Permit IN 9 CITY OF TIGAR ELECTRICAL RESTRICTED ENERGY PERMIT
2 ;' • COMMUNITY DEVELOPMENT Permit #: ELR2009 -00062
Date Issued: 03/23/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135DD01400
Jurisdiction: Tigard
Site address: 11630 SW HALL BLVD
Subdivision: Lot: 0
Project: Sayler
Project Description: Install burglar alarm.
Owner: FEES
SAYLER, ANNA R Description Date Amount
PO BOX 23757 Restricted Energy Permit 03/23/2009 $75.00
TIGARD, OR 97281 12% State Surcharge - Restricted Energy 03/23/2009 $9.00
PHONE:
Contractor:
SOUND SECURITY INC .
8220 N INTERSTATE
PORTLAND, OR 97217
PHONE: 503 - 223 -5822
FAX: 503 - 973 -7773
Type of Use: SF
Class of Work: ALT
Total Number of Systems:
Audio & Stereo:
Security Alarm: Y
Garage Door Opener:
•
HVAC: Total $84.00
Vacuum System:
Required Items and Reports (Conditions)
Other
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 942- 001 -0100. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 0}� A. r VC. (...._ U.32i , Permittee Signature: ��� i� it � � C
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'N 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.
Electrical Permit Applieatrofig � It - FOR OFFICE USE ONLY
City of Tigard DEEiew y • f , Perm t No.: C l (2.2.. / . It '! 13125 SW Hall BvdTigard, O 3 1 g 2009
Phone: 503.639.4171 Fax: 503.598.1960ry - ^ Date/By: Other Permit: — _
TIGARD Inspection Line: 503.639.41 OF TIGARD Date Ready /By: - iuris: /// S5 See Page 2 for -
internet: www.tigard or.gov BUILDiNG DIVISION Notified/Method: 1 t Supplemental Information
,
4�,a »t:, .W fi ,.,, -. iii. , :.,,�, 4
.. <, n� "" , ,. ,,- k a. „ i ` r �� `' PI Al Itl \t`IL' z
>..�, - ..� "u.:,.- �� -.,.. �.... ,. .,,, „ � ^� , ,,, ., ,.,.. iP W O R KF,,,,. ,.. � .- ..: ����J.. ... ^..> ..
_u.
❑ 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.
w ,«
� - � � ' ' "1�; �;,;:. �� \ „_ >;, y,.,x exceeds 10,000 amps at 150 volts or Floating buildings. "` .G E` ORI10.F..G(1NSTRCIC I'« „4,U `,.., ; .; :-
^
-M :z
¢, ., a ..F, ... J ''x`- ":\t.:io:`'�Iln• a'vf •:;'`a"d.
mss',' ru °:,s..a.,i, ^.,<o:�...gx;'o, :.. , - - .., ,;x, .. ..:s^ Si4`'X.-�xxs,.x.: "::,g?: ��.cx '?..,... � `."';n- ,^e,n.
��° >�-� ° -�° less to growtd, 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
. a.> ..: .,,".^::, .::.,. a.:: .a; >,,..v s5 .. ❑ Emergencysystem. system.
l
:, - "m <�,.,,.., � c; ,> . -; ..r.; ANTI AND' =Y. AN `. % load of Ia separately tZ y er3 ve
,�. J()$ SITE IN>E' : ON;M (Q� . -`E� >` ❑ Addition of new motor o d o ❑
.•E�'•i���'4't�€i . .. x, ^Q�. -.'3s ,,, �„ . >, ws:,,,�,•r•�.a�r. «s. ,;,� � „r;,.�,,,ao�a., ,A S:...,.. .,..�... . .,.. _ ...., ,'I;�,i's Hai' �=
100 HP or more occupancy.
Job no.: PV09005 Job, Site address: 11630 SW Hall Bvld. __ ❑ Six or more.residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Sayler Residence ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Description I Qty. I Fee. I Total I *
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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: energy, residential
75.00 2
er e
Limited en sl
r;r:. °;; (with above sq. It.)
Limited energy, multi - family 75.00 2
Installation of Security System residential (with above sq. II.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
!Wit-V- _: _;;� ',;T A ., .., ?, >:, 201 amps to 400 amps 106.85 2
-
PRPERCY,UWNER'` ., P P
401 amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps.or volts 454.65 2
City/State/ZIP: /State /ZIP: Temporary services or feeders installation, alteration, and /or
Y relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
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
Owner signature: Date: - A. Fee for branch circuits with -
)?' GtON ACT: :f igaolumil above service or feed er fee, 6.65 2
each branch circuit
-
Business name: Sound Security, Inc. B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: John Sage first branch circuit
Address: 8220 N. Interstate Ave. Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 97217 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 223 -5822 Fax: : (503) 973 -7773 Reconnect only 66.85 2
E -mail: jsage @sonitrolpacific.com Pump or irrigation circle 53.40 2
;: ;z>a Vii” _+ n> ;'3'` Si or outline lighting 53.40 2
;;. a ,; s , is ' a — --
Signal circuit(s) or limited -
Business name: Sound Security, Inc. energy panel, alteration, or
Address: 8220 N. Interstate Ave. extension. Describe: Page 2 2
City /State /ZIP: Portland, OR 97217 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 223 -5822 Fax: (503) 973 -7773 Investigation per hour (I hr min) 62.50
CCB Lie.: 53535 Electrical Lie.: 26370CLE Suprv. Lie.: 21 10 Industrial plant per hour 73.75 • ,, ...- ,r ,_;,::� >:.,
l II
�,.� ira `' �sa -: °..< ELE< R �, C�i�`..,, PE1. 2Nt [TF�ES�:., >�S�Rr <:t�8:,�.�..;;
Suprv. Electrician signature, required: Subtotal: 7 .00
Plan review (25% of permit fee): —44,4-5—
Print name: � • - Q____ Date: C J C7 State surcharge (12% of permit fee): 9.00
Authorized signature: Y `_ � ��� TOTAL PERMIT FEE: - '-tb2'T5 -8u',(
Print name:
�V61.4I �e e ( ,t (�,.n ,a Date:3 (� v 07 This permit application expires if a permit is not obtained within 180
�ee / days after it has been accepted as complete.
' Number of inspections allowed per permit.
1:\Building \Permits \ELC- PermitApp.doc 05/29/06 440- 4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
ii0.51
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
® Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
•,. >...:�....w ^rT.:�e ssrm . �: N.' � %�4
AR EITOALA%�D K® LY. .......__ _.
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*
n 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:\ Building \Permits \ELC- PermitApp.doc 03/23/06