Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELR2012 -00018
[GAM) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/01/2012
T
Parcel: 1 S136AD06000
Jurisdiction: Tig'ard
Site address: 11437 SW PACIFIC HWY
Project: Carl's Jr. Restaurant Subdivision: VILLA RIDGE Lot: PTS 1 -2
Project Description: New drive -thru restaurant.
Contractor: GLOBAL SECURITY & COMMUNICATION Owner: EJM PROPERTIES INC &
3212 MAIN ST MAVERICK DECATUR GEORGIA LLC
VANCOUVER, WA 98663 3633 E BROADWAY
LONG BEACH, CA 90803
PHONE: 360- 693 -1900 PHONE:
FAX: 360- 906 -9692
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/01/2012 $150.00
12% State Surcharge - Electrical 02/01/2012 $18.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: N Boiler Controls: N
CCTV: Y 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 $168.00
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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �_ �� 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' 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. 31. 2012 2:17PM No. 5225 P. 2
INJED .
Electrical Permit Appli I :•. l (,ri (Olt l � ,1 ONO
City of Tigard i bm 31 2012 tga: G :,P - .q4 ,
&
13125 5W Hall Blvd, Tigard, Ole Pe / �
Phone: 503,718.2419 Roc 503.59883 a . Oth f L°ic i ' , (f'w ) t 06
T 1 . , • r . I', inspection line: 503.639.4175 CITY u " + 1 GA'i'OD I3 pe. lteadylBy: - 0 see hat; Po?
Internet: www,tigerd-0r.gov 1 �'ri�1 DIVISION 1Votife4!Merhod; �� Su ilemeoal Information
�• :U � �+ R^q .•� K Y t P v ry;'i�5.� � :;',54. W; •,o.
4tnt c s ? ,.W .:s , is 9' '!1 ;3 f v h..' `� • d71lq r 'i lx r3 `
..s .._. 8• h� � , dc.. p yR: . t'.'�r " , h �.. ' ah.. � n.N.,ux: �; " ..�r.2 ..✓.cx 4 - ^w ,.. 2�.1'.:i:x:...:
® New consttnerion 0 Addition/alteration/replacement late deck all chat apply (aahmlr2,sets aFpl■ns tvfirems decked below):
❑ service or feeder 400 amps Of move o Making VW &Ter entice.
❑ Demolition 1 FY�Sae ❑ Otter . o wbe�v use evadable fault mat 1:1 Merinos and bomr141
.i • _ r°j ,rl :F , �' '1F i fa r t- d tjVli 0 L,f '+ 7 1 :. i : u'l. .t ::: ' E A '. 4 ' 7 ' • :,, : 1 pond, or exceeds I Golfe � ID Comm t • a O g7lcuItUti1 •_ x � ti_
❑ 1- and 2- 63mily dwelling gi Cottuata eia1/mdustrial ❑ Accessory building amps for all od erinemlladees. building'.
0 Multi vD�yyt y 0 p Master builder ❑ , t Ot t h 7 e a r: ��7�!�1 �Q}Qf G,{1 LIF pimp, OIa fisaw a f75 KVA or
' ∎ `E . i0' I WIIY: w7M.'dkn�J �i e . 11 s 11 k to 1� 7fr'7�ni_ D_1 ❑ A a m, boa separately arately derived ayakem
a 3w r• $w � eey ❑ Addition of soap motor load of ❑ "A ", "r."1.2", "1 -3'
Job no.: Job site address: 1 1001IP aemoee. oRP !-
IM 1
❑ $ix or more /Gad■mial sada. ❑ Recreational vehicle pats.
City/State/ZIP: Tigard Or 97223 : ail 3 7 ❑Hoahb•emt facilities - 0 Supply voltage rot more than
(JBsaardaaa locations. 600 vole nominal.
SuiWbldg, /apt no.: Project name: Carl's JR . ❑ pia or feeder 600 amps or mar■.
Cross street /directions to job site: '. °'h Porniewee QV. k:r i t •4�<"�• ,' _ '=;11 _ b urr ' '1. '. <p ':.�� z '.T - •
New revideuttal aiogle -or multi - family dwelling unit
Include; attached garage.
Subdivision: Lot no.: 1,000 sq. ft or leas 168.54 4 •
Tax mt;p/parcel po.: FA ■dd'l SOn aq, tk or portion 33.92 1
w� Limited energy, residential 75.00 2
•n4•:yXi..6. •v �r�; -* i.,: ; , 44 . % 7.' '�i3 . 01 - 1 >:Ri - V :' F:c 4 :2 :n. ?: Nr twilit 9b"e A fc) 1
limited= orgy, multi- family 75.00 2
_
Install of Security alarm and CCTV System residential (with above sq. ft.) --L—
' Services or feeders losmllation slreretlon, And/or relocation _
200 amps or less r 100.70 2
%:;,' ��/� dd'''era c.TV;h:1° v.vr, • � iii �, , - c ;ii �; 201 an76 tD 400 amps 133.56 2
i∎ . :_A r. t 'a m • , Attl J 'L:`aYYTrl � _ ..4 J r +• , iF.iL �A • • Y :si` ::... a , a, a ••. - P. 1 i
Name; 401 amps to 600 amps 200,34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 snips or votes 552.26 2
relocation Temporary sooicd or feeders installation, alteration, and/or
City/State/21P;
Phone: ( ) Fax ( ) 200 amps or less 59.36 1
Owner Installation: 'Ibis installation in being made on property that I own which is not 201 amps to 400 amps — ]25.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
441 999 crops 1
2
Branch circuits - new, alteration, or ertensloa, per pawl
Owner oignotu e: Dade: A. Pee for branch clreults with
�,> x
; r �ti� ,, t , �s+a _ c k. '.- y ; > yy � ` y �- above service or feeder f
..., n F 1 JC'' � L� A (`: ? " 'wi�F!.!' kA+y .y�1" �o.zugi "C� % 7.42 2 �'
%; ��svf,�;•- . C 6 �. � ; l; >�S�e7i'SIL �.. •: i,li•,�. :`;tt'"��.�1'L'•�.. ;... Cetlb bisect] II Clr1t
Business name; Global Security B. Pee for branch cinnuia %/1tho a '
serdee er Rader fee, fires 56.18 2
Contact name: Jeff 1saak brsncb circuit
-- - - - - - Each add' l branch circuit 1,42 2
Address: 3212 Main St Miscellaneous (service or feeder not la cluded)
Ci /SraWZdP: Vancouver Wa 98663 Each menuracn a nod/ modular I 67_B4 2
dwelling, service and/or &vier • l . ,_,
Phone: R60) 693 - 900 Fax: : (360) 906 Reco®ecronly 6714 2
- - . Pump at irrigation circle 6714 _ 2
F, - mail: jnffi@global4sceurity.cotn Sip or outline lighting 67.64 2
;' 0 't& �s;7` ` �'' " 1 -e + . i .l 4_ 3 a7 kti., circuit( )
r,' . 1: �4 stnFl , a W a.� ?i J' Len?: �• �x� s. 3R; r, S7 S 0r lwiord •c
Bashiess name: Global Security
ne altemfia. aaraa®sian � ? P 2 150,00 2
1ta A itlonal lab pcctlon over allowable In any of the aboWe
• Address: 3212 Main St Addiliano3 inspection (1 hr into) . 66.25/14r _ T
' Investigation (1 In min) 66.25/ hr
Caty/5tate/Z1P: Vancouver Wa 98663 - i ai P lant (t hr m in) 78.18/ ht
Phase: (360) 6931900 Fax: (360) 9069292 Imspecrioes fbr which no fee is 90.00/ hr
s. oitlra listed S4Srmin
OCR Lic.; 6970 Q / I Electrical L a.: 26 -7 1 Suprv. Lie. : 1 81 z ( �' . rc;, ; : � e.- ia•`. a a,�1 p -- s . ; , t;;,t:. ;,;r,<,
J J — Subwtab 150.00 _
Suprv_ Electrician sign required: y ''11 l I aye i Plan review (25% of permit tae):
Print none :. wile Be.E T p1./ 6.10../76.10../716.10../71:1 r0 Bate: - Statesutchergc (12 %ofpotmitfee): 18 - 00
TOTAL PERMIT FEE: 168,00
Authorized Sip:ratwe; , .'
f r ' „- .._ . Mr permit application eaPtey ire wank Is not [Malawi within 150
� Date: 1 /31/2012 dare star h has been aneptel as compute•
Print name: Jeff I,/ Number of inspections allowed pm' p,QrniC
•
IdH /iaoelPeredtm0- Patnk/ pp.da 07101/10 e413- 4413T(1 rttSJCOMIWE9
'
"°I Biri769SEEOS ' - dSa :E0 Zt IC U°['
Jan. 31. 2012 2:17PM No. 5225 P. 3
, Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
SID^
Fee for all 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*
LI Other:
A -
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
❑ I
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other CCTV
Total number of commercial systems: 2
*No licenses are required. Licenses are required
for all other installations
la uilQing\PermitsTLC•PermicApp.da 07101!10