Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
It • • COMMUNITY DEVELOPMENT Permit #: ELR2012 -00277
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2012
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 150
Project: Diana Harrison CPA Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: (1) low voltage for additional intrusion security devices and (2) audio sensors and 1 door
Contractor: SONITROL PACIFIC Owner: PACIFIC REALTY ASSOCIATES
8220 N INTERSTATE AVE ATTN: N PIVEN
PORTLAND, OR 97217 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 223 -5822 PHONE: 503 - 624 -6300
FAX: 503 - 973 -7773
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/18/2012 $75.00
12% State Surcharge - Electrical 12/18/2012 $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: Y
Security Alarm: N Other: N 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 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 9 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling ' 503. 23 ' 2.1 I 987 1r1 or1.800.332.23 / 4 � 4... ; I I
Issued By: '[� , � . i .4 _! .1. Permittee Signature: 0 /l.l , l PPL / f010
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 503.839.4175 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.
De" '7. 2012 2:50PM Sound Security Inc. No. 2699 P. 1
Electrical Permit Applicatio FOR enter. tlsli ON
City Tigard Received ?JI g� r e1/ /a - v
Ci of Tr and L. e I / a 5 — Permi No.
ti 13125 SW Hall Blvd., Tigard, OR 97 t � 2012 Plan Review
/
' Phone: 503.718.2439 rat: 5o3.s98.I9 E C / Date/13 : Other Permit: 0 // ,y a .. 7LL '
f 1 < A It f) Inspection Line: 503.639.4175 a Date Ready/By: Judi: ga See Page 2 for
Internet: wtvw.tigord,or.gov CITY OF TIGARD Notified/hfethod• 7--/-- Supplemental information
• .... a DING DI. I _ - • PLAN REVIIE s� - ::
• ❑ New construction ® Addition/alteration /replacement Please cheek all that apply (submit j sets of plans %v/ireins checked below
0 Service or feeder-100 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boagrrrds.
• EGORYr • OIF' CONSTRUCTION ' " ` exceeds 10.000 snips at 150 volts Or 0 Floating buildings.
less to ground or exceeds 14,000 ❑ Commercial -use agricultural
El 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other inslnlietions buildings,
El Multi - family ❑ Master builder ❑ Other: 0 Fire pomp, ❑ Installation of75 KVA or
` -
s .. ❑ Emergency system. larger separately derived system.
;'JOB`31`I'L 111 +43 AND LOCATION
. , - Q Addition oP new motor load of ❑ "A" "&° "1 -2" "1 -3
Job no.: P120168 Job site address: 15350 SW Sequoia Pkwy IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Portland, OR 97224 ❑ Health -care facilities. 9 Supply 'toltage for ,no,e
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 150 Project name Diana Harrison, CPA ❑ Service or feeder 600 amps or more.
FEE- SCHEDULE' a =;'. '•...<; . ,.,. •
Cross strect/directions to job site: Dm ripiies I Qty. I fee. I 'real I •
New residential single- or multi - fancily dwelling unit.
Includes attached garage.
µ
Subdivision: Lot no.; 1,000 sq ft or less 168.54 4
Pa. odd'1500 sq. ft. or portion 33.92 l
Tax map /parcel n0.: _ Limited energy, residential 75.00 2
•, • DEsCIllifIIOr pF WOIUC ::'.:::,-,....%4W%:.: _
. x s�; :. ; ` (with above sq. R.L
..__ - Limited energy, multi- family 75.00 2
Lrstallation of add! intrusion security devices. 2 audio sensors and 1 door residential (with above sq. ft.)
Services or feeders Installation, alteration, and/or relocation
contact. 200 omps or less 100.70 2
"0 PROPERTY OWNER yam^ ` -- ;TENANT 201 amps to 400 amps 133 56 2
401 omps to 600 amps 200.34 2
N ame: 601 limps to 1,000 amps 301.04 - 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation
Phone: ( ) 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 125.08 2
intended for sale, lease, rent, Or exchange, according to ORS 447, 449, 670, and 701. 401 maps to 599 amps 168.54 2
_ Branch circuits- new, alteration, or extrusion, per panel
Owner signature: Date: A. Fee for brooch circuits n-ir /r
above service or feeder lee,
1:1 AYPLIC 1NT " .. Tom' �`�
, El PlsfiS v,, — each branch circuit 7.42 2
Business name: B. fee for b nch circuits i cir h onr
service or feeder fee. first 56.18 2
Contact name: branch circuit
J
Each add'1 branch circuit I 7.42 I 2
Address: Miscellaneous (service or feeder not included)
_
Ci /Slate /ZIP: Each manufactured or modular 67.64 2
dwelling, service and/or feeder
Phone: ( ) Pax:: ( ) Reconnect only 67.84 2
— Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
* t ~ ''' CONTRACTOR
'' 3'`L° " :'' ' � . -- Signal circuits) or limited -energy
Business name Sonitrol Pacific panel. alteration. or extension. 1 Page 2 75 '� 2
Each additional inspection over allowable In any of the a bove
Address: 8220 N Interstate Ave Additional inspection (1 hr min) 66,25/ hr
City /State /ZIP: Portland, OR 97217 Investigation (I hr min) 66.25/1
Industrial plant (1 hr nun) 78.18/ hr
Phone: (503) 223 -5822 Fax: (503) 973 -7773 Inspections for which no feet is 90 / hr
. specifically listed (5 hr min)
CCR Lie.: 53535 Electrical Lic.: 26370CLE Suprv. Lie.: . • , . • ELECTRICAL PERMIT FEE$ ?'-- -
Suprv. Electrician signature, required (25% Subtotal: 75.00
f/ U^�" - flan review (25 /e of pcnnit fee):
Print name: Gordon DuCette 3567 LEA Date: 12/17/12 State surcharge (12% of permit fee): 9
TOTAL PERMIT FEE 84.00
Authorized signature: ( -7
This permit application expires if a permit is not obt ained w lthln 180
days after it has been accepted as complete.
Print name: Ann C Moore Date: 12/17/12 • Number of inspections allotted per permit.
toaui :d'ngtPumasi6LC- Permitnpp.doe 07/01/10 940 46157(11N5/COMAVEO
Dec. 17. 2012 2:50PM Sound Security Inc. No. 2699 P. 2
, Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT PEES:
Fee for au residential systems combined,.,..... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener's
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
❑ Other:
COMM °ERCT?LL: C ORK QNI:X: ,'
•
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved;
0 Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ IIVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
® Other Security devices
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I: USuilding \PennilAELC.Penn9Npp.doo 07101/10