Permit 14 ; f' � CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' CO MMUNITY DEVELOPMENT Permit #: ELR2009 -00297
TIG 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/29/2009
Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7324 SW DURHAM RD
Subdivision: Lot: 0
Project: Performance Systems
Project Description: Adding /relocating fire alarm devices, adding security.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 09/29/2009 $150.00
PORTLAND, OR 97224 12% State Surcharge - Electrical 09/29/2009 $18.00
PHONE: 503 - 624 -6300
Contractor:
PERFORMANCE SYSTEMS INTEGRATION
COR
7324 SW DURHAM RD
PHONE: 503 - 641 -2222
FAX: 503 - 641 -1464
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: Y
HVAC: N Instrumentation: N Total $168.00
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 OF R 952-001-0100.
`�Yl 00. You may o Q ^ a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800 332. 4.
Issued By:` �/I I{ DU ,a Q / 1.L Perm ittee 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 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.
E EIVE
Electrical Permit Application S 2 9 2009 FOR OFFICF USF ONLY
City of Tigard P ? ro6 4 • y,
v 13125 SW 11011 Blvd., Tigard. OR 07223 CITY OF TIGARD !'Inn Rct icw
a - phone: 5113. 039.4171 Pax: CO . i9S.1 ) Other Permit:
5 ( UILDIIVG DIVISIO' D a t e l; `
'TLCrA R'Llt Inspection Line: 03.63 ).417; Date Ready lh': tier Page 2 for
- - Internet: wwtv.tigard- 01.g(n Xotitle(1:bletiuxf: Supplemental Information
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I ,�I ACICflh rI)`nitCl'Uti011're�liteen cI)1 I'., cheek all that 4 submit - ? sets of Pions wlitem; checked below).
❑ New construction 7 I ❑ Service or feeder 400. Imps or more ❑ Building over rbn•e stories.
❑ Demolition ❑ Other: who e the available (hull current ❑ Marinas and txtatvards.
.a,X \� :, ... :...:. . :i+'-ti:,,,..:t•_L„-.,' -+ ..i 3-'•1��. exceed, 1 t t unto S •1 buildings.
.a. £. E s_ -sass � �• -a - - _ L(H)1 r nyt. at I. U volts Its nr ❑ Ploatm =_ huildin_.
_ , �c�,. i. Ec)iz�s;'(ir :cb�s�riii�Cr :I�i�> ,j, _ 'n � > > ,, :: � _
xr..
kv to ground. or exceeds 14,000 ❑ Commercial- use agricultural
El - ^ and 2- fancily dwel ling ' Commercial: indu tt'ial ❑ Accessory maps for Al other iltst llanons. building,.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Dire pump ❑ Installation of 75 KVA or
- - - -- - =z - 1 �a�: ' - <�rart : +s ❑ Emertencv' S\',tem. lancer se usenet' derived aystem.
'� ) a Ti :'�i )Z(R 1 AT• ") :`�, ` �%�p ` . ' = _ :! > ::
.~:4>. , . . . ., ., . _ ,sss ,.5,;,ia u _.- „.,r.l...,,_ _ ._ . : _.,, > :a „- - - ° . r -: - I new f motor luau of -A
� .. 1ob no.: Job site address: 10011P ormore,. occupancy.
�7.3 a 1 sly � ;, i� . ❑ Six or nano residential writs. El Recreational vehicle parks.
❑ Ilevhh -care facilities. ❑ Supply voltage fix
Clh'!State;Z IP: P` r7 more km
a }t�II E}V 1 1 (! 1 1` t � ❑ Hazardous location. WO volts nominal.
Sllttr.bldLJapt. no Project name: ❑Scn'ico. oi lcedern00a Inps UI more.
Si ii - ' `«< ,-1 =�G ;'�,;:t,< ���'xrv;
Cross strcut % llirotaiunsto job site: `�' ��/ t / � .' :�r �x�� ?a�_. ._., ..., .....- ,t�.._ :..�.....�. � = ` «` :'�'�a :.. :. :,.s'; ^ €�.; :,
s tat)S b,,,L,}, sw i. fist-K -a- (ixoA..��j ,,. Description - '0,410M ,. :..,�.- .r., _ ) Qty. . I .. ( Total I `
New residential single -or multi - family dwelling omit,
't Zc Includes allachcd garage.
Subdivision: Lot no.: 1.000 sq. ft. or less 145.15 l 4
La. ndd•I 500 sq. it. or portion 33.40 I I
Tax map. parcel no„
Limited energy, residential
rv: _- _ ;�a +s;;. _ _ _ - ' ^r' :;?r.i _ __ _ _�'.�-'= : fi:%i;a,s;;. ,::F : 75.00
. r`. ��,�. '>1 � - with atwt^ s li
_ ��?' -: `Dt (( Ake. vt)I F � •
3'i'`= ' -�+.� . - . .sass - <.� "I' :;;'y;`
r':;<z v,ur arse,,
,vase, r5 -�
: >c -; ,,.; . ,. , _sas s . �: c� r,:
I Limited energy, nnilti- Iunily i
• IvC arIf F),�
! -) a'�1( 2-1% /limp, ,t..1, j residential (with above sq, ft.) 75.00 -
Services or feeders installation, alteration, and /or relocation
50.30 2
,; ��� ,'} . �}' fit° 200 amps or Icss
- _t ,v<A _ �. :! ",zF.>.'t :• : ::1; °g ".: k : x�i4�, i. :i- - -�- . "�r. _ _
w�.. p a ,77' ., s_, - 201 urn x to 400 amps 106,85 _
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
C ity /Stale ZI P: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( 1 200 amps or less 60.55 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.3)) 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
Owner signature: Date: A. Fee for branch circuit with
_ S - - r.'. I , y ;w
?4 , r� ante, - _' 1 �,f: - )` ;a^ ''' w' vi
; �7+ - - , ,�: �r��t :,'� ' we see rCe o feeder lee.
�APRLf1.CA7, ,1� - :- w.<� -? rr;� „_ _ t - i >i ?'.GQ'1•I'%AG1 := ),Elt.
.';'.fir' <) :i_... .xa` :Ee��.�ae�...r -a .y._ -sass , . ............i iii,. :.: , ?.u' �� �is�,. ,..w.,�; : ?k;:�i_7 ._,_ -.. -, ,,..� ->!;- ,-^sass. -, 7a�o., ..s?ESx?rr :=,�', 2
each branch circuit
6.65
Business name: 13. Fee for branch circuits
wirhaul service or feeder Ice,
Contact Hanle: 46.85
fnst branch circuit
Address: Each add branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State2IP: Each manufaentrecl or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 6615 2
E -mail: Pump or irrigation circle 53.40 2
- := +% `;:.,, =`a =_ - ,, ,,, < :,.�, - ' ^?a >,.. :�tt - - : . Sign or outline lighting 53.40 _
„�sri - «r�..'.�`�•' :_ .,,: >GORa12°i1GT();R;'�= . , - :��9;'- f . :r�' ,.�_� .. _
• - .xe „u. •_, .,.a, _,Y, sass -.,- ._: ,:a. , `i,. _, �, ...,. ... �,_. ,,.- �:.. , �j , 3�'�.- , ? "..�,...a- _,='rxt. < - �'•��,x : ._>~e.>", :�, ._ _. 53.
Business nsttne' Signal circuits) or limited -
C�-F>ar2.. 4�,K'E= SIS'r .tS energy panel. alteration. or
Address: extension. Describe: Page 2 75 2
City%StaleiZIP: p )2.1 4Na 1 . ( 7 ._ l.4 Each additional inspection over allowable in and of the above
1'erinspection 62.50
Phone: I s(3?�1C l{ e _ 2...-L ` Fax: ( 3 (4t'( 1- III C{ investi per hour (1 hr min) 62.50
CC B Lie -, ,5� - )t .j•-•) I Electrical Lie.. 31/•5- 2j,.Cad Suprv. Lie. / ,e /op 3. Industrial tdanfperhour ,, 73
ter °+ ;c=ash '
=v+"t:°ra3:.gs a3 ` - s' 'sa +>~ -r: `
C'r�+: a= ,.sass - ._:•�±= ' #'.�)'aY'i±i�j� }-^!;. rill" i« W1. i+ l�; 111��:! i' �S ".'G�rf3i�.�Y : : :eiiY�:- iiy�elS
Supr'. Electrician signature. required: Subtotal:
Print nalnc N { s{ , 4, • l f e . �.. Date: g "e :/ <,
Plan review (25 ",6 of permit fee):
Y� k =� ,, / " state surcharge f 12'%, of permit fee):
Authorized sigrWtiulr _ _r TO'l AL PERMIT FEE:
This permit application esplres if n permit is not obtained is thin 180
Print name: Date: da,s after it has been accepted as complete.
\umber or inspections allowed per permit.
P Building Perm IFLC•t'ennitApp nine ItS 23 05 -140-16151111 03 com t ( wlitt
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
-y.•> .. JP° ',C��� ^U +f�.. ..
5'x ,,, °'<� �'PY� ^..v .4'i'•�• '�- ''; °a- j•.:iy^.i'<�i
E' I{ESI�D R- NT*WgRa iNWE :. -3�...A {.: nZER
Fee for all residential systems combined $75.00
Check Type of Work Involved:
7 Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
WitifORMOMIONEVERINEWIMM
Fee for each commercial $75.00
system
(SEE OAR 918- 309 - 1)000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecom irmnication installation
g Fire Alarm Installation
❑ IIVAC
❑ 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
1- Haddim,Penms EI.C.PenanApp.dnc O. ii (ffi