Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
Ill t - COMMUNITY DEVELOPMENT Permit #: ELR2011 -00061
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/15/2011
Parcel: 25101 CB00500
Jurisdiction: TIGARD
Site address: 12670 SW HALL BLVD, BLDG# 2
Project: Apex Industries Subdivision: Lot: 0
Project Description: Security system.
Contractor: STONER ELECTRIC Owner: TCTPI LLC
1904 SE OCHOCO 25977 SW CANYON CREEK RD #J
MILWAUKIE, OR 97222 WILSONVILLE, OR 97070
PHONE: 503 - 462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/15/2011 $75.00
12% State Surcharge - Electrical 03/15/2011 $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: Y 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 952 - 001 -0090. You may obtain a copy of the rule 'rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1111111111b 7
Issued By. i� a��`a l Per mittee Signature: _ - _ /" - — •
n
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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.
Mar, 14. 2011 12:45PM Stoner Electric Group No. 7113 P. 1
Electrical Permit Application. FOR OH- It l. lISL ON 1,1
City of Tigard Received , LIVAIMEMIEMEMII
11 13125 SW Hall Blvd., Tigard, OR 97223 Pi ew
; Il Phone: 503.639.4171 Pax: 503.598.1960
/I R Date/B : ....mara
Other Penni!:
Inspection Line: 503.639,4175 Dare Ready/By 111 See Page 2 for
.)
I I(:Alt.l
Internet: www.tigard NolinedMethod. allin Supplemental Information
4 7:TYPE ot'lir,0,10. • :' . ::,. :. .:::';`'szsgi.::: , '....i.r,40,,1 4EvigYi'.4
lime cheek ill that apply (submit 2 scrs of plans wii(erna checked below):
El New construction Addition/alteration/replacement
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 2 Other: where the available fault current 0 Marinas and boatyards,
EV:Ur - :V . .' • ::
GORY ORONSIROCf104: - : ' ,, :'':'L':!-SMIll
or D Floating buildings,
19,000 0 Cormnerci al-use agricultural
0 1- and 2-family dwelling al I mmercialiindustrial 0 Accessory building amps for all other inEtallations. buildings.
0 Multi-family 0 Master builder 0 Other; 0 Fire pump. D Installation of 75 KVA or
.. , ..,..,, , -- -„,. . .. In Emotgeocy system. larger separately derived system,
:"..11SH 'SITE INp04ATION Aril?,,g.,40#10N ''' ''''','''' ''::?:.- . -;-, naddiiion of ncw tno ior load of 0 A "I-3",
1001-1? or more occupancy.
Job no.: 13 lob she address: . —,:vi 6 . c— El Six or more residential units, 0 Recreational vehicle parks.
0 Health-cue facilitiei. DI Supply voltage for more than
City/State/ZIP: .<2,:ov i902. 9'12,43 DHazardous locations. 600 volts nominal,
Suite/bIdg./npt. no.: ;2 Project natne: e peg Xtiv L., i rg/ E C 0 Service or feeder 600 amps or more.
.s.a :All
Cross strcet/directions to job site: Description 1 Orr. I Fee. I Total 1
New residential single- or mum-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'i 500 sq, ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
DE 75.00 2
&REPTION 15),NOitft 7,1.1°. ,,:: , .
(with above sq
? ft.)
Limited energy, multi-family 75.00 2
// - _3 1. 1 i . r- residential (with above sq. ft)
Services or feeders Installation alteration, and/or relocation
200 amps or less 100.70 2
rOatigiitTY '0W1‘101 l- - : $,,-. • #gAN:;: ik 201 amps to 400 amps 133,56 2
N 401 amps to 600 amps 200.34 2 ame:
601 amps to 1,000 amps 301,04 2
Address: Over 1.000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less _ I 59.36 1
201 imps 10 400 amps 125.08 2
Owner installation: This installation is being made on property 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 2
Branch circuits — new, alteration, or extension, ter panel
Owner signature:_ Date: A. Fee for branch circuits with
VitIGANT ' , - frie,: -:;! y L ‘-wv-coNTAdo s
k ',,1 above service or feeder fee.
,, ...... :94,..., - -,--4,-r, -,- , —x.-, ---- •-- - each branch circuit 742 2
Business name: • B. Fee for branch circuits without
. service or feeder fee, first
- 56.18 2
Contact name: branch circuit
Bach add'i brunch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
,...
Each manufactured or modular 67.84 2
City/Stale/ZIP: dwelling, service and/or feeder
Phone': ( ) Fax! ( ) Reconnect only 67.84 2
!
Pump or irrigation circle 67.84 2
_
5-mail:
, ,..,, . Sign or outline lighting 67,89 2
;11:,;-:: :7::-:t0f/I'iTRACTI111744:.: . . '4..2:- -. - 2 tS'M7: Signal circuit(s) or limited-energy ,
panel, alteration, or extension. rf Pager 2 .. 75 2
B usin ess llama: STONER ELECTRIINC. C INC
_ , .,._ Each additional inspection over allowable in any of the abov
Address: 1904 SE OCHOCO . Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
CitY/State/ZIP MILWAUKIE OR 97222 Industrial plant (1 hr min) 78.18/ hr
Phone; ( 603) Fax ( 503) 659-4908 Inspections for PO fiC is 90,00/ hr
specifically listed (1/2 hr min)
cat Lic.: 44823 Electrical Lic.: 26-122C Suprv. Lie.: 3496S Vi: . .1:,nt(1111cm- /PA.' Y FEES -, :::, , e- .- $7.•E!?'.:
Subtotal: 75. 000
Suprv. Electrician signature, required: ly t ie j,,a ,14......,. Plan review (25% of permit fee): -
Print name: MICHAEL FALCONER Date: State surcharge (12% of pennit fee): i3.. crt)
TOTAL PERMIT FEE: ea*. CO
Authorized signature: Thls permit application expires ire permit is not obtained within IOU
_
days finer it has been accepted as complete.
Print name: Date: 4 ' Number ofinspeciions allowed per permit.
imatdinoerreits\ELc-rerrnirapodoe ofroino 440 itastcoM/WED
Mar.14. 2011 12:46PM Stoner Electric Group No.7113 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
IZ,ESYri�I�TTYA;I..:WOR�.a�I�.'� °-1
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 Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
CQl1!,ER,GALI�WQRNL"
Fee for each 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
❑ I-IVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
Other 5 ry
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: .doe 07/01 /10