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Permit y q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I ! 11 • COMMUNITY DEVELOPMENT Permit #: ELR2009 -00234 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2009 Parcel: 2S113B000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Subdivision: SEWER TREATMENT PLANT Lot: 0 Project: Clean Water Services Project Description: Install restricted energy for access control. Owner: FEES CLEAN WATER SERVICES Description Date Amount 2550 SW HILLSBORO HWY Restricted Energy Permit 07/31/2009 $75.00 HILLSBORO, OR 97123 12% State Surcharge - Electrical 07/31/2009 $9.00 PHONE: Contractor: SOUND SECURITY INC 8220 N INTERSTATE PORTLAND, OR 97217 PHONE: 503- 223 -5822 FAX: 503 - 973 -7773 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 at other applicable law. All work will be done in accordance with approved plans. This permit wit 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 -Q01 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503 246.66 or 1.800.332. 344. Issued By: � " ` 1 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. J -27 -09 11:04 AM SONITROL —PORTLAND 9r.rrr., P.01 f i EIeC n E flit A 1i ne OFFICE I IM: c►vt.t' t IN City of Tigard Received rc Perm Nu.: 1305 SW hull iilvd., Tigard, Olt U7�z, � 'ay vte ___, _ T _-l-I 2 • CCy ,� c1, a Phum 501,(39.4!71 Fax: 503.598.1900 J Rew 116nR Inspection lane 503.639.4175 U L hay, _ odlcrpermil: 9 etc Rea4y /fay, iuru O See p ----•– " Intornel www'.ugurd -trr. o v CQ 9 r N Yur u 0 ' ahred.'Mcitnd: TO lioglrntsllnfu n • ,�M.. :: TYPE OF % , ; . , . / i : G.1 , ; •- ri > .; PLAN' RF'V.WW :.'; Fl v , ... . r 0 New construction ❑ Addition /alteration /rep , V' /oi Please check all that apply (6ubIi 3 sets billions w lans hums checked be low): u Ut n)Olittnn Other: o r y ID Service or lewder 400 aiitpi or unor CI Building over three stories. ., whor the available fault corona [j Marinas end boatyards, =F '` c.►TECORY OF CONSTRUCTION • ••• , . ,;.', : exceeds I u,uu0 arupe at 110 volts or Q Floating buildings. I • and 2 dwelling 1 less to glom!. ,1)00 ❑ C'omnlcrcial-aw a aw Y g © Commercial /industrial 0 Accessory building or exceeds 14 s' ieuhal y ✓a amps for 811 ether installations, buildings. [] Multi family [] Master builder 0 Other: 0 F'irc tm 1. P 4 0 lnstullatiun u!' 75 KVA or a 4, . •. 0 Eu wrge n•y system. Ihtser separately derived system, . JOB' tilt INFORMATION AND 0C,ATION . ' . ❑ Addition (WNW motor load of ED °A" •E ••1-2", "1.3", Job no..P090101 1 Job site uddress16580 SW 85th Ave !b)1H Purua.rc . occupancy, ..._._. _ __ .... _.- - -- — ❑ $Ix or more ns mills. 0 Ito:mallow! y[hicle parks City/State/ZIP. y portland OR 97224 C] Ilealth -taro facilities. 0 suppl vulwgc cur no than -• 0 Hazardous locations. 11)111 wills nominal. Suitwbldg, /apt. n Projectnumeclean Water Durham P1a4Elscrvit :cot redder 000anip,urnoro _ — . ,...1 '„ a:.....,.. S . Cross street /direetionw to job site fi. FFE CHEDULE `"t . x o 7.......,,.�.- _._ -�.... ._ -_._._ n ...�__.. Hrdnttun T, 21 ', Far. 0' New residential single- or nulti•fotn1y dwelling unit. •.-. _....•. • .,.._ „— _ - _._...--- .. - .._. • Includes attached garage, Subdivision: Lot no.: 1,000 sq. 11. or less 145.15 4 ' - - — __.. - _----- .,,,,..., _,_.. _ .- E:t. WI 500 sq, L o p on ti Tax map /parcel no,. _ , Limited energy, residential i s , El „:01,.::,„1:4....:. _ - -- ' DESCRIPTION OF WORK • Sw(IIl allow 6, . _ ^ — 75,00 - • Limited energy, multi- family 75.00 IIIII© _.. 1n.sto l.. at.:Loa_a access KYSt- Pm_ fox. ... resilential(w `( 7 t es or feeders Installation alteration and/or relocation i Services �P W e 1. - V t P,.. 200 amps or less _ BO.3O �9 s ;'';;ti. '::PROPERTY .OWN R j U ENANT 201 amps to 400 amps ._ 1(16.85 �� ' G.85 i ! Nome. 401 amps to 600 amps I b0.(1) �©¢ _— - 601 amps to 1,000 amps 240 60 i Address - - _� Over 1,000 amps or volts 454,GS U City/Slate/ZIP: Temporary services or feeders Installation, alteration, and /or 1 Phone: ( ) Fax: ( ) 200 amps or less 66,65 awn 1 Owner Installation: This installation is being made on property that I own which is not 201 amps — tu acts amps_ ttxt.30 © ' ' ) intended fur sale. (case, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 umps 133.75 Branch circuits - new, alteration, or extension, Cr an Owner signature; •• , D al _..... - - _ _ _ Date; ; °.."; >. circuits l APP)~ CANT.: °' ' Is � A. Fee for s ervice or t fee .�.,.• .,�'Ci. � .. . -; _ . , . - CpIHT'AG'T:PTRSdN .�:� 6.trs II Business name: each branch circuit 6 l � . 13. Fee for branch circuits l Contact name: - -' wit /loin service or feeder Pee, 4ti.g 2 ,. -..... .__.____ .... ___ ___ �_ W t i tit branch circuit Address; Each add] brine( circuit M_ 6,65 ' Mil " "- -- "" -- -- Miscellaneous service or feeder n Included City /State /ZIP: Each manufactured or modular 90 90 Mi , . Phone: ( ) ~. dwelling, service and /or feeder Fax: , ( ... __. Reconnect only 4 { >.g5 E •mail: Punlp or irrigation circle -. :. ,. .. 53.40 � a .r' �: CONTRACTOR ' . Sign or outline lighting 5 3.40 Business name: Signal circuit(s) or limited- Son otrOl. Pacific energy panel, alteration, or • Address: 8220 N. Interstate Ave exlrnvinn. Desctihc: ` Page 2 City /State!?.'IP: Portland OR 97217 Each additional ins ectianover allowable inen of the above • .-- -- --- _.:... Perins Ili ( 503 22_3-5822 Lax: ( ) PC' _ 6 -._ I. Phone: i 503 973 -7773 lnvashgation hour (I hrmin) 62.50 ,, CCI3 Lie.: 53535 __ J Electrieat L.ic2 6 _ 3 70 C _ LE super. I.te ; MUM - Industrial plant per hour 73. - Sok5'. Electrician signature, required: ,,,._ / ' ` .j.;'''• •• • „: ,ELECTIttcAL PERMIT PEES!'. r l.a, > • __ \ p +�1. _ Subtotal; 7 5 , . f rfo7V`J \'� j — • Dare:. ' - 1 —p� * ! Plan re view ( of p a m l' j Sla ._...__„ w surehurgc 112W ul•permit 1'txt): linill Authorised signatures Tt]'fAl. PERMIT FF:fi: • . Print Hume; 1 Date: Tbi1 permh apphcalion expired tf u permit h not obtained within 180 –•�• – —_. ( ,, days after It has been xecepted as remotely. ' Number of Mspt:ctious slowed per permit. I n. ildireir .P.mitirriC•1•enu„A131 0:31'1e' 440.151 Tr( I1/u5K'C3M /WSp 4UL -27 -09 11:05 AM SONITROL PORTLAND 9737773 P.02 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: SWENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of work Involved: Audio.) and Sterrt> Systems* ❑ Burglar Alarm ❑ Garage tl;e IDoor Opther* ❑ Floating, Veniiltatitan and Air Conditioning System* ❑ Vacuum Systems* 4 t ❑ Other; Roc TALWORK ONLY: Fee for ri commercial $75.00 system (SEE OAR 9t8•309 0000) Check Type of Work Involved: ❑ Audio and Stereo Syttetus ❑ Moiler ( :d ?taarols ❑ Clock Systems 0 Data Telecommunication Installation ) ❑ I'ue Alarm Installation ❑ I1VA(: fi • ❑ i • Instrunicrat,ari „n ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* Li Mcdical ❑ N urse t:n11t: • ❑ Outdoor Landscape Lighting* ❑ Protective Sign;tling Other &ALA ac C. e, 5 Total number of commercial systcnta: *Nn licenses are required. Licenses are required for all other installations I +Nnildinp,l4,nn, t' I I II. m J 0v1,hn,