Permit -r .: CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00124
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/21/2008
PARCEL: 2 S 109 BA -04 5 00
. SITE ADDRESS: 14112 SW WAGONER PL ZONING: R -7
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 LOT: 027 JURISDICTION: TIG
PROJECT: HASMAN
Project Description: Installing (1) low voltage burglar alarm 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: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
STUART HASMAN PROTECTION ONE ALARM MONITORIN
14112 SW WAGONER PL 15500 SW 72ND AVE
TIGARD, OR 97224 STE. 100
PORTLAND, OR 97224
Phone: Contact #: PRI 503- 624 -0244
FAX 1- 866 - 223 -9925
FEES Reg #: ELE 34- 428CLE
LIC 116325
Description Date Amount
[ELPRMT] ELR Permit 5/21/2008 $75.00
[TAX] 12% State Surch 5/21/2008 $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: — -- ,, / A
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.
, EMAY.20.2008a112:44 • 1 P. NbULCatlon , ,, ( >rt. c;� n, NO. 444 P 2
City of Tigard Received
r 13125 SW Hall 131vd., Tigard, OR 97223 MAY 2 0 2i'11 te/l3 . .S ITV C� �� "
Phone: 503.639.4171 Fax: 503.598.1960 Mill11111.11.11 Other p
Tic (�ttn Inspection Line: 503.639.4175 ,, / 0'1,; "• c_ dy/By, forte,
Interact: www.ti rd-or• ov �,5► • k f . ; ® See Page 2for
����jj(��jj �{J g . t I k D I e thod • supplemental Information
a Rlllll{i �`�ilt �'ta1tE0U ,I l�ai o�t� m �� t l. I `' : 1 ', t
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❑ New construction ®' Addition/alteration/replacement Please check all that apply (submit seta of plans whberrn chocked below):
❑ Demolition ❑ Other; ❑ Service or feeder 400 amps or mom ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards,
ut , , {{ : Uta 1 , 11171111
'`K;� El, '':i�� o rol'gtlila „5,r,til, a a ll i/ 0 v. t ' ' N A
hen „ ; 0.14 `A ; R �� . ,n1��! n ,,,,,r8ft �u1l,n 1 18ItPrtl0 I .' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
1 • and 2 -famil dwelling less to ground, or exceeds 14 ❑ Commercial-use agricultural
Y g ❑ C ❑ A building amps for all other installations. buildings.
❑ Multi -family ❑ Master builder ID Other: Q Fun pump. ❑ Inatallatlon of 75 KVA or
I '111111111. pp
(f� '. : }•Vita i4 rr t !. n lit Of+ qt nu U ' n {ti „ '
i ll
I 14 It t i 0 0 r ' " t , ❑ T orte zn a larger separately derived system.
tl ,, I an ' 1, a it lr t i a tt to so ' r :. 11
❑Ad dition of now system. mo tor load of ❑ "A ", "6 ", "1 -3 ", "1.3 ",
Job no.: ,'" Job site address: M11 a , a a,�te J 100IiP ormore. occupancy
❑ Six or more residential units ❑ Recreational vehicle parks.
City /State/ZIP: * , at may► 4 ❑Health -care facilities. in Supply voltage for more than
J 11..- OA ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no,: Project name: AM ", a ,. is ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: ��,��+ ���1 ;�:� 1���� (1 t����Y Lt,P!��'t a Pie, ,��'„ :,;I
ms-- i n OIY. Fee. Total *
New residential single- or multi- flunily dwelling unit.
Includes attached garage,
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ta /parcel no,; ` � lj ��p n ,� y � Ba. add'l 500 sq, ft. or portion 33.40 1
Wl4tR!���� IIIIIIWI�GN:, ��,iya iGlmgqnll�a�" �'''l' ����'��'�, r" l m I! {�{�{ I � ly ` Limited energy, residential
t e :� :11 I't0 , ntl,ll:.l�alaii:�jtliiiR �`�I kIN111�14'e�k 11 •�I�tl�liM —with above aq.ft) 75.00 2
Limited energy, multi- family
�' t It �i� ,11,A _ residential (with above sq. ft.) 75.00 2
f il 3ervIces or feeders lustallatiokalteration, and/or relocation
200 a sorless
�' "F ur m t tr�� � I ��p { �p�p� ���� �{� I I �� Wi roP 80.30 2
1't I m7 „ ihrN? i t 93 ' t;EItr 181 I�Of11ll'illll i111�,t11! n ��� ' "1 kli�illtl `G�IIIIellifl! 201 amps to 400 amps 106.85 2
- : slmd tt t:
Name: 401 amps to 600 amps 160.60 2
Address: 601 as to 1,000 amps _ 240.60 2
Over 1,0 a or volts 454.65 2
City /Stato/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, nei anel
A. Fee for branch circuits w
{ i t I I Nip } k{ ty } TT I t with
i :1 `111 ; r:{�� a;' 111 li ' .:' u�{lili��I iOIIN� :���1 �ltl� �l : �: t ' 111{111 :' ': above service or fender fee,
each branch circuit 6.65 2
Business name;
B. Fee for branch circuits .
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 1 6.65 2
Miscellaneous (service or feeder not icluded)
City/State/ZIP: Hach manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Pax: : ( )
Reconnect only 66,85 2
E - mail: Pump or irrigation circle 53.40 2
VM 1 ililY MNIJ1BlWIERI "" o ;11,3,IMPIlingirERISNIMMININIF lflili Sign or outline lighting 53,40 z
Business name: Signal circuit(s) or limited -
mw.l.- - -� wp' �jmr - energy panel. alteration, or
Address: lr r ., extension. Describe: Page 2 2
City/State/ZIP: .01, , fir, • C l 0' S Bach additional ins . - Ctlon over allowable in a , of the above
'� ,��,,`
Per inspection 62.50
PhonC:
Ligall ( NI ;2 i. Fax: `C S-- r` ,Aga Investigation per hour (1 hf min) 62.50
t r� r � I Suprv. Lie.: Industrial , lantperhour 73.75
Suprv. Electrician signature, required:
11tl111I, , .. 4:�!1,1?1Z�at c ` 1 3,73ai ' °^ ' i, '1111, ' ,:y, , i .
Subtotal: ,00
Print name: Date: Plan review (25% of permit fee):
Authorized signature: l r 1 State surcharge (12% of permit fee): I .00
I . A • `t. • ' I it! '` TOTAL PERMrr FEE: •"1 r
Print name; , 1 I This permit application expires If a permit is not obtained within 180
r ✓�� Date: � S' .� days after it has been accepted as complete.
g 'r Number of inspections allowed per permit.
I.lauileline ermaeiBLGPumltAppdae 0543/06 440.4615T(ltg15/C0M/WSB
CITY OF TIGARD
BUILDiING DIVISION PERMIT #: ELR2008 00124
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/21/2006
Phone: (503) 639 -4171 LigtI�I�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 614/2008 TIME: 7 :01AM PAGE: 63
SITE ADDRESS: 14112 SW WAGONER Pt. CLASS OF WORK:
SUBDIVISION: HII.LSHIRE SUMMIT NO. 2 LOT #: 027 TYPE OF USE:
PROJECT NAME: HASMAN A 61
DESCRIPTION: Installing (1) low voltage burglar alarm system. CALL
OWNER: HASMAN, STUART PHONE #: \ 36 1 .1 % 11
CONTRACTOR: PROTECTION ONE ALARM MONITORIN . PHONE #: 503.624 -02M
Inspection Request Scheduled For: Date: 6/4/2008 Pour Time:
Code # Inspection Description • • • m # Contact # Message
135 • .. a. a 070731 -01 503-579-2886 N Y
etb °1 F'i iJ ALA
_ - - ..... - _ ructions:
N) i N 1 ch/V
WI cUE L_£s6 6 Lis
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: X1461. Date: • L i' �� Phone #: (503) 718 - �.+�