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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ..Vy" COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00044 TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/26/2008 PARCEL: 1 S133DC -16600 SITE ADDRESS: 13091 /SW LAURMONT DR - 100 ZONING: R - SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 021 JURISDICTION: TIG PROJECT: ISOM Project Description: Installing low voltage intercom system. 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: INTERCOM : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: STEVE ISOM DELTA FIRE AND COMM, LLC #174599 13090 SW LAURMONT DR 33585 SE FRANCIS TIGARD, OR 97223 GRESHAM, OR 97080 Phone: 503 - 579 -1633 Contact #: PRI 503- 663 -5940 FAX 503 - 663 -1275 Reg #: ELE CLE122 FEES LIC 174599 Description Date Amount [ELPRMT] ELR Permit 2/26/2008 $75.00 [TAX] 12% State Surch 2/26/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: - Permittee Signature: �' �37/4//'d� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503:639:4175 - by 7:00 -a.m. for an inspection business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. /114 ., 02/26/2008 10:58 5036631275 DELTAFIRECOMM.COM PAGE 01/02 E ectlrical Per Application . FOR OFFICE USE ONLY •. y City of Tigard _ ' dc .6 l : 4 f _ �� Permit i o - r/t /�� Ctrig ,.. ,.. • 13125 SW Hall Blvd., Tigard, OR 97223 ¢ plan iteview II I ' Phone: 503.639.4171 Fax: 503. 98 1 Date /B : Other Permit: 7 --- UUJ f Inspection line. 303.639.4175 D head /By. rums, t' I • lee' it I) p Y t3 See Page 2 for Internet: www.tigard or,gov r• CQ , &j '/ jl,'3 .Notified /Method: supplemental Information " TYPE OF WORK t Z. ! PLAN REVIEW w _ Please apply submit sets of plans w /items checked below : El New construction El Addition/aitezatio�ldr��l � - .lt� 'o41�l ase check all that a C enOre or Pp , ( � P ) V 1L�` ' -q .$' U ❑ S .feeder d(X) Amps or more. 0 Building over three monies. ❑ Demolition El Other. where the available fault current 0 Marinas and boatyards CATEGORY UJf (X.11113T1'RUCTION exceeds 10.000 amps et 150 volts or 0 Floating bwldinga less to ground or exceeds 1 4.000 0 Commercial -use agricultural Z 1- and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other [nstauarions. buildings ❑ Multi-family 0 Master builder [] Other: : ❑ Fire pump. ❑ Installation of 75 KV A to JOB SITE INFORMATION AND LOCATION 0 Emergency systern. larger separately derived system -- - -- ❑ Addition of neap mote had of ❑ "A" "F.", "I 2" - l _3" Job no,: Job site address: 13090 SW LAURMONT DR. Ivory or more. occupancy. ❑ Sin or more residential units. ['Recreational vehicle parka City /State/ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than - Q Razardnuc locations. firm volts nominal Suite/bldg, /upt, no.: Project name: 0 Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: From Hwy -217 N., t sit #4 (Scholts Fr. Rd ueacrIPNoa _ I Qn. I Fit. 1 xorai • i -. rn - J New residential single- or multi - family dwelling unit. left on Scholls Fr.Rd; Left on SW I30; Riight on SW Shore Dr; Lett on Laurmont Includes attached garage. Subdivision: Lot no,: 1 sq. ft. or less I45.15 4 Ea. add'l 500 sq, ft or portion 33.40 1 Tax map/parcel no.: Limited energy. residential 75.00 2 DESCRIPTION OF WORK ( above sq. ft.) Limited energy, multi- farnily INTERCOM S YSTEM -- residential (with above sq It) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 1 80.30 2 S PROPERTY OWNER 1 © TENANT 201 amps so 400 amps 106,85 2 Name: CORRINE & STEVE ISO 401 amps to 600 amps _ 160.60 2 601 amps to 1,000 amps 240.60 2 Address: 13090 SW LAURMONT DR Over 1,000 amps or votes 454.65 2 City /State/ZIP: TIGARD, OR 97223 Temporary services or feeders installation, alteration, and/or __relocation _ _ Phone: (503)579 -1632 Fax: ( ) 200 snips 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 intenchetl for sale, lease, rent, or exchange, according to ORS 447, 449, 670 and 701. 401 amps to 599 snaps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, r panel - A. Fee for branch circuits with El a 1,N"E.L1C',ASt'"l' C] CONTACT PERSON above service or feeder fee, 6.65 2 Business name: DELTA FIRE & COMMUNICATIONS LLC B. _ Fee e for brtutch circitirs Contact name: FLORIN PANAITE _ without service or feeder fee 46.85 2 first branch circuit Address: 33585 SE FRANCIS RD. Each add'l branch circuit 6.65 2 Aliscellarteous (Service or recder not included) City/State/ZIP: GRESHAM, OR 97080 Each manufactured or modular Welll . 3 g ervtce 1115{ior feeder 90.90 2 d Phone: (5013) 663 - 5940 Fax: : (503) 663 - 1275 Reconnect only 66.x5 2 w E -mail; deitafirecomm@hotmail.com Pump or irrigativrl circle 53.40 2 3n lighting CONTRACTOR S( or outline li tin 53.40 2 Business name: DELTA FIRE & COMMUNICATIONS LLC � Signal circuit(s) or limited. l energy panel, alteration, of Address: 33585 SE FRANCIS RD. extension. Aes��ibe: 1 page 2 75.00 2 INTERCOM SYSTEM City /State/ZIP: GRESHAM, OR 97080 Each additional inspection over allowable in any of the above Per in,peukiOn 62.50 Phone: (503) 663 -5940 Fax: (503) 663 - 1275 Investigation per hour (1 kw rria) 62.50 CCF3 Lic.: 174599 Electrical Lic.: CLE122 Suic.: Industrial plant per hour 73.75 Suprv. Electrician signature, required: r EL>rLCfRiCAL PERMiT a l Subtotal: 75.00 Print name: FLORIN PANA ITE Date: 2/26/06 _� z'lan review (25% of permit fee): - - State surcharge (12% of permit fee): 9.00 Authorized signature: gn s 1'O1'Ai,: PERivlIT FEE 84.00 Print name: FLORIN PANAITF T7 rttis permit application expires if a permit is not obtained within 180 Date: days offer it has been accepted as complete. --- --.w • Number of inapectiotta allowed per permit I:\Luildittbt Pormila 0LC- PemdtApp.doe 00 /23,06 140- 41.1T(1 t /05 /COM,WtB CITY OF ' ��n n u n�`n TIGARD BUILDING DIVISION ~°~°"~~~~""°~= ~°"°"~°"~~"° PERMIT #: ELR2008'00044 13125GVV Hall Blvd.. Tigard, OR07228 � DATE ISSUED: 2/26/2808 Phone: (503) 639'4171 ° Inspection Requests (24 Hrs.): (503) 639-4175 0:414- J.. INSPECTION WORKSHEET FOR DATE: 2/27%20p?* TIME: 7:00AM PAGE: 51 � Je ��° D SITE ADDRESS: 1 NT DR `" CLASS OF WORK: SUBDIVISION: mLLAoE ATSik0&0ER LAKE PARK LOT #: 021 TYPE OF USE: PROJECT NAME: |S0K8 DESCRIPTION: 1un:taUing low voItg intercom system. OWNER: (S0W\ STEVE PHONE #: 503 CONTRACTOR: DELTA FIRE AND COMM, LLC #174599 PHONE #: 60�663-5940 Inspection Request Scheduled For: Date: 2127/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 195 Low voltage 065702'01 503-663-5940 N Corrections/Comments/Instructions: ' / 1 `' , _PARTIAL APPROVAL - n CANCEL O � r NOACCEG8 ��0�' CALL FOR INSPECTION ! | ADDITIONAL FEES ASSESSED i .) �� /� Z-W /� |Inspector: Oa�m� ~-��~ �/ �^~ Phmna #� (5O3\ 71 N�m� r / ` ' . .