Permit • ti
•
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00160
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/29/2007
PARCEL: 2S 102DA -00401
SITE ADDRESS: 13125 SW HALL BLVD PD ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: POLICE DEPARTMENT
Project Description: Low voltage installation of (2) card readers at telephone and IT rooms (see other).
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: : X
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
TIGARD, CITY OF SELECTRON INC
13125 SW HALL 7225 SW BONITA RD
TIGARD, OR 97223 TIGARD, OR 97224
Phone: Contact #: PRI 503 639 - 9988
FAX 503- 684 -4357
FEES Reg #: ELE 26- 497CLE
LIC 64341
Description Date Amount SUP 3645LEA
[ELPRMT] ELR Permit 5/29/2007 $75.00
[TAX] 8% State Surcha 5/29/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
i AT t Issued By: _ L , i4 , / Permittee Signature: ; C OWNER INSTALLATION ONLY CYn
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.
. , ... — ......._.—..... ...— ..._,,,,.......... ,... —.., s .:., ...... .. , ..... ...,"..1.,..,....l, .. • - . , , . .
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Electrical Permit Application ' . ..'...-;•.-.• -...:17012',OFFICE:•,USEPNLy-f:::' , !=.: , .. i ..: . ::;,,t4!,.. ,,„_,,,-,..:::
.- - ,--- :-.4.› ,..,-,... g• . , 1 "."=?. . Received „
City of Tigard - tl i 4 - K 1 ), ;: r 1
p
. ...,--,t L. .. .. „.., 9 • ' Date/By: , -. 1 CI 0 ...4 _
Plan Review Permit No.: EL r ts - &• 1 , D
Phone: 503.639.4171 Fax: n.5 ,'-' `--, •-4 ''''' Oar,Osaotital: Date/By- Other Permit:
Inspection Line: 503.639.4175 „4-ill:1(X'' .'::i. , Date Ready/By: Juris: A See Page 2 for
Internet: www.cistigard.or.us NAY 2 9 2007 Notified/Method: .hoor Supplemental Information
1- ':*•'N --= ':': ' ::' ' : 4 0 .- • ! ':, 5 -'4. -i '::: ; '' Z A - 1 1 `. :
0 New construction --' I AtICiftiort/alidaffiMreptacement Please check all that apply:
El Demolition PT TE,Dr iji V 1 SiirV. 0 Service over 225 amps, comm'l P Hazardous location
_., . ['Service over 320 amps - rating OBuildng over 10,000 sq. it,
'`.•:• .,...:;::,..-4,1-2-42 :w-.1.,.- -.:-'-'"- -•"- - • --- - '' "---'-'". - - ''''-"''''"''''
CATEGORY :-.4,W4:1,,:.r.',-="--:;',':VIR4,,,,:-
tr.::',1:g4tri?:11 9k9WIWg3I9.NN of I- and 2-family dwellings 4 or more new residential
Ej 1 and 2 dwelling ) 6 Commercial/industrial El Accessory building 0 System over 600 volts nominal units in one structure
['Building over three stories OFeeders, 400 amps or more
0 Multi - 1:i Master builder 0 Other: "n7t Occupant load over 99 persons I:Manufactured structures or
. 0,-,:•-:,;,1,...0.6:it.0..;s - LApite,,, ,- -'"'•-•-,r, -- "'Vi'- - " 4 '-' '-•-' ',' ' ' ,, 1 .ec
Cl
";' DEgress/lighting plan RV park
OHealth-care facility 0 Other:
Job no.: i Job site address: 131.-- SW 1_61 --- A v d
Submit 2 sets of plans with any of the above.
City/State/ZIP: i (,( The above are not applicable to temporary construction service.
6,T ;::*:00.
Suite/bldg./apt. no.: ° Project name: 0'_i 4_ 17,.,
—0 Description Qty. Fee. Total **
Cross street/directions to job site: New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. addl 500 sq. It or portion 33.40 . I
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non-residential 75.00 2
i-S k$ 'Okil'ff,0.1',..40:1C61 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
in( ( 2 ) C-..r.cl rt....6,1e)cs 64— 4.-Y.,phoyuo V ) . I rbill-n Services or feeders installation, alteration, and/or relocation
- ( r p---. 200 amps or less 80.30 2
P.MIZ 'Oliff i6:iiK6i:IZ,M-,Z1` 201 am m 400 amps 106.85 2
160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: • Over 1,000 amps or volts • 454.65 . 2
Reconnect only 66.85 2
City/State/Z1P: Temporary services or feeders installation, alteration, and/or
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 600 amps 1 133.75 1 2 '
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
fpfife 0$0,WZ-"EikoKi',;;:6;elping6WM4W A. Fee for branch circuits with
-,.., --: 0.'i,.1(f1 i ,‘, S, ,,,_." -_,- ,--..!,....--, :-..V:..S...-- ..,,, ,..,t4-
service or feeder fee, each
5
Business name: branch circuit 6.6 2
B. Fee for branch circuits
...
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Adciress:
Each addl branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
giWg5 ener P anel ' alteration or
extension. Describe: 1 Page 2 -600 2
Business name:
Address:
Each additional inspection over allowable in any of the above
--- SW "I I k e _ RA
Per inspection 62.50
City/State/ZIP: po, cp.._ 4 Investigation per hour (I hr min) 62.50
Phone: (S03 )( _gcia, Fax: (( i3S---/- Industrial plant per hour 73.75
i?.::.-SZ/;-13.MA: = 0-.K.0 - 10 1 0ALO*Elti40-iltt$,-'11172
CCB Lic.: 1 i Electrical Lic.:- - Suprv. Lic.: •- L-&04 Subtotal - 660 . ...
Suprv. Electrician signature, required: IDI 1 Ide Plan review (25% of permit fee)
State surcharge (8% of permit fee) L b
name: t,
Print ne- ' Date: /2 3) 0
Date: o ... ,.1. G r5 .._ c v.-, TOTAL PERMIT FEE ) .0(::■,
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed.
i:\BuildingTermits ELC itApp doe 12/03 440-4615TO 0/02/C OM/WEB
CITY OF TIGARD
1 BUILDING DIVISION T , n, PERMIT #: ELR2007 -00160
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2007
Phone: (503) 639 -4171 ttj id
Inspection Requests (24 Hrs.): (503) 639 -4175 ...: -,,, � �..
INSPECTION WORKSHEET FOR DATE: 6/14/2007 ' TIME: 7:00AI PAGE: 41
SITE ADDRESS: 13125 SW HALL BLVD PD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CITY OF TIGARD
DESCRIPTION: Low voltage installation of (2) card readers at telephone and IT rooms at PD (see other).
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: SELECTRON INC PHONE #: 503 - 639 -99I0
Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 050177-01 503-670-5216 N
Corrections /Comments /Instructions:
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�/A SS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: 6 ' 4"/ A/ Date: ■ / Phone #: (503) 718 -