Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
I • CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I I "F- COMMUNITY DEVELOPMENT Permit #: ELR2009 -00196 .TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009 Parcel: 2S113AC00103 Jurisdiction: Tigard Site address: 7204 SW DURHAM RD 300 Subdivision: Lot: 0 Project: Consumer Cellular Project Description: Install restricted energy for burglar alarm. FEES Owner: PACIFIC REALTY ASSOCIATES Description Date Amount ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Restricted Energy Permit 07/22/2009 $75.00 #300 12% State Surcharge - Electrical 07/22/2009 $9.00 PHONE: Contractor: MASTER ALARM LLC 1110 NW FLANDERS PORTLAND, OR 97209 PHONE: 503- 222 -5083 FAX: 503- 227 -4992 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: Y Other: N Other Desc: 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332 344. Issued By: ` C �� Q , O Q/ Permittee Signature: i , � Qb 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. •4 ' 07/20/2009 12:26 5032274992 PAGE 02 E Permit Application FOR OFFICE USE ONLY IF a t Mall B 1 R vdaTigard, OR 972 9 4� ; Plan e n RC v � , Permit 7o.: �i . Wy (cj I e : Phone: 503.639,4171 Fax: 503.598.1 0 Da1C /By. Other Permit: TICiAR13 Inspection Line: 503.639.4175 JUL 2 0 2009 Dotc Ready /By: Jurist RI See Page 2 for Internet: www.tigard- or.gov Notified /Method; ( I C Supplemental Information TYPE OF Woit �;1J-� OF TIGA f, PLAN REVIEW ID New construction Addition/al terat�? i � NISI' Pl ease check all that apply (submit 2 Sete of plans w /items checked below); CI Service or feeder 400 amps Or more 0 80ilding over three stories. ❑ Demolition 111 Other: where the nvnilthic fault current ❑ Marinas and boatyards. CATEG P ' Y OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings. • 0 less to ground, or exceeds 14,000 © Commercial -use agricultural 1- and 2- family dwelling E Commercial /industrial D Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. 0 installation of 75 KVA or JOB SITE INFORMATION AND LOCATION o Emergency system. larger separately derived system. 0 Addition of new motor load of 0 "A ". "E ". "1 -2 ", "1 -3 ", • ( �� p .,lit 100HP or mom. occupancy. • Job no.: Job site address: 7z0 c ^�' da'� ., O Six or more residential units. ❑ Recreational vehicle parka. City/State/ZIP: ct,�c/ 00", 7 7.z2- ❑ Health -care thcilitics. 0 Supply voltage for more than 0 1 l [ �r� i I Ik', � Lli" ID Service or s e e der 600 amps 600 volts nominal. E S C . FE Suite/bldg./a°. no.: Pro Set n p FEE SCHEDULE Cross street/directions to job site: ueacriottaa 1 Om 1 Fee. I Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. R. or less 145.15 4 Tax map /parcel no.: Ea. add'i 500 sq. R. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. R) Limited energy, multi family 75.00 2 pL(i_' ( - )l Q,17 - (qty residential (with above sq. ft.) T� Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER El TENANT 201 amps to 400 amps 106.85 2 Name; 401 amps to 600 amps 160.50 2 - — 601 amps to 1 ,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or .. ._ relocation __ _ Phone: ( ) Fax: ( ) 200 amps or less 66 -85 I 7 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel 1 Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fec, each branch circuit 6.65 2 t. Business name: B. Fee for branch circuits without service or feeder fee, Contact name: first branch circuit 46.85 2 Address: Each add'l branch circuit 1 6.65 r 2 - Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax :: ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53,40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: Master Alarm LLC / Phillips Electronics Signal circuit(s) or limited- energy panel alteration, or Address; MO NW Flanders extension. Describe; J Paget 7 2 City /State /ZIP' Portland OR 97209 Each additional inspection over allowable n an f�of / the above Per inspection 62.50 Phone: (503) 222 -5083 Fax: (503) 2274992 Investigation per hour (1 hr min) 62.50 CCB Lie.: 125364 Electrical Lie.: 26213CLE Suprv. tic.: Industrial plant per hour 73.75_ ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: -71e---4,4— '� Subtotal: 7 :J P � �q 6 ,.... 44 „,„ 4 „..._ D ate: ,,, ' ,7 Plan review (25% of permit fee): Print name: ti' l State surcharge (12% of Hermit fbe): C� Authorized signature: TOTAL PERMIT FEE: J g This permit application expires If a permit is not obtained within 180 Print name: Date: days After It has been accepted as complete. ' Number of inspections allowed per permit. t\ Building \Potmiw6t,C- PermiIApp.dot 0584 /ne 440-4615T(II /OS /COMM'E5