Permit r '• CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
:rig !� 1 COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00037
.
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/19/2008
PARCEL: 2S102CD -05400
SITE ADDRESS: 13877 SW 95TH AVE ZONING: R - 4.5
SUBDIVISION: FLETCHER WOODS LOT: 004 JURISDICTION: TIG
PROJECT: FLETCHER WOODS
Project Description: Low voltage (all encompassing)
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: LL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS:
Owner: Contractor:
C & L PROPERTIES LLC QUADRANT SECURITY INC
11755 SW CLIFFORD PO BOX 14833
BEAVERTON, OR 97008 PORTLAND, OR 97293
Phone: 503- 646 -1309 Contact #: PRI 503 -234 -5558
FAX 503- 236 -2322
FEES Reg #: ELE 26- 565CLE
LIC 96806
Description Date Amount
[ELPRMT] ELR Permit 2/19/2008 $75.00
[TAX] 12% State Surch 2/19/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180.days. ATTENTION: Oregon law requires you to follow 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 copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: _i4rged ---� Permittee Signature: ) VA �_
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.
. r>ical E _
ermitlii) '`t 0 . i • i' O F
FOR I '
Elect ICL USE ONLY 4 ' a•' t
N RO Nl 1t, -. I ' 1 I. .,..
Cit Of Ti and }/� Received. /
y g��{r r) J Date /B) q Q Permit Nom /
1 3125 SW Hall Blvd "f.1 T RA2 2' / '
i / t1 , QQ Plan RevieN Other Perm
Phone: 503.639.4171 Fa.. 5 3. c}8.1 Date /B
TIGARI} Inspection Line: 503.639.4175 Date Ready /By: J See Page 2 for
Internet: www.ti 3r TIGARD Notified /Method: 111=1 Supplemental Information
B U I.L Q•cli dF4 'INN PLAN. REVIEW
I New construction 0 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 ❑ Marinas and boatyards.
CATEGORY..OFi. CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 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
❑ Emergency system. larger separately derived system.
JOB SITE". INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 "I -3 ",
Ito.: Job site address: J� I ' , �1! IODIiPormore. occupancy.
Job
t / �� �W V ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: " "`1 4 9 , n ❑ Health -care facilities. ❑ Supply voltage for more than
• ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: L e, ❑ Service or feeder 600 amps or more.
- FEE SCHEDULE
Cross street/directions to job site: Description I Qly. I Fee. 1 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
Tax map /parcel no.:
DESCRIPTION OF WORK Ea. add'1500 sq. ft. or portion 33.40 1
Q + - Li mited energy, residential
k c i (with above sq. ft.) k
75.00 , -- r 2
PROPERTY OWNER ❑ TENANT J
Limited energy, 75.00 2
i gy, multi - family
Name: C . U- -62_ 4 residential (with above sq. fi.)
Address: Services or feeders installation, alteration, and /or relocation
City /State /ZIP: 200 amps or less 80.30 2
Phone: (c(}3 ) /k.1 3O 9 Fax: ( )
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 106.85 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Owner signature: Date: 401 amps to 600 amps 160.6(1 2
❑ APPLICANT ❑' CONTACT' PERSON
Business name: b01 amps to 1,000 amps 240.60 2
Contact name: -
•
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and /or
City /Stale /ZIP: relocation
Phone: ( ) Fax:: ( ) 200 amps or less 66.85 1
E - mail:
' CONTRACTOR •
_ 201 amps to 400 amps 100.30 2
Business name: c- -'
Address: "`) 1 �. 401 amps to 599 amps 133.75 2
City /State /ZIP: 1 C `A ( 1 C - C - -'
�v t"-" ) C -' (. - `.� Branch circuits - new, alteration, or extension, per panel
Phone: (a �1 _ 55 5 ) < Fax: j A. Fee for branch circuits with
`" '�t� ` ( u ��� )�� /� (9\7-y,-9,—,1:),,, _ above service or feeder lee,
CCB Lic.:C' Electrical Lie ( Suprv. Lic. each branch circuit 6.65 2
`' �� \� �� B. Fee for branch circuits
Suprv. Electrician signature, required: '-J' 14_ wi /latl/ service or feeder fee, 46.85 2
first branch circuit
Print name: "7 -1 7 -TiC :C? Date , ( 0 _
Each ad(I'I branch circuit 6.65 2
Authorized sign, tire. a / , ,
�' ` ti . - Miscellaneous (service or feeder not included)
Print name: W I 1 _ # . ' _ Date. —
I:\nu !ding \Perm its t/LC- Permit App.doc 05/23/06 445- 4615T( I I /05 /CO6l,W1:13
Restricted Energy Electrical Installer Log
Cit of Tigard
B uilding Division
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 Inspection Line: 503.639.4175 Internet: www.tigard-or.gov
PERMIT NO.: i: � 8 _ D00 3 ISSUED BY: -3 B DATE:' el D i
T .. m a . _ :V,V W :V.P I TE VltVSTPMI NG =� tili SDI. DTI 1•k
*�.eaw. - .a�,.�� a� �;`s -..��k ,*,� mss-.- �.,..a.. - _,.� - <,%� 11., '•"n-etak
CHECK TYPE OF WORK INVOLVED:
1 & 2- FAMILY COMMERCIAL
$ Audio and Stereo Systems* ❑ Audio and Stereo Systems
X L Burglar Alarms ❑ Boiler controls
❑ Vacuum Systems* ❑ Clock Systems
A Data Cabling ❑ Data Communication Systems
Cl Other ❑ Fire Alarms
❑ HVA
❑ Intercom and Paging systems
❑ Landscape Irrigation Controls*
'1'I-US MUST BE POSTED AT THE JOB SITE AT OR NEAR THE SERVICE ❑ Medical
PANEL. IF THERE IS NO SERVICE PANEL, POST ON OR NEAR THE ❑ Nurse Calls
INSTALLED PRODUCT. AN INSPECTION SHALL BE REQUESTED
ONLY AFTER ALL OF THE ABOVE PERMITTED SYSTEMS HAVE BEEN ❑ Outdoor Landscape Lighting*
TNSI'ALI.ED, AND THIS LOG HAS BEEN SIGNED BY THE SYSTEM ❑ Protective signaling
CONTRACTOR(S). OAR 918 - 309 -0400. ❑ Other
TOTAL NUMBER OF COMMERCIAL SYSTEMS:
* Electrical licenses are not required for these items.
Construceron Contractors Board license is required for all installations.
,ry,�i PTO ` BECOMPL ETEDxBY6INST__ALLE #R "�� ��„
System tp ❑ System
Company: & . ' -. ' Phone: 3)3 CIS I . Company: Phone:
Address: CCB # i' [$o b Address: CCB #
Sig.: —577;,...t Lic. # 3 9%4 LE3k, Sig: Lic. #
''C System ❑ System
o 4- D ;cam' -fin,
Company: ,r ?.,A-osti; Phone: Z;63_2 ss a Company: Phone:
Address: CCB # . q (�'d p Address: CCB #
Sig.: f Y r,, ] '�' Lic. # � Jv Sig: Lic. #
❑ System ❑ System
Company: Phone: Company: Phone:
Address: CCB # Address: CCB #
Sig.: Lic. # Sig: Lic. #
❑ System ❑ System
Company: Phone: Company: Phone:
Address: CCB # Address: CCB #
Sig.: Lic. # Sig: Lic. #
❑ System ❑ System
Company: Phone: Company: Phone:
Address: CCB # Address: CCB #
Sig.: Lic. # Sig: Lic. #
❑ System ❑ System
Company: Phone: Company: Phone:
Address: CCB # Address: CCB #
Sig.: Lic. # Sig: Lic. #
I:\ Building\ Forms \ELC- RestrictedEne 02/01/07 1
918- 309 -0400
Restricted Energy Electrical Permit Application
(1) A separate Restricted Energy Electrical Permit Application Form and Restricted Energy Electrical Installer
Log are created and adopted.
(2) The Restricted Energy Electrical Permit can be taken out by a general or subcontractor, limited energy
installer or property owner for the fee set by the board in OAR 918- 309 -0030 for limited energy transactions
provided the requirements of this rule are met. The person applying for the permit must:
(a) Assume responsibility to call for an inspection when the permits are signed by appropriate persons,
installations are completed and after all corrections are made and comply with the requirements of the restricted
energy electrical laws and the restricted energy electrical rules;
(b) Be responsible for all corrections required by the inspector under the permit, regardless of who performs the
work;
(c) Call for a final inspection when corrections are made and the work is completed.
(3) Options. The person obtaining the permit may:
(a) Limit the permit to only the work of the permittee; or
(b) Include any and all limited energy installations including those done by separate installers, but the
installations must be ready for inspection at the first inspection call. When this is done, the permit must be
completed and separately signed by the person, also identifying the business responsible for each type of limited
energy electrical installation.
(4) The restricted energy activities to be covered by the permit must be declared at the time of the purchase of
the permit:
(a) It is not necessary to identify the contractor at the time of permit issuance;
(b) New permits must be purchased for all other restricted energy installations;
(c) If a contractor is changed, the contractor who completed the work must be identified.
(5) Regardless of what was initially intended the permit only covers those installations that are in place at the
time of the first call for limited energy electrical inspection. A separate permit must be purchased for all other
limited energy installations whether the installations become ready for inspection at a later date or are done at a
later date.
(6) This rule does not apply to an industrial plant when ORS 479.560 is applicable.
(7) The Restricted Energy Electrical Installer Log must be posted at the job site for signing by appropriate
persons installing the separate electrical systems as shown on the form. A municipality may require more than
one log to be completed and left at the job site if it chooses to.
I: Buildin Forms \ELC- RestrictedLnergyLog.doc 02/01/07 2
CITY OF TIGARD r . ;_ ,
BUILDING DIVISION PERMIT #: ELR2008- 0€0037
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/19f2008 Phone: (503) 639 -4171 �p'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 r� ":_..
INSPECTION WORKSHEET FOR DATE: X120/2008 TIME: 7:00AM PAGE: 54
SITE ADDRESS: 13877 SW 95TH AVE CLASS OF WORK:
SUBDIVISION: FLETCHER WOODS LOT #: 00,4 TYPE OF USE:
PROJECT NAME: FLETCHER WOODS
DESCRIPTION: Low voltage e (all encompassing)
OWNER: C & L PROPERTIES LLC, PHONE #: 503-646-1309
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503.23'1 -5558
Inspection Request Scheduled For: Date: 2f2012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 065249.01 503 -234 -5558 N
lc\ ° FtiAL—___
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: VSi L -
Date: XI 0 v Phone #: (503) 718- 1.44