect name: branch circuit 1 Bach add branch circuit T 7.42 2 Address: Miscellaneous (Service or feeder not included) City/State/ZIP: Each l manuflcturcd or modular 67.84 2 ng, service and/or foedor Phono: ( ) apex:: ( ) Reconnect only 67.84 2 1 Pump or irrigation circle 67.84 2 Erman: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuil(s) or limned - energy Businlessname: STONER ELECTRIC, INC. _ panel. alteration. oroxtension- PaKez `"7S° 2 Each addllional Inspection over allowable in any of the above Address: 1904 SE OCHOCO Additional inspection (1 hr min) 66.25/hr City/Sta c/ZIP: MILWAUKIE, OR 97222 Investigation 1plant mm) 66.25/ hr industrial plant (1 hr m in) 76.118 / hr — Phone: ( 503) Fax: ( 503) 659 -4988 Inspections for Which no fee is 90.00/hr specifically listed OS hr an) CCB Lie.: 44823 I Electrical Lie.: 26 -122C I Suprv. Lie.: 3496S ELECTRICAL PERMIT FEES Subtotal: 7s o6 Suprv- Electrician signature, required: 1 „,,,4„,,,../ ,11.-......... Plan review (25% of permit fee): -51- Print nante: MICHAEL FALCONER Date: , /Z„ / ( Slate surcharge (12% rank fec): 9.0o TOTAL FIIItMIT PEE: 84.0D Authorized signature: Thla permit application esplrsa Ira permits not obtained within 180 Print name: Date: • days liner it has been accepted su cumplel e. Number of inspections allowed per permit. r:1BoildiagtPemilABLGPan ilApp.doe 0701/10 410-46151'(1 IO5RbMIW6 Feb. 2. 2011 8:44AM Stoner Electric Group No.6526 P. 2 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RgsIDENT :WOU CNIXL " • Fee for 111 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: COMMERCIA.14 WORK OILY Fee for tack 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 ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems C] Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling Other •c- Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:1Bd6A.glPamitaLC-PemiUPP.doo 09A1N0