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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00169 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/17/2008 PARCEL: 25101 AB -01607 SITE ADDRESS: 07540 SW HERMOSO WAY ZONING: MUE SUBDIVISION: HERMOSO PARK LOT: 009 JURISDICTION: TIG PROJECT: LUBY BUILDING Project Description: Installation of low voltage for burglar alarm. 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: URG ALARM : X TOTAL # OF SYSTEMS: 1 Owner: Contractor: LUBY BUILDING LLC AMERICAN VETERANS SECURITY LLC 7360 SW HUNZIKER ST 4420 SW 110TH AVE SUITE 206 BEAVERTON, OR 97005 TIGARD, OR 97223 Phone: Contact #: PRI 503- 808 -9010 FAX 503- 808 -9018 Reg #: ELE 34 -501 CLE FEES LIC 135086 Description Date Amount [ELPRMT] ELR Permit 6/17/2008 $75.00 [TAX] 12% State Surch 6/17/2008 $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 iLwo. k is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility • ification Ce -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules •r direct questions • • - C at 503.246.6699 or 1.800.332.2344. Issue By: � � iJ/ , u :� 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'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 A I' 1 EIVE.0 .03R i>rri<r:i,�ir o'i.v • Received permit No City of Tigard 1 Z Plan Review oos Date✓1' : , /. /• �,�, /t /1 :' 1 - a 13125 SW Hall Blvd -, Tigard OR Other Permit, - Phone: 503,639.4171 Pax: 503.5 1960 Q t Date/B Inspection Line: 503.639-4175 O� • T G' Pt D Bead rufu. VI S Page 2 for -1,1,i.1 I Supplemental Information �al ( 1SIO% Notified/Method: Suppl , Loma, tvu +w.tigazd- nr.gov nn �,..a, ,.. �. .. ,. ru:...r ,.,::,r , e' ...r,.,.: : 7' rfV, °,� .: , i E +' t ,nrg: p� r ,^ ' 1 t , -t,+ , I r. ' „bl i ,1 ':: ' r •, ?• ;!•` ' :11 ' r,g d r1 ! f ��f F L { }f dR �rq ' id -,•,�re"ki t . t ,, .,,,��e° �`-•i''f; ,,'(�' d1} t'�' f g d +lair:. r 'r r .!, >{: M1 r „i L , ' �� r „!,f' ^ � ,,/, f6 p171,' I :( }; ;. lli {, , i :: ^a, 1 i .t .3 u - � A h ^ {t ,I1!I r ai:; , ` e; . - sh t - :nt4.,.., ,:9,r, A rs v d:i! • r t. ' k. ;Id;fi la`l,r,ili d li- „ ��t „r f �,?:IiS ; ,” �1' `1t 1 7 ''� �+ � r! , 4{{% tt..: , .du'� ` klrc � � 'r , - � Please check all that apply (submit a sets or plans w /items ebeelced below): © New construction ® - t Addition/alteration/replacement anon /replacelnent ❑ Service or feeder 400 amps or rxtoze ❑ Building over throe stories. 0 Demolition ❑ Other: where the available fault current is Marinas and boatyards. s t r o. i , ,. , '+,r. r f it I I N r A r � !; ; 'i a.e.R4; t0,oc0.mps at 150 volts Or O Floating buildings. "4r.,1 ,.• It f C t'117 R ow' , �'`e,, :,, ° ; Vi '' W • � yu � "., i,l �jl 0. ,' a .rl ;, gpittiittt,,, + ,,, i, , ,,,,t ie ,. , ,. r ..l . r „ '',; Ctat - use agricultural „r, , !d„ t. , - • less to g round , or exceeds 14,000 ❑ Comuncr Li 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations, buildings. builder Other ❑ Fire pump. ❑ Installation of 75 KV A or ❑ Multi-family ❑ „e: „ ❑Emergency system. larger separately derived system. p as ,i d , , IIk'i, o rlodt. i �plr t , . r i, 1 r " i l P u , , ) ,: Mast 'l�m� Ti�f� u , ! I ❑ Add i tion of new motor load of ❑ "A° .. l �., 1 1, iCp i 10011P or more. ocrupaney. Job no.: Job site address: 7540 sw hermosa ❑ Six or more residential units. ❑ Recreational vehicle parks. ❑ Healthcare facilities. ❑ Supply YOitage for more than City /Statel2lP: tiger d, or 97223 Y p Hazardous locations, 600 volt nominal. ❑ S or feeder 600 art. s or more, :,r rrrr y3 +: +. + Suite/bldg./apt. no.: Project name: luby law firm ;:;;u'r.,l t r'i:i tp .si . a a.- •! : ' 'dfr; ; ; t , dl, I . :: ,I . oire.rr . YdF = �c'i�, ^ ��� :ii:re f ,`: can +r�tafu, ;lie + Cross street/directions to job site: veseription Q(y Fee 'total - New residential single- or multi- farnity dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 d Ea. add' l 500 sq. ft- or portion 33.40 1 Tax map /parcel no.: ,: biroited energy, residential 75 -00 2 + r; if { y { . r rr r - ,E 1 rw)R „'r �' ' 1,,., �} " ` ° (with above sq. ft.) !lk,k,�'1 trt i ?i g ,, cI i ,1 +:^ 414,11171 t'7b7,`a., dt' ..:., r r .,. Limited energy, multi- family 75.00 2 alarm System residential (with above sq ft.) { , Services or feeders installation, alterations, and/or relocation 200 alum or less 80.30 2 r-- , : , ,r „ rd:: ; ,ld . : <. { - f,�, :,a,,,:: 106 f t 1 'o , : y r� r + rn, i tr p � , Ce 7 3 ,d ,lit, °,,,., "'; r ,. : :,„ 201 amps 2 ,' -' it IIl 5 a n"E.+ . A (,'', Idl ! nrr, ■l.,l r i lk ',i lt ;:' p L :.: •f P 401 amps to 600 amps 160.60 2 Name: - 601 amps to 1,000 amps 240.60 2 Address: Over 1,0 am s o r volts 454,6 2 Temporary services or feeders insta a and/or City/State/ZIP: relocation Phone: ( ) - Fax: ( ) 200 amps or less — 66.65 201 amps to 400 amps 100.30 2 Owner installation: This installation is being made on property that I own which is not 401 amps s to 599 am p s 133.75 2 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - - Branch circuits — new, alteration, or extension, per panel Owner signature: _ Date: 4 A. Pee for branch circuits with NNE y 'y� �r { fir; I . °'� q above service or feeder fee, • ,. { l r . 0 ti ' , l'Q fk rt �r� � 'JEi.,r(H`Ifp , x .. 7 1 ' ll . i . � i jh7' t, rf - II � ..„ in � t t, • { . .. , J e'w,3 f , , L � I,'u'1 6.65 T 2 each branch circuit Business name; B. Fee for branch circuits without service or feeder fee, 46.85 2 Contact name: first branch circuit _Each add'', circuit 6 -65 2 Address: — M,acellaytous (service or feeder not included) r ,^ City /State/ZlP: Each manufactured or modular 90 90 72 dwellin service amd/or feeder Photo: ( ) Fax: ( ) Reconnect only 66.85 2 Pump or irritration circle 5340 2 is mail: „ ^ 59.40 2 t •., xr. :,Gro= , ;,;, �Vir � ?u %iiljN ^? ., i i i:% ai C: ;'j,I ii R St nor ODUi lightin Fly '`ti; 3i� a ,ii, r l u ° " {l � t i�I� � !�'�' , t � nfri 9li. it3h f � r l',1,',:,,P;:=:"1'.., . , : „ AAii p k I i , • Signal circuit(s) or lirnited- $usirless name: American Veterans Security, LLC energy panel, alteration, or extension. flesn Page 2 2 1 75 Address: 4420 SW 110 Ave, City /State /ZIP: Beaverton, OR 97005 m _ Each additional inspection over allowable in any of the above _ p 62.50 Phone: (503) 8089010 Fax: (503) 8089 investigation ,er hour (1 hr min) 62.50 Industrial •lint par hour 73.75 CCB Lic.: 135086 A r 50 4 is it 7[v Lic.: 22771ea r'r Industrial d „ tit l :- , ;�t 1 ! :', /, i l : 1 ; ,,, ; .. 1 „,rt ..c.,, i. - ;*,� dg llttl Thi i,l, ilp i Suprv,. Electrician signature redui ` : % • . • Subtotal: 75 V41Y �� ate 6/17/2008 Plan re view�(23 9c of permit fee): Print name: John Ke . State surcharge 12% of permit fee): 9 Author' • •i- � : •t -i .� r� 1'f TOTAL PERMIT FEE: $4 ' .r• .�w� This permit application expires if a permit is not obtained within 180 �9� ilva D ate: 6/17/2008 days after It has been accepted as complete. e 1-lumber of inspections allowed per permit. :1 %Uilding.F' 'shAEl- • rentApp.Sac 55/231Ut •040- asl3711/03 /C01M•1raeB Electrical Permit Application. - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: i { ,. N )nleY ",rsr i .� Fee for a residential systems combined .. $75.00 Check Type of Work Involved: O Audio and Stereo Systems* O Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* d Vacuum. Systems* n Other:. Fee for each commercial $75.00 system (SEE OAR 9118 - 309 - 0000) Check Type of Work Involved: • Audio and Stereo Systems • Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ I-IVAC El Instrumentation Intercom and Paging Systems • D Landscape Irrigation Control* fl Medical • Nurse Calls • Outdoor Landscape Lighting* El Protective Signaling Cti M Z Other alarm sy§tcm — 6 Total number of commercial systems: 1 *•n licenses are requited. Licenses are required for all other installations I:\ oildingPcrrnirs \2LC- PctmirApp.dnc ()3/2:i/06 CITY OF TIGARD i 40//f BUILDING DIVISION PERMIT #: ELR2008- 00169 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/17/2008 Phone: (503) 639 -4171 .��Imlingl�ilr Inspection Requests (24 Hrs.): (503) 639 -4175 =�� INSPECTION WORKSHEET FOR DATE: 6/16/2008 TIME: 7 :02AM PAGE: 39 SITE ADDRESS: 07540 SW HERMOSO WAY CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 009 TYPE OF USE: PROJECT NAME: LUI3Y BUILDING DESCRIPTION: Installation of low voltage for iiQar ar alarms OWNER: t.UI:3Y BUILDING LLC, PHONE #: CONTRACTOR: AMERICAN VETERANS SECURITY LLC PHONE #: 603.808- 9010 • 9 01 Inspection Request Scheduled For: Date: 6/18/2008 Pour Time: I ' .Pv, Code # Inspection Description Confirm # Contact # Mes age ;It - 135 Low voltage 071562 -01 50x•319.4754 Y Corrections /Comments /Instructions: 1- ,e / ■ r v9r i MK ue ��� AV / Ao • . ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS I I FAIL n CALL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED Inspector: '� Date: / Phone #: (503) 718-