Permit 1 1111- CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'= COMMUNITY DEVELOPMENT Permit #: ELR2011 00041
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/18/2011
Parcel: 1 S135BB00500
Jurisdiction: Tigard
Site address: 10355 SW CASCADE AVE
Project: Fisherman's Marine & Outdoor Subdivision: Lot: 0
Project Description: Fire alarm.
Contractor: ALL COUNTY ELECTRIC LLC Owner: RAM /CASCADE CENTER LLC
15515 NW 2ND AVE. BY ELLIOTT ASSOCIATES INC
VANCOUVER, WA 98685 901 NE GLISAN ST
PORTLAND, OR 97232
PHONE: 360- 904 -7923 PHONE:
FAX: 360- 314 -2244
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/18/2011 $75.00
12% State Surcharge - Electrical 02/18/2011 $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: Y
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: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR • - 001 -0090. You may • . - . - co• of the r • ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By - Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Friday, February 18, 2011 5:07 PM All County Electric LLC 360 - 314 -2244 p.01
Eteetrietti Permit .pntii ati9t t t1t1 (,11 1t 1 t �l' fr ,I \ •
City of Tigard , i c-k) amn No : •-" 4
P '
Om sw Halt Alert TipArel, nR 97721
II 10110: 500.639.4171 f.r,
'' '1 503.5981 horPerm ' ' tx / ,r
71 c.. I' II' Inspcctian Lint: 503.679.417 •. thtc xr..dyiay; l.i.' goo r.irz r..
Internet: www.tig9rd- or.gov "\ Nant:ed(M p nrerru
r'hod: 1 776 Su pie 1lararmer;nn
�,y'�,y�p r� fir! :
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''':::',..777:77:1.7T, ... ..... _.
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:. Fi,. `'
n::, i'i ,��iL :fl '' - !W �.' , -. ,.,
LI Now rpnstruction Addition(alteration /re �`I''`' 1 d. all' Ottsonny pnbr. it/ acts trfid ers ;Miens checkedbelowl:
C.11- �` 4� ❑$ervite Cocks 4Arl rows ot mom 1:1 Building over Rua glories.
U Demolition U Other. 'Icrothea
_ -� ^*., :,• L �.�....�� C] Mariner and boatyards.
"'' ...''' -�, _.,''';' ., ' _. _ 0 - ', _ - ` " 7af= •Alt's'!' a weds 10.000 mm at 150 volts or Matins buildings.
'a IwM to pound, or tumors. 14 050 ❑ C macinl•oac ecriculemal
[] 1 • and 2- family dwelling Comtnereirki(induattial ❑ Aeces5oty building amps for ali other ineediannn
tNldinYs.
❑ Multi-fattUly ❑ Master builder ❑ Other: ❑Ftropoatp. ❑ Installation of 75 KVA or
. . :•. : _ i( _� . : : . E :.'; - ._ . - - : ❑frost goner ayrtrm /alley' }eparaldy derived p
... ... 1 i 11 0::04,., .__.. ---,., ,_. ° :�1`. •, .:-.. _l.u� ❑AdAllbn Oros.* motor load of � -.^.. ..f.. ..1.7_'•1.7 °,
' - Job 110. Jot, site ntddre5s. �� � IOOHP or more. occupancy. u.._,.,..,._.,..,_.„.,..,.,_ 9 D Six or mono ratidoMMI lava, C] Nemennonal vthialo park[.
City/State/ZIP: , K___ 0I4ealth -one rr.ilitier. ❑ Slowly volteos for more then
. ` A. (1!L.A.. la.,•fin.+. GOO volts nominal.
Suite(bldg,(apcno. project name: �i ❑rn
6mecc feeder 000Amp ow mom.
Cross street/directions to job site: ,
4 .,. Pry TnfN •
Nam rosideatial ei+rple .•.- .n..Iti-4 dwcIllno unit.
includes attached garage.
Subdivision: [.At no., - --
I 9 SO R. or less 168.54 4
"Max mop/parcel 110.: Eo. add'I 500 sq, fl or Donlon .1.1.97 1
_ , Limited energy, rcaidcnrisl
- i .' � m , r. :!s ` :z ', (WIt11800v4 K. fl) 15.00 2
•
— l Limited energy, mew - ramify - 75.00 y
► ) a (arr� , residential (with above sq. ft.)
-. __.___..., ._... . __.. Kervltp or reCtlert in5taltttinn alteration, and /or relocation
200 amps or loss 1 0007 2
. ;je _io R'E _ �R : 1';l'; :F; i 4 ' b ,";_ n j te; 201 amps to 400 amps 13156 la
NA/71:: 401 sines to t•00 anon 300.34
...,-- ,- ,- .,_..... ....,..,........ . _..._._W ..._ 601 n
npsta _ 301.04 2
Address: Dvrr I,OA(1 :viva .nvoila 552.20 2
City/State/ZIP
•
--------
- 1'81ororary services or recdero installation, alteration, and/or
...-- -- t.�.._.. ti rglnehflAri
Phone: ( ) Fttx. ( ) 200 amps or I� 59 }ti
Owner' installation: This installation is being made on property that 1 own which is not 201 nips to 400 amps 125.08 e
it,tendai for .al 1.e, r nt. err vercban € acco.dip to ORS 447, 449. 670, anti 701. _ 4AI snot l0 5911 arms 1 Ge.s4
Branch circuits - Dew, alteration of txtellaioe ''' . not
CWIYCI signature: I]atc: R Fcc far NranOh circuits with
4' ' , : : :,`_ . ;' =5 scene 'Ac lr SON 'sat 'viu or feeder &c. 7 42
„'�'.ilE1�i�7�tYF ' ' t " above W cacht*anchcircuit
Business name: B. Fee for branch circuits without
w_ ecreicc or reeler fee. finis
Contact name: brnneh circuit 56.18
--- Faeh add'I Diana cirt111t 7 di a
_— ,., ................._....., Miscdlaneaus aerviee .rrfceder nMindaden
City /State /71P: tadr manitfactutd or modular
________ _ &milkie . service and/en/ceder 67 .84
Phone: ( ) 1 : ( ) -- Rc ono col only 0.134
- Pump or irripit c
E - trlail: w circle le _ - 67.84
i ,-., w n z: Sign or outline light 07,114
,.._ _, ;.', _ -ae `t i c:_ 1 `` �. i 9ignldcircuit (elorlimitetllntaRy
Ausincys name: LL Co4hIW r iJ - �1, 1, atm/mien , aT excen iyL s' .c z Z
.. Elach addltloael imPeetion over alltrwaote in any of tacit b
Address: f s S /' tci ' 4 ^dditlOnyl in5pr ctian (t ht Mitt) 66. 2511ir
City /State/VP; \ / a.. lnvcati can 1 hr min — O �[ � lndvvrinl pistil (117r min) MERIN II
Phone: ( mod " o 4 Fax: (3100 ' f 4 - a')411 tropeetiost or which rea fee Is
s• eif listed'hrmin 90.00/ hr
CCl3 Lie ; 117 34.7 Electrical Lie.: ' 31 is Su n... t L.: 74€ a a .- ,I, b ?!i`s... .T » - ma x ';x :-
Supfv. Electrician signature. required: i ? - - - -- Subtotal
_ / Ilan review (25% ref permit Fee).
Print name: !/� r Date: 5/ , / %/ ~ Stab surGbayc (12 %of vomit Fee):
eA - ) // /B Sc vcJ ``''// I _
Authorized signature: TOTAL PERMIT FEE:
— 1%6 1..•Mil .ppllrnrteo expire. if. permit u net *Calmed within flip
I Print name.' Dale: dsra.0ar it h.. tore .eeen.rd au e.anrere.
l NrrmberoflnS
- _— �._- ,...--' . _ -_ _-. _ ` ... _. 'peettena N IOwad Per Oenn.r.
lABoiliinettermitetEl _C- I'ea 07/01 /I0
4 +0-4 t 1'r(11 t0!u1.UMM'Cfi
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
PRESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
Vacuum Systems*
r:
( WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n / Data Telecommunication Installation
E Wire Alarm Installation
n HVAC
▪ Instrumentation
• Intercom and Paging Systems
n Landscape Irrigation Control*
▪ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC- PermitApp.doc 07/01/10