Permit r
CITY OF IdARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00145
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/16/2007
PARCEL: 1 S135BD -00300
SITE ADDRESS: 09735 SW SHADY LN 203 ZONING: C - G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: ION SYSTEMS
Project Description: Installation of camera system (see other).
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: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: CCTV X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HAZEL INTERNATIONAL, INC AND HECKTEC TECHNICAL LLC
HIGASHIYAMA HIGHLANDS CO, LTD 3484 HILLSIDE CT
BY NORRIS + STEVENS REALTORS HUBBARD, OR 97032
PORTLAND, OR 97204
Phone: Contact #: PRI 503 -572 -1827
FAX 503- 981 -0478
FEES Reg #: ELE CLE 14
LIC 162394
Description Date Amount SUP 1496LEA
[ELPRMT] ELR Permit 5/16/2007 $75.00
[TAX] 8% State Surcha 5/16/2007 $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 .uestions to OUNC at 503.246.6699 or 1.800.332.2344. 5 Issued Permittee Signature: fJ p I Ct, rl /r /.ice
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.
Kevin eck 503 -981 -0478 p.
I t
E ' l ect rl cal Permit A licat•o - FOR OFFICE USE ONLY
' ,.R. City of Tigard UtI CU Received 0 Permit No .: E L / _
13125 SW Hall Blvd., Ti Bard, OR 97223 Daa . ter/
Tigard, Plan Review
Phone: 503.639.4171 Fax: 503.59 0 1 6 2007 Dale/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jun - Hi See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: - 1 1 er Supplemental Information
TYPE O®vame DIVISION PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please cheek all that apply (submit 2. sets of plans w /items checked below):
❑ Demolition ❑ Other:
CI Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
El I - and 2 - family dwelling ® CommerciaVindustrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ Accessory building amps for all other installations, buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 K VA of
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system
❑ Addition of now motor load of ❑ "A" "Ii" "I -2" "1 -1"
Job no.: Job site address: 9735 SW Shady Lane N203 1001W or more, occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, Or 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 203 Project name: ION Systems ❑ Service or feoder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
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
Installation of camera system. residential (with above sq. II.)
Services or feeders installation,_ alteration, and /or relocation
'200 amps or less 80.30 2
❑ PROPERTY. OWNER I ❑ 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: Datc: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
6.65 2'
each branch circuit
Business name: Hecktec Technical LLC B. Fee for branch circuits
Contact name: Rachel Heck without service or feeder fcc, 46.85 2
first branch circuit
Address: 3484 Hillside Ct Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: Hubbard, Or 97032 Each manufactured or modular 90.90 2
Phone: (503) 572 -1938 I Fax: : (503) 981 -0478 Reconnect only 66.85 2
E -mail: hecktec@msn.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Hecktec Technical LLC Signal circuits) or limited -
energy panel, alteration, or
Address: 3484 Hillside Ct extension. Describe: 1 Page 2 75.00 2
City /State/ZIP: Hubbard, OR 97032 Each additional inspection over allowable in any of the above
Phone: (503) 572 -1938 I Fax: ( ) Pcr inspection 62.50
Investigation per hour (1 hr min) 62.50
CCB Lie.: 162394 I Electrical Lie.: CLE 14 Suprv. Lie.: LEA4196 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 75.00
Print name: Date: 5/7/07 Plan review (25% of permit ice):
State surcharge (8% of permit fee): 6.00
Authorized signature: L'e iti-e /k TOTAL. PERMIT FEE: 81.00
Print name: Rachel Heck Date: 5/7/07 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I: taaitdinswemtns \ELC.Pem,itApp.doc 05/23 /06 4404615r(II/o5/COM/WEa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00145
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/15/2007
Phone: (503) 639-4171 4:15:11111
Inspection Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE: 5/30 /2007 TIME: 7:00AM PAGE: 54
SITE ADDRESS: 09735 SW SHADY LN 203 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ION SYSTEMS
DESCRIPTION: Installation of camera system (see other).
OWNER: HAZEL INTERNATIONAL, INC AND, PHONE #:
CONTRACTOR: HECKTEC TECHNICAL LLC PHONE #: 503.572 -1827
Inspection Request Scheduled For: Date: 5/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 049209 -01 503 -572 -1938 N
Corrections /Comments /Instructions:
'PASS . ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G'' 114 6 t Date: 61 101 09 Phone #: (503) 718 - .1-41i4