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Permit CITY O F I FI GA R D ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00043 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/26/2008 PARCEL: 2S 102DA -00800 SITE ADDRESS: 13335 SW HALL BLVD ZONING: R -12 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: CITY OF TIGARD Project Description: Installation of low voltage for security alarm. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X 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: TOTAL # OF SYSTEMS: Owner: Contractor: CITY OF TIGARD METRO SAFETY AND FIRE INC 13125 SW HALL BLVD 14324 SE STARK TIGARD, OR 97224 PORTLAND, OR 97223 Phone: 503 -639 -4171 Contact #: PRI 503- 231 -2999 FAX 503- 256 -4691 FEES Reg #: ELE 26- 1154CLE LIC 63651 Description Date Amount [ELPRMT] ELR Permit 2/26/2008 $75.00 [TAX] 12% State Surchai 2/26/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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 503.246.66** • .800. ' .2 •4 Issued ::y: !�/ , . Permittee Signature: X 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 Application . /- F OR OFFICE USE ONLY o City of Tig DateB ,g� Os, o ff / Permit No.: ������' C � • q 13125 S W Hall Blvd., Tigard, OR 97223 y I g Plan Review :._ Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit: T 1 GA R D Inspection Line: 503.639.4175 Date Ready /By: mri ® See Page 2 for Internet: www.tigard - or.gov Notified/Method. i' Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans wlitems checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: 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 JOB SITE INFORMATION. AND LOCATION ❑Emergency system. larger separately derived system. . ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: toollP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 13 3R s 3 w 14 13 Iva/ _ a Health -care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: J-ANn r a t..ekL [�,vS� El Service or feeder 600 amps or more. `v" FEE SCHEDULE 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.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) � Limited energy, multi - family 75.00 2 C �P C v p. t _I A l A4L� s 4c-,......- a residential (with above sq. ft.) h Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 X PROPERTY OWNER, I D. TENANT 201 amps to 400 amps 106.85 2 Name: nn II 401 amps to 600 amps 160.60 2 l t`�. O F 1 I '� 601 amps to 1,000 amps 240.60 2 Address: 11 Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I 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 -X APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit • Business name: B. / Y��O SR F �- ICi R� I �nJG Fee for branch circuits • without service or feeder fee, Contact name: m A le C c 2 J first branch circuit 46.85 2 Address: ' 3 a S F s. k ST: Each add'1 branch circuit 6.65 2 7 Miscellaneous (service or feeder not included) City/State /ZIP: Poi24,114N © . Q ) 3 Each manufactured or modular 90.90 2 r // dwelling, service and /or feeder Phone: (5b3) a3 1_ x59 9 / I Fax (Sa3) ZS(, ��7�Q1 Reconnect only 66.85 2 E -mail: 4,70.4 C Q i iiergosArfirici AN ggg , (_p✓M, . Pump or irrigation circle 53.40 2 CONTRACTOR / Sign or outline lighting 53.40 2 B Signal circuit(s) or limited - Business name: /� amp p S 4- C e Std � .-A-C.. energy panel, alteration, or Address: extension. Describe: / Page 2 75,00 2 City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) / /l 7----- I Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lie.: Electrical Lie.: Su : Industrial plant per hour 73.75 Co,3 1 383 L�4 ry p! t Et/ C. LA ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: 00 Print name: ^ - I Plan review (25% of permit fee): 8-- /� A // I C CA.s 4:* ' Z( 4 State surcharge (12% of permit fee): ,9 , � l Authorized signature: 1���� TOTAL PERMIT FEE: �je/ d6 . Print name: Date: This permit application expires if a permit is not obtdMe within 180 days after it has been accepted as complete. * Number of inspections allowed per permit. t\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 l /05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 Supplemental Information ^~ LIMITED ENERGY PERMIT FEES: I RESIDENTIAL WORK ,ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: I COMMERCIAL, WORK ONLY: 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 n 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 I: \Building\Permrts\ELC- PermitApp doc 03/23/06 CITY OF TIGARD BUILDING DIVISION " - ' - - ' PERMIT #: ELR2008-00003 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2008 Phone: (503) 639-4171 Jail t Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 3117/2008 TIME: 7:01AM PAGE: 25 SITE ADDRESS: 13336 SW HALL BLVD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CITY OF TIGARD DESCRIPTION: Installation of low voltage for security alarm. OWNER: CITY OF TIGARD, PHONE #: 50639-4171 • CONTRACTOR: METRO SAFETY AND FIRE INC PHONE #: 503-231 Inspection Request Scheduled For: Date: 3/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Bullied final 066781-01 503-348-2699 N Corrections/Comments/Instructions: • Ilk . . \ PASS El PARTIAL APPROVAL 0 CANCEL n NO ACCESS FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Cr 6 (St2) Lt C Date: S Phone #: (503) 718- 144