Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11 11- ! COMMUNITY DEVELOPMENT Permit #: ELR2011 -00232
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/15/2011
Parcel: 2S112ACO2800
Jurisdiction: Tigard
Site address: 14865 SW 74TH AVE 150
Project: Precision Door Subdivision: 2003 -009 PARTITION PLAT Lot: 1
Project Description: Security system.
Contractor: ADVANTAGE AUDIOVISUAL Owner: FANNO CREEK ACRES LLC
400 SW 141ST AVE 14865 SW 74TH AVE STE 300
BEAVERTON, OR 97006 TIGARD, OR 97223
PHONE: 503 - 481 -3933 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/15/2011 $75.00
12% State Surcharge - Electrical 11/15/2011 $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 rules or direct questions to OUNC by calling 503.232.1987 or 1.8 0.332.2344.
Issued B . —_ «i t 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 �� ** FOR OFFICE USE ONLY
City of Tigard I � % AA \ Date/By: I : �` P No.: ',
III ived
" 13125 SW Hall Blvd., Tigard, OR 3 , , A Plan Review
ll P 503.718.2439 Fax: 503.598.19660 \ `S Date/By: Other Permit:
I GA RD Inspection Line: 503.639.4175 t�� 1� Date Ready/By: mils: H See Page 2 for
Internet: www.tigard - or.gov ^ � �1 v , G� Notified/Method: p Supplemental Information
TYPE OF WORD PLAN REVIEW
❑ New construction E Additlon/alteratioi eplacement 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 ❑ OtheI: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ 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
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 14865 SW 74 Ave. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 150 Project name: Precision Door ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Tow 1 *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'] 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R.)
Limited energy, multi -family
75.00 2
Installtion of Surveilance system with 5 cameras residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Precision Door Service
601 amps to 1,000 amps 301.04 2
Address: 14865 SW 74 Ave. Over 1,000 amps or volts 552.26 2
Ci / State/ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
ty g relocation
Phone: (503)784.4852 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amiss to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, Per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'i branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Ci / State/ZIP: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
Business name: Advantage Audiovisual panel, alteration, or extension. 1 Page 2 75.00 2
Each additional inspection over allowable in any of the above
Address: 400 SW 141 Ave. Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Beaverton, OR 97006 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 481.3933 Fax: ( ) Inspections for which no fee is
90.00/ hr
specifically listed (V2 hr min)
CCB Lic.: 191383 7/ Electrical Lic.: CLE243 Suprv. Lic.: 752LEA ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: o Subtotal: 75.00
Plan review (25% of permit fee):
Print name: Jim Rylander Date: 11/12/2011 State surcharge (12% of permit fee): 9.00
TOTAL PERMIT FEE: 84.00
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Jim Rylander Date: 11/12/2011 * days after it has been accepted as complete.
y Number of inspections allowed per permit.