Permit II CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
II: g COMMUNITY DEVELOPMENT Permit #: ELR2013 -00057
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/14/2013
Parcel: 2S110DCO2400
Jurisdiction: Tigard
Site address: 11565 SW DURHAM RD 100
Project: Dr Auzins Subdivision: 1998 -128 PARTITION PLAT Lot: 2
Project Description: (2) low voltage systems for data and audio
Contractor: POINT MONITOR CORP Owner: DRT PROPERTIES LLC
7869 SW NIMBUS AVE 9805 SW CHOCTAW ST
BEAVERTON, OR 97008 TUALATIN, OR 97062
PHONE: 503 - 627 -0100 PHONE:
FAX: 503 - 627 -0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/14/2013 $150.00
12% State Surcharge - Electrical 03/14/2013 $18.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: Y Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y 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: N Total $168.00
Other Desc: Required Items and Reports (Conditions)
r
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 a - - • -nce • 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 - , quires you to follow the rules adopted by the Oregon Utility Notificati• • - enter. Those rules are set forth in OAR
952 -00 1010 throu!h OAR 95 •' 90
By: �� - <' ■-L Permittee Signature: •u may obtain a copy of the rules or direct questions to OU y callin• 0 . 1987 or 1.800.332.2344.
Issu> • B L nature: ' 5.-- `—J
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' li i '.-,,L_____, 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.
03/13/2013 13:15 5036270110 POINT MONITOR CORPOR PAGE 01
Electrical Permit Application, M ` M i.i►It ()1. 1: I tit. (
Received / permit No.: 11 a 2O! 3 — OOt)5'7
C I S f Tigard Tigara, OR 97223 MAR 1 2 0 13 D�a Review
Phone: 503.718.2439 Fax: 503.598,1960 n� , i Date/13 : other Pertnis: 4 D��� D ®0,39
I 1 . \ I c I inspection Line: 503.639.4175 CITY V • TIG ms Bl
to Ready /By: s: See Page 2 for
Internet: www.tigard•or.gov * � >�G tjlV I M tified/Method: Supplemental Information
� . - 1 ll • 1 ,44,l; , lI N ', I, 1 , 1 , t } r It 2 ,r N l - i i," �, A `,'.;',',',1' i, r 1 • r��
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Please cheek all that apply (submit 2 sets of plans w /items chocked below):
❑ New construction ® Addition /alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available bolt current ❑ Marinas and boatyards.
p�� y n; unnr mr par m *aa r.. ' ' i 1 1 by i i{ti•rry --:4 •exceeds 10,000 amps at 150 colts or O Floating buildings.
f " af ZIG fi *!l - ' o e i ft a:, s 1 i t 1� ' 1!li 1 4 /' ,:, 14. ?44
ti tl�• ail. T : t .►*� rrrnl, a { µ lr n - �r I , • : h, . • � less to ground, or exceeds 14.000 ❑Commercial -use agricultural
❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fin pump, C7 installation of 75 KVA or
i ;j r / , i 1 r r r r y .y r,w i � v,l r t r I x t r j 1 ; t 0,44 "
: l �r ,, l ❑ cy s. larger separately derived system. • a ^, ' 1.. tit t.:, r :Otis ,..i .; ,, ,.a... ,1 n . r 1,,,t+_ , . iat. <.1.. tin , r A h } . ,.
r,t
` .. "- _ ❑ Addition Emergen o fn sy ew tem motor loadof
(3-A", I. a. .. -1
100HP or mom.
Job no.: Job site address: 11565 SW Durham Road El c reation
six or mom residential units. ❑ R ecreali0rml vehicle parks.
City /State /ZiP: Tigard, Oregon 97224 ❑ Health - care f ❑ Supply Voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suitc/bldg. /apt. no.: 100 Project name: Dr. Auzins ❑ Service or feeder 600 amps or more. !N/ y
��tt1Elillg !rff11i fi�tt} i r�f7f i , a s rt E M» l �r T, '�tkE'f Il NTtri7�1' i
ULI }111�(J.II'}c Ji�r16,r.,�tiN!�..: I,.,.e ..,a,rr.t:Y d...v....li 43...1' ;J.
Cross street/directions to job site: Descriard.n Qtr. _ Fat Total •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less _ 168.54 4
- Ea. add') 500 sq. ft. or portion 33.92 ^ 1
Tax map /parcel no.: ( �( (with above Limited cnerby, residential
+ rkPi t:41O 7, .n r R, '1) , l
`t ,71 1 1 o , I : `4 Y 'r k ` , , . ft.) 75.00
• a, x ,! . t •.M Jn ol, - .A ,..., t.(. U M+.! Lim energy, multi - family 2 ■
Limited Energy - 2 circuits (Teledata, Audio) residential (with above sq. ft.) 75.00
Services or feeders installation, alteration, and/or relocation
200 amps or less 100,70 2
„ ' r "'1', n r . 17 , u a1 j t ,e1�t' \1'� 1 201 to 133,56 2
r"R '' '.R11 it \ ^ A' 3 h],�u , ,t P , .1 r t I s { Al' 4 •:_ . amps Pa
� - r ^' �It i i ,r , , ,. �PTM'Slr��� i S?l. � „t',MirV.! • . � !!
, , ' rn7�iJGh .11 W, t. ;.Z.i6, i.,
401 amps to 600 amps 20034 2
Name: - w 601 amps 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: ( ) I Fax: ( ) 200 amps or less 59.36 1 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits new, alteratlor or extension, per panel
_
Owner signature: - Date A. Fee for branch circuits with
• i 7 r 4 ry, rr•trr r tyi;• ° qn { � lt� ,� 1 ,� n '4 „ t!n �r <' pl 1 :9 , li 1 above 6CrV1Ce to feeder fee,
1 1 „ "„;,,,;;„,i - 4,u4iii ...w.v, },,e••• 1 a•' ,.1,, .,t'.? ;...,• }r utZns ',t . ,. P lltrt.t.'I.,$`i. each branch circuit 7 2
Business name: Point Monitor Corporation B. Fee for branch circuits without
-- service or feeder fee, first
56.18 2
Contact name: Steve Bruns branch circuit
Each add' I branch circuit 742 2
Address: 7869 SW Nimbus Avenue MIsce (aneous(service or feeder not Included)
Each manufactured or modular 67 84 2
City /State/ZIP: Beaverton, OR 9700$ dwelling, service and/or feeder _
Phone: (503) 62 - 0100 I Fax: : (503) 503 672 -0110 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: SBruns @PolntMonitorcom ,p Sign or outline lighting 67.84 2
! ' c��y r.e3 �, .0 r l��,,DD)„ • h i, X 15 1 . 1 ,- .� .v t pa 4 1, 'lp 7 }r.... tl.11h�, it .3'!t t!i tl ^rrt '.1a'Sl. . .. ,di Tyr., ., �,,,,i .i ` l.tll. . -.e„I n.,f.n.r'trw•- Signal c or limited- e nergy
Business name: Point Monitor Corporation panel, alteration, or extension. 2 p 2 150 2
Each additional in pection over allowable in any of the abov
Address: 7869 SW Nimbus Avenue Additional inspection (1 hr min) 66.25/ hr
investigation (1 hr min) 66.25/ hr
City / State/ZIP: Beaverton, Oregon 97008 Industrial plant (I hr min) 78.18/ hr
Phone: (503) 627 -0100 I Fax: (503) 627 -0110 Inspections for which no fee is A 90 -00/ hr
ificall listed Y= hr min
CCB Lic.: 135901 I Electrical Lie,: 34 -50$CL I Suprv. Lic.: 4460LEA "•' , f '., -M u” it. HIr.i c:: =,: 9
S rv. Electrician signature, r ui - a Subtotal: 150
g Plan review (25 h of permit fee):
Print name: Ben Breit ate: 3/13/2013 State surcharge (12% of permit fee): 18
Authorized signature: /// f
itacc S � TOTAL PERMIT FEE: 168
in
St This permit application expires if a permit la not obtained within 180
daps utter 11 has been accepted as complete.
Print name: Steven M. Bruns Date: 3/13/2013
• Number of inspections allowed per permit.
1;\ auit4iea \Perntlla\ELC- PennnApa.doc 0710) 110 440- 4615111 /COM/VEB
•
03/13/2013 13:15 5036270110 POINT MONITOR CORPOR PAGE 02
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
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.
'
.
g �1i
�.IZ.:114 �r r L
1,f l l.u.. 11�i a � ��..4 7 YI.hf9.,.:�4
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
El Fire Alarm Installation
❑ HVAC
El instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Li
❑ Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
IABuildineermits1ELC-PermitAap.doc I
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11565 SW DURHAM RD 100, TIGARD, OR,
97224
Commercial - Electricial Limited Energy
135 Low voltage
04/25/2013 00:00
ELR2013-00057
PASS
Violation Summary:
Inspector Contractor