Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00314
TIGARD
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/16/2007
-\ ‘ PARCEL: 1 S136CD -90000
SITE ADDRESS: 08060 SW PFAFFLE ST 200 ZONING: C -
SUBDIVISION: CAMERON PLAZA LOT: JURISDICTION: TIG
PROJECT: LILE INTERNATIONAL
Project Description: Fire Alarm low voltage.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
G3 LEASING LLC FIRE & SECURITY GROUP LLC
19480 SW 118TH AVE 5933 NE WINSIVERS DR. #242
TUALATIN, OR 97205 PORTLAND, OR 97220
Phone: 503- 691 -3500 Contact #: PRI 503- 254 -4506
FAX 503- 262 -5296
FEES Reg #: ELE 37- 992CLE
LIC 153226
Description Date Amount SUP 4333LEA
[ELPRMT] ELR Permit 8/16/2007 $75.00
[TAX] 8% State Surcha 8/16/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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: A Permittee Signature: enr1 Q„/�� _ ' ( „-- ,�--,:
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 li ELVED FOR OFFICE USE ONLY
City of Tigard y Received
City g 1 2001 DateB 1�1 �� : • • ,�q. e) -o , 'A
• 13125 SW Hall Blvd., Tigard, OR Plan Review
Phone: 503.639.4171 Fax: 503.5 196_0
9 0 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Gil Y F TIGARD Date Ready/By: Juris:/ ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: 1 Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition / alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
� ❑ Service or feeder 400 amps or more ❑ Building over three stones.
CI Demolition ❑ ther: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling M Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ['Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "I - ",
// 100HP or more. occupancy.
Job no.: Job site address:
IOC, O S iA ffj FrL £ ❑ Six or more residential units. ❑ Recreational vehicle parks.
� J &A RA ❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP: J C) o 7 Z -�
r ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: L, i L E I,(, RA) if 1 0 ,,9L ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: ?
J 9 �� J . r L �j �) 7 nes<rlpeaa I Qty. I Fee. I Total
New residential single - or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. 8.)
/ Limited energy, multi - family 75.00 2
(/ , (1^ residential (with above sq. ft.)
Services or feeders installation, alteratie_r_, and/ !.- �•7.1•rstioni
200 amps or less 80.x:; '' 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps 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
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Fii E t " A t ;I'? �7Qovf B. Fee for branch circuits
without service or feeder fee,
Contact name:
aisoJ 4 'IFNSOA first branch circuit 46.85 2
Address: c 33 A) WiA7 s1 J 5 ks AR 5Tb VIZ, Each add'l branch circuit 6.65 2
/� Miscellaneous (service or feeder not included)
City/State /ZIP: P02r1- A f)2 x 1722 p Each manufactured or modular 90.90 2
1 ' dwelling, service and/or feeder
Phone: (t ) 25"N - ( 4 6 .. 42 4 . Fax: : (9J) Reconnect only 66.85 2
E -mail: MI seW3 r(~'iasE - -o iz . (rf ( -, e o ut - c v f a, Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
I Signal circuit(s) or limited -
Business name: FIRE r S 2 oil G - P - 0 P energy panel, alteration, or
extension. Describe: Page 2 2
Address: S 133 Ai( i-,4 A7 A 4/(Rs M. sr f, 2.t( Z,
City/State /ZIP: P a R ! /1y/1 t )12._ cJ 7 ZZ 9, Each additional inspection over allowable in any of the above
` ° Per inspection 62.50
Phone: (b3) 2r4 - y6-0 4 Fax: (6 ) 2(, Z , 52 g' 4 d \ � Investigation per hour (1 hr min) 62.50
CCB Lic.: 1 . - - S 2 . „ 2 . . . , 6 -Caistri Suprv. Lit:.: 4333L A Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES
Suprv. Electric'.' sill � u required: t r # 411 ,,...1 ..1 _ Subtotal: '
Print name:, Date' review (25% of permit fee):
` vi' — =y
•- % • /S . p State surcharge (8% of permit fee): t , ,
Authorized signature: _ TOTAL PERMIT FEE:
...---- This permit application expires if a permit is not obtained within 180
Print name: ` f1 • ' dr � Date: A „ tc. 0 7 days after it has been accepted as complete.
-0 ,
1 / • Number of inspections allowed per permit.
I:\ Building \PermitsEELC- PertnitApp.doc 05/23/06 440.4615T(11/05/COM/WEB
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 Work 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- 260 -260)
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 -
Totarnumber of commercial systems: i
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007.00314
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16/2007
Phone: (503) 639 -4171 l IV
Inspection Requests (24 Hrs.): (503) 639 -4175 FL .
INSPECTION WORKSHEET FOR • DATE: 11/9/2007 TIME: 7 :00AM PAGE: 12
SITE ADDRESS: 08060 SW PFAFFLE ST 200 CLASS OF WORK:
SUBDIVISION: CAMERON PLAZA LOT #: TYPE OF USE:
PROJECT NAME: LILE INTERNATIONAL
DESCRIPTION: Fire Alarm low voltage.
OWNER: G3 LEASING LW, PHONE #: 503-691 -3500
CONTRACTOR: FIRE & SECURITY GROUP LLC PA N Vv PHONE #: 503 -254 -4506
Inspection Request Scheduled For: Date: 11/9/2007 Pour Time:
Code # Inspection Description Confir -- : Contact # Message
135 Low voltage ' 05940501 503577 -4115 Y
raq F -iN6L•
Corrections /Comments /Instructions:
O
x PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c, N W 1_ Date: it VI Phone #: (503) 718- WO_
CITY OF TIGARD
• BUILDING DIVISION - PERMIT #: ELR2007 -00314
13125 SW Hall Blvd., Tigard, OR 97223 �,t DATE ISSUED: 8/16/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 K_
INSPECTION WORKSHEET FOR DATE: 11/8/2007 TIME: 7 :09AM PAGE: 66
SITE ADDRESS: 08060 SW PFAFFLE ST 200 CLASS OF WORK:
SUBDIVISION: CAMERON PLAZA LOT #: TYPE OF USE:
PROJECT NAME: LILE INTERNATIONAL
DESCRIPTION: Fire Alarm low voltage.
OWNER: G3 LEASING LLC, PHONE #: 503. 691 -3500
CONTRACTOR: FIRE & SECURITY GROUP LLC PHONE #: 503 -254-4506
Inspection Request Scheduled For: Date: 11/812007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 059226-01 360. 510-4568 N
Corrections /Comments/ Instructions:
Fin] AL P^ ∎ n,1 17-61t h.
d� y 4fri % N LI) i N)s ,g�i dam_ 1 �o9
1 1 I kkk
? R,1pa kZ 00iL IttNT ec kle(.
N .Niz
12,E N . povJea. S o t' *') A ' � 2. .
VL . Qswect. SovQ.c5L g -
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
'VAIL \CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Date: 4. %'d ! Phone #: (503) 718- 7-A14)0
CITY OF TIGARD /
A -
BUILDING DIVISION PERMIT #: ELR2007 -00314
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2007
Phone: (503) 639 -4171 .gr� l(
Inspection Requests (24 Hrs.): (503) 639 -4175 "_..—
" INSPECTION WORKSHEET FOR DATE: 8/17/2007 y TIME: 7:01AM PAGE: 13
SITE ADDRESS: 08060 SW PFAFFLE ST 200 CLASS OF WORK:
SUBDIVISION: CAMERON PLAZA LOT #: TYPE OF USE:
PROJECT NAME: LILE INTERNATIONAL
DESCRIPTION: Fire Alarm low voltage.
OWNER: G3 LEASING LLC, PHONE #: 503 -691 -3500
CONTRACTOR: FIRE & SECURITY GROUP LLC PHONE #: 503 - 254 -4506
Inspection Request Scheduled For: Date: 8/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 054 ?45-0 360. 518 -4568 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 0 lam► Date: 1 I 01 Phone #: (503) 718- ti-m.,