Permit r ,, CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
/111 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00136
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/16/2011
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 220
Project: Archibald Subdivision: PACIFIC CORPORATE CENTER Lot:
Project Description: Low voltage for fire alarm.
Contractor: STANLEY SECURITY SOLUTIONS INC Owner: PACIFIC REALTY ASSOCIATES
15495 SW SEQUOIA PKWY #100 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE:
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/16/2011 $75.00
12% State Surcharge - Electrical 06/16/2011 $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. se rules - - •rth in OAR
952- 001 - 0010th 952- 001 1- 009�ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 0.332.2 • .
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.
• Electrical Permit Application , , l� '_ ` FoR OFFICE USE ONLY
�1 of Ti and _. I t� S Received Penm
No.: -
114 ty g $fate /B : I , / t � , � �I l3
° 13125 SW Hall Blvd., Tigard, OR 97223 y Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JUN 16 2011 Date/By: Other Permit
T IGARD Inspection Line: 503,639.4175 Date Ready/By. Rids. 0 See Page 2 for
Internet: www.tigard - or.gov CITY OF T IG fl RD Notified/Method: Supplemental Information
w, -'�` a �.� x :es- s.- , ,,,,r°;.: r lr�a CITY l.{' Y i.,vfl l ,•,n.M.w ;�;, e,�.e.• .r `, e°'
• ): TYPE AF WORK ' 1. ! , �F :, ~ kF` it
.. .: f.� t c . J �rLAN REVIEW tx ,:
❑ New construction ® 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.
s i , .. �:'�{"'M3?� assxm ' x a. �:` w ,F p..; g y ;a
' l . CATEGO i rDF C , t m exceeds 10,000 amps at 150 volts or El Floating buildings.
P1" - Att,..:: , ..x t..x s. its,t�i, ^�'� amt ;� .c z €C ,s. .kli , s ' 5 ' .*. ...
less to ground, or exceeds 14,000 0 Commercial-use agricultural
❑ 1- and 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
- -� -- El Emergency system. larger separately derived system.
,''.','• M � , - y� J OB SL INiFOR i "ATI ?A n EO � ,, ' ' E, ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 6650 SW REDWOOD LANE #220 I00HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: PORTLAND, OREGON 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ARCHIBALD RELOCATION LLC ❑ Service or feeder 600 amps or more.
t& ? , f FEE SCI p ;E = , .. zk
Cross street/directions to job site: Description I Qty. I Fee. I Total
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
* " Ea 1 ESCRItTION' OF~ WORK t— 7 " : '"�' (with above sq ft.) 75.00 2
ADD ONE HORN STORBE AND ONE HORN /STROBE SUITE 220 TO Limited energy, multi family 75.00 2
EXISTING EXPANDER residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
.a ' y ®PRpPE QlV§M " t €a - . . T ENA kf 201 amps to 400 amps 106.85 2
, o .. , , � h, ,,',, ,e t ., - A , ,...i, 1. : :'' 401 amps to 600 amps 160.60 2
Name: PACIFIC REALITY ASSOCIATES 601 amps to 1,000 amps 240.60 2
Address: 15350 SW SEQUOIA PARKWAY Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: PORTLAND, OREGON 97224 relocation
Phone: (503)624 -6300 Fax: (503)624 -7755 200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with •
p- . ,®
: A I ANT P "N I � r5 ,CONTACT�ERS �r` above service or feeder fee, 6.65 2
..�� � _�, � w��.E -� t -rte r , �h each branch circuit
Business name: STANLEY SECURITY SOLUTIONS B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: GARY TAUSCHER first branch circuit
Each add'I branch circuit 6.65 2
Address: 15495 SW SEQUOIA PARKWAY
Miscellaneous (service or feeder not included)
City /State /Z1P: PORTLAND, OREGON 97224 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 968 - 3355 Fax: : (503) 968 - 3398 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
F - y CONTRA /CTOR Sign or outline lighting 53.40 2
d.;; ..., �.. " r "tea � ' _.
Signal circuit(s) or limited -
Business name: STANLEY SECURITY SOLUTIONS energy panel, alteration, or
Address: 15495 SW SEQUOIA PARKWAY extension. Describe: Page 2 2
City /State /ZIP: PORTLAND, OREGON 97224 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 968 - 3355 Fax: (503) 968 - 3398 Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
CCB Lie.: 161567 Electrical Lic.: 7-1054C Suprv. Lic.: . ,; Wa Ei ECTRTCAL PERMIT FEES 4
Suprv. Electrician signature, required: Subtotal:
6.4../ Plan review (25% of permit fee):
Print name: STEVE MOREHOUSE Date:
10 State surcharge (12 /0 of permit fee):
Authorized signature: TOTAL PERMIT FEE:
PP �, This permit application expires if a permit is not obtained within 180
Print name: STEVE SNYD Date: v�� VI, days after it has been accepted as complete.
* Number of inspections allowed per permit.
P \Building\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
PES°IDENT W ORKtON Y ;; � � _. :
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:
[C ®,MMERCIAL WO,MCO_ NLY k
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
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Building\Permits\ELC- PermitApp doc 03/23/06