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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ii . ' COMMUNITY DEVELOPMENT Permit #: ELR2012 -00057 Date Issued: 03/30/2012 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S102AA04201 Jurisdiction: Tigard Site address: 8955 SW COMMERCIAL ST Project: Essential Planning Group Subdivision:NORIN'S ADDITION - VACATED 142/18: Lot: 26 Project Description: Low voltage for access control. Contractor: STONER ELECTRIC Owner: KING ELAINE HOLDINGS LLC 1904 SE OCHOCO ATTN HAL MARTIN SR MILWAUKIE, OR 97222 8305 SW CREEKSIDE PL #A BEAVERTON, OR 97204 PHONE: 503 -462 -6500 PHONE: FAX: 503 - 659 -4968 FEES Description Date Amount Specifics: Restricted Energy Permit 03/30/2012 $75.00 12% State Surcharge - Electrical 03/30/2012 $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: N Other: Y 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 : - •rdance w • 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. AT NTION: Oregon : =... es you to follow the rules adopted by the Oregon Utili . Center. Those rules are set forth in OAR 952-001- through OAR 952 r • -009 ; • . • may obtain a copy of the rules or direct questions to OUN• •rT�Y•ryk .1987 or 1.800.332 344. Issue. • : y: � �� I — .ii 4r� Permittee Signa . i i' ' II � ' 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. • Mar. 30. 2012 8:32AM Stoner Electric up No.2048 P. 1 E lectr>tcal Permit A,pp)icatro i i� I. c ) r, c ►I I. 1 ( 1.' t . .I . t l \ t \ Received City of Tigard \ 1 De FIJKOT) Permit Na: 41., bl� _ DOS i 13125 SW hall Blvd., Tigard, OR 0 el � ' Plea Review _ • Phone: 503.639.4171 Fax: 503.598.1960* �Q Deeds . Ma Pamir. T t t; A u t n Inspection Ling 503.639.4175 \``t�\` t(4N: tRote Reedy/sy.. lyric 61 see hle z for Internet wwwtigard - orgov rr O�� © \ � \C \I'�1 6edlMahod SupplementalIoformadon ' - ' TYPE o WO \ PLAN REVIEW • • ❑ New construction eAAddition/alterati aoement Prramr die a an mm apply (tumuli 2 son aprons Mittens chocked below): ❑service er Moder400 mipeaMOTE ❑B,tildmgOMQ three stories. ❑ Demolition ❑ Other. where lc available huh current ❑Marinas and boatyards. CATEGORY OP CONb`TR1rG1'ION cccceda 10.000 amps at 150 volts or 1:1 Floating buildings. • ❑ 1- and 2 dwelling tommercialrndustrial 1:1 Accessory building r ground. allot other i exceeds ce= O Commercial hse agricultural wnpsroreuotbaiaIIelleficas buildings. ❑ Multi family ❑ Master builder ❑ Other ❑ Eue pump. ❑ Iaslallation of 75 KVA or • JOB SITE INFORMATION AND LOCATION . . ❑ �eaaot larger separately derived system ❑ McNeil deem motor load of ❑ "A"."13". "1.2 ", "1-3". Job no.: I q q 5 v I Job site address: 155.5 5 W C a� 100oP or more. ate• ❑ O J ❑ Sur or more eoodearid mice. . Recreational vehicle parks , IIHedrh�elnalide:. ❑ Supply voltage for more than City /Stater2lP: �1 p i C)� h 73 74.9 _ . _ . ❑Hazardouslewdons 603 volts nominal, Suite/bldg./apt. no.: V I Project name £c ok..W l Y`gNKr 6�) ❑ servtaorfeeder600ampsarmore. Y FEE SCIIEDI LE Cross street/directions to job site: D"rais6eo I 01 8. 1 P... I Tara 1 • • New residential single- or mulls-family dwelling unit. Includes attached garage. Subdivision: Lot no 1.000 sq. it or less 168.54 4 Tax map/parcel no.: Ea. add'/ 500 sq. ft or portion 33,92 t Limited energy, residential 75.00 2 • DESCRIPTION OF WORK . • . • _ (with above sq. ft) Limitedenergy, multi- fhmtly 75.00 2 aaL C ` 4K y‘ _ • residential (wit aboveso.f.) Services or feeders installation, alteration, and/or relocation 200 amps or less • 100.90 2 ❑ PROPERTY OWNER ' I. . . _ ❑ TliNANI` 201 amps to 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 55126 2 City/ ��: Temporary services or feeders lnstallatlos, alteration, and /or relocation Phone: ( ) I Fax ( ) 200 amps or less - 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps I25.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits . new, alteration o r extension, per panel Owner signature: Date: A. Fee for branch circuits w /rh ❑APPLICANT I ❑ CONTACT PERSON above service or feeder fee. each branch circuit 7.42 2 • Business name: B. Fee for branch circuits without service 5618 2 Contact name: branch circuit Each add'/ branch circuit 7.42 2 Address: Miscellaneous (service or feeder not Included) City /StatrILIP: Each manufactured or modular 67.84 2 . dwcllinh, service and/or feeder Phono: (503) 4 bZ ¶Z 11 Fax: : (5 ) 6 • _ (ci % Reconnect only 67.84 2 � �J 0-1.\,_ • 0 OCR- 12 o(�� Pump r outline r l circle 67.84 2 E -mail: . t:� signarGghling • 67.84 2 • CONTRACTOR ' Signal eircult(s) or limirod wergy ,cf1 Business name: STONER ELECTRIC, INC. panel. alteration. or extension. 1 Pa/to2 1 5; 00 2 Bach addltlonal lnstecflon over allowable In any of the above Address: 1904 SE OCHOCO Additional inspection (Ibrmin) 66.25/ hr �' MILWAUKIE OR 97222 investigation (lhrmio) 66.25/hr Ci /S ____ Il': Industrial plant (1 In min) _ 78.18/ hr Phono: ( 503 I Fax' ( 503) 659 -4968 Inspections for which no foe is 90.00/ w CCR I.ic.: 44823 . Etcctrlcal Lic specifically listed EL C1 R I 1 \9 26 -12 2C I s�Prv. l. ic.: 3496S • ELECTRICAL. parr PIES Suprv. Electrician sign required: 1 1f I�•rN�� /*" O/r dig Subtotal: "] �� Plan review (25% of permit fbe) Print name: MICHA L FALCONER Date: 3 30 Zc21 State surcharge (12 %of pens* fee): ° 11 00 TOTAL PERMIT FEE: % , 00 Authorized signature: • b1x h S . J This permit npp urarron expires If a permit is rot ObOlined nttbia 180 Print name: `+ ` days after Itbaa been accepted as complete. �t]yl� r SQ�� (V4tS Vl Date: 3 /301z o1 Z • N umbercri�ocaonsanowedpap.rmit. tlBuikEastPerrri 181.C- PamiiApp.doc 0201/10 ( 4 6151 11iVS COM /WED Mar. 30. 2012 8:32AM Stoner Electric Group No. 2048 P. 2 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: • RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75,00 Check Type of Wotk Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: 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 ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling / -‘ Other_ L ) LO A Total number of commercial systems: 4 1%10 licenses are required. Licenses are required for all other installations Mildm lsW-LCaa�;upp.dae 01101110