Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: ELR2012 -00006
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/10/2012
Parcel: 2S112DB00200
Jurisdiction: Tigard
Site address: 15255 SW 72ND AVE
Project: Pittman & Brooks Subdivision: FANNO CREEK ACRE TRACTS Lot: 45
Project Description: Security system.
Contractor: SONITROL PACIFIC Owner: BROOKS & PITTMAN RENTALS
8220 N INTERSTATE AVE 15255 SW 72ND AVE
PORTLAND, OR 97217 PORTLAND, OR 97224
PHONE: 503 - 223 -5822 PHONE:
FAX: 503 - 973 -7773
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/10/2012 $75.00
12% State Surcharge - Electrical 01/10/2012 $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 • • • • - rule •irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. —
Issued By: /ti' ✓/ .mV ' Permittee Signature: L�
'�
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.
Jan. 9. 2012 10:18AM Son i t rol
\ r
-, ‘;* • No. 0644 P. 2
Electrical Permit Ap lication c 4 FOR OFFICE USE ONLY
Permit No.; E AA)
City of Tigard ( Received ,
3 'it 13125 SW Ilan Blvd., Tigard. OR \...\ N.% Date43 : / Ma
,i,.;\c) plan Review ,*
- - : Phone: 503.718243 9 Fax: 503,59 .1960 Is - ..(s,C41"`.,,A,..‘baTe/BY: Other Penn it:
TitiAktp
Inspection Line: 503.639.4175 Ck r .,, c, N ` N ' 0 to R d /By: Avis: 121 See Poo 2 tor
N...P cr • N ethod:
Internet; WWW.ligard 7."--C; SuPplemenial Information
..'.;:.i.:"':':::..:-,:.•:,';.:.',:',:v:i.....-4A1*.0.,;*0IP<..,),:..:.;:ir.'.:,..:::,3,1:. l'.. ,:': ;•.",::!:',•:::;,:::: .!,:."':'':'''11-;411'.,:d*.:':."'::
New construction D Additionfalterationablacemenl Please check all that apply (submii 2. seta of plans witems checked below:
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition Ejl Other: where the available faun current 0 Marines and boatyards.
'.: 7 '. • ' - :' : ''' s''''. ' ''. " " ' .' ' :' '... — ' ' " ftlf' : OF 'CONSTRtleTION .:" ' ' . ' ' ."'. . ' .:', exceeds 10 NO am s at 150 vollS or D Ploatin buildio 3 less to 'on,id, or oeceedt 14,000 9 Commercial-use agricultural
p I- and 2-family dwelling CE Commercial/industrial 0 Accessory building amps for 111 other installations. buildings.
El Multi-family D Master builder p Other: D fire pump. 0 InstallatiOn Of 75 KVA or
larger separately derived system.
,' :. i ', '', :'...‘,t ." ' ...:, ,, • , ,: .4 .$ 4'. ANP..0.cf:11 - .,. ':.,::...,..:, . ,.... :-..: 0 Addition of new motor load of 0 "A "E", "1-2", "1-3",
Job no.: P12003 Job site address: 15255 SW 72" Ave 100111 or more, occupaney,
1:3 Six or more residential units, 0 Recreational vehicleporks.
City/State/ZIP: Tigard, OR 97224 ['Health facilities. 0 Supply voltage for more than
9 1la2ardons locations. 600 volts nominal.
Sllildbldglapi, no.: Project name; Pittman & Brooks 0 Senrice or feeder 690 amps or more.
FEE SCffEDJLE
Cross street/directions to job site: I:410110o 1_01.s. I ice. 1 Tail I .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54
Ea. addl 500 sq. St. or portion 33.92 1
Tax map/parcel nO.: Limited energy, residential
75.00
':',..':•:.,'•::...:,:'..;J; . :.,":•; l].- : I : , :..F, .:::, ::':: .:.:,DF.,$.(111WTION.:0F;WORK:.- ::',....i..: ,.,.., :r ., :: : ,.: . . (with above sq, R.)
Limited energy, multi-family 75.00 2
Add security equipment residential (with above sq. R.)
Services or feeders inslallatIon, alteration, and/or reloca lion
, 200 amps or less 100,70 111
. .; - 0 PROPERTY dci :. ''.' ...: '....:..: ::.:r. ..El •:'Oti■L:tNt.'..::,:.: ;H /..:.',... 201 amps io 400 amps 133.56 2
. ... . ,.
Name:
401 amps to 600 amps 200,34 2
- .
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, And/or
City/State/ZIP: - relocation
200 amps or less 59.36 1 I
201 amps to 400 amps 125.08 2
Owner Installation: This installation is being made on property that 1 own which is not
401
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 70). amps to 599 amps 168.54 2
Branch circuits - new, Alter1111011, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
0 ' ".'.',:: ' .:..."•:.!•:' .. 1:1.•ONticr •Ikasdii.''' ' '..': above service or feeder fco,
7,42 2
. . _ .... ...., each branch circuit
Business name: Sonitrol Pacific B. Pce for branch circuits without
_ service or feeder fee, first
. ' 56 2
Contact name: Leslie Erickson branch circuit
Each add'] branch circuit 7.42 2
Address: 8220 N Interstate AVo _ Miscellaneous (service or (ceder not Included) )
Eachmanufacnired or modular
City/Stare/ZIP: Portland, OR 97217 67.84 2
dwelling, service and/or feeder
— •
Phone: (503) 223-5822 Fax; ; (503) 973-7773 Reconnect only 67,84 2
PtInlp or irrigation circle 67,84 2
1.1,-inail: leriekson@sonitrolpacific,com — _
Sign or outline lighting 67.84 2
— Signal circuit(s) or limited 1 75.00
panel, alteration, or eXtenSion. Page 2 2
Business name: Sonitrol Pacific Each additional Inspection over allowable in any of the abov
Address: 8220 N Interstnte Ave Additional inspection (I hr min) 66.25/hr
Investigation (I hr iniri) 66.251 hr
City/Statc/ZIP: Portland, OR. 97217 Industrial plant (1 hr mia) , 78,18/ hr
Ph011e: (S03) 223-5822 Fax: (503) 973-7773 Inspections for which no fee is 90.00/ hr
specifically limed OA hr min)
CCB Lic.! 53535 IIIMICIMEE Suprv. Lic.: ::.....'•:;.::.. ... ELECTRICAL PERIITT • FEES . • .. • ' '''''' "' ''.
Subtotal: 75.00
Suprv. Electrician signature, required: Plan review (25% of permit fee):
—
Print name: Gordon Wicettep . ' At Dale: 1/9/2012 State surcharge (12% of permit fee); 9.00
%OVAL IA
- IralUi. TOTAL PERMIT PEE: 84.00
. ,
Authorized SignalullirMilf. . /
This permit application expires If a permit is not obtained within 180
12111:1EMTM111111.111111 -
Date. 1/9/2012 days after il bas been accepted 01 complete,
• Number of inspections allowed per pennit.
tAllulldlneermitaLc-rermitApost• 07/01/10 440
Jan, 9, 2012 10:18AM Son itrol No. 0644 P. 3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for a residential systems combined $75,00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
;,:COIVIME;ItCIAL WORK:ONLY;`.::,:,'
Fee for each commercial $75,00
system
(SEP OAR 913- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data "Telecommunication Installation
• Fire Alarm Installation
❑ I -IVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other SeFy�xr Equipment
Total number of commercial systems:
No licenses are required, Licenses are required
for all other installations
\BuildingWermiis\ELC- PcrmhApp,dx 07/01110