Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
g - COMMUNITY DEVELOPMENT Permit #: ELR2013 -00098
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/02/2013
Parcel: 1S133CA11400
Jurisdiction: Tigard
Site address: 10959 SW SAGE TER
Project: Shumacher Subdivision: VILLAGE AT SUMMER CREEK Lot: 37
Project Description: (1) low voltage for burglar alarm
Contractor: ADT LLC Owner: SCHUMACHER, AARON
2815 SW 153RD DR 10959 SW SAGE TERR
BEAVERTON, OR 97006 TIGARD, OR 97223
PHONE: 503 -469 -7219 PHONE:
FAX: 503 -469 -7128
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/02/2013 $75.00
12% State Surcharge - Electrical 05/02/2013 $9.00
Type of Use: MF
Class of Work: ALT
Total Number of Systems:
Audio & Stereo: N
Security Alarm: N
Garage Door Opener: N
HVAC: N
Vacuum System: N
Other: N
Other Desc: Total $84.00
•
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 for • • OAR
952 - 001 -0010 through OA 2 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • �'%�' Permittee Signature:
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 503.639.4175 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.
05/02/13 02:1OPM HP LASERJET FAX p.01
Electrical Permit Application CEIVED [OR OFFICE E ( SE ON1,1
City of Tigard Received
a- 3 sr , Penh Nel.: (�aQC3 - 0 1 v9:
N.,.._ ` 13'25 SW Hall Blvd„ Tigard, OR 97223 MAY 0 2 2013 Pl R view -••
Phone: 503,718.2439 Fax: 503.598,1960 Date/I3 ; Other Permit:
Inspection Line: 503,639.4175 Hatt Re /l3 : - -�'
1 t <; ,,1.1 CITY OF TIGARD .dy Y lws.: 0 sae P ate 2 for
Internet www,ligard or gov A 11, Notified/Mthod: 13 C.. Supplementa' lnrorruarien
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�l u��l�fr��• :.�1�r1��lggl,li�IC��tt{�,��#�11�r �'h t'. �:�.; .,�fm 0•.• y .2 ��t al�j� r t S f`.r V.vt ^ i� t tS �7'� ��'�}�i r �� {1' " i +i�t,g ' _ .
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0 tdcw eortstruction ®Addition/alteration/replacement Please check all that apply (submit I sets of plans w /uems checker! below)
Demolition 0 Service or feeder 400 amps or more 0 Building over three stories.
0.} 0 Other:
k + V k t tr • p ;�� k117 i (�� y e stri ww' r t u�l t r: a� , 4 Y , ..wok, where the available fault current 0 Marinas and boatyards.
I , I ttRi ;'kl f i A l (^, l l t JJ i ✓a�Nb� rt S1Pi w .)11IN O � ' 1 7 lr 0�}�( l. 7 2 , fi,1 1 ; i v . I l j lk , l e> .4, 10,000 am at 150 volts or Floating buildings
i d1 m n ■ t p' 1 i' ,, Pi .. `k ; 4 r I, kt ins to groom. or exceeds 1; 000
0 1- and 2.family dwelling 0 Commercial /industrial ( Accessory building O Commercial - use agricultural
IZI amps for all other tnstalladoos• buildings,
Multi family 0 Master builder l Other CI Fire pump. 0 installation of 75 KVA oe
�w w , ' a ^l " y r 1 11 1 r qt" � wm 0 Ernertte Y "rs" 1. larger sepannely derived system -
ri .; � ' : ; , � r! „ � 1 , � l Atm : s tn � y i isst W sista ' A 1 r 4 iAr : 'imoi , 9 t {. e hra AgukS 0 Addition of new motor load of 0"A", "E", "1-2", 1.3 ",
Job no., 814.50534 Job Site address: 10959 SW Sage Ter 10010 or more occupancy.
--- _ 051s 0 51s or more residential nits. 0 Recreational vehicle parks -
C Ily /State/f lP: Tigard, OR 97223 0 Health -care facilities. 0 Supply voltage for more than
'- -- -^•"••••••• --- • - --• - - - -- 0 Hazardous !creations, 600 volts nominal,
Suite/bidg• /apt, no - ; Project name: Aaron Schumacher 0 Service ur feeder 600 amps or mom
re
Cross gtroct /directs s "
— __ j ._ I t t, l' r r r irk ' n 1 i, ' i i' r � , ,i
apt t0 ob Sete: '41.S ti. ,(. ! .i' i 4, $ {k.,:ri t l :L' � �;, , f I .4'') ti rt 1�} � iivi1j'at4 4:,:1.' �nl� a klj
�""-^� —• .......... ncw t Fe Total
New residential single - or multi- family dwelling unit,
•
.- _- .., ,",........,.._.�__..._ _,- ,�..,,..,.W _•.. "- ..W..._ •..- .•. ,.
:.w..,. Includes attached garage.
Subdivision: Lot no.: 1.000 sq. R. or less I68:34 4
Tax map/parcel no.: - En ildd'I 5th sy. ft, or portion 33.92 i
M "
t r u i � (.lotted energy, residential "�•"
tart .. , 1 fn 1. rr 1 lITI au � t' "+ ! ,�v: r i , j:t q r i•xry
r :" 7•.L. , ;,'.0:•. t ■.S.. i c: .t- .2..14 , W∎7' , ' , ut, n et ,* t - 0 li )Ii f i trY r u llrrVitifiL }ft{\ (±�t Il / `ts Q43i'tli psi ( a •r. ft 75 -00 2 • - .... «......,..,.
I,irnited energy, multi - Family 2
Low voltage burglar alarm residential (with above milt. . /5,09
m .,.. Services pr feeders installation, on, alteratiotl And/or' rel0eathta
200 amps or less _ 100.70 Mw
r t ':','';':7:7, i"1';',7 x ; {c , C, ', p1j'° MY Y 'I;thrc .� &'Ir. 't 1 4 w p ;� }-
t.r,', r. ,, : r •.r t" , ..:.r., �l t, -V'; 1,4. . :r ife !' ; ,,� ' i �1p1 i t Y ' , i twi, i m1 yt i�qq ai! / ( I �,�t�� °! f k . 201 amps to 400 amps - „..•,,., -u.. _ 133.56...._ ” 2 Name: y 401 amps to <100 amps - - - 200.34 '— 2
",w " . ,.,- - ._ �T...,.,.,, 60) amps to Lamps ,_.•.W, 301.04 .:,..,,., 2
Address: — —" __. ,: Over 1.000 amps or volts V 552.26 __ • 2
C sty /SCate/ZIP: �� .. - ..0 Te mporar y services or feeders installation, alteration and /or
relocation _
Phone: ( ) Fax: ( ) �„ 200 antes or less ,• -_ 59.36
_..
Owner installation: This i nstallation is being made on property that 1 own which is not 201 amps to 400 amps ^� 125 0$ 2 - .
intended fi >r sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 mps tto 599 amps 168.54 "'" """ 2
Owner signature: Branch circuits — n ew ailerr�Hon, or rxeension or net
, fate: A. Fee for branch circuits with
„
t i r "tZ t -S +i n 7 t.r ry Ca ri r J „a w ._..w., tn� iu s r, ��er rusx „ u t Y
�rt t . , i k ,\r� Ir(v � i ,,.
nA { tut r tr ;M` r . I t C } :. .. e achbrnc h cirCUlt rrl CderfcK1
�t. _t. ; � J. i . :,t. :.. , . :. il: h
r r_.7>t ! �V +, i�.t �! �iM1rrS , h, gy
... .1.. � :,, , .,,. .:b�.f. , . ,, a... each branch G 7,42 2
Business name: H, Foe for branc c t rv U r zs wdrhnut ”
"" - -" --- - --"• service or feeder fee, first
56.111 2
Contact name: lunch circuit
""" --,- -_ -_ ` " "" .'""'" ,".,. .. Each add'( branch circuit 7.42 2
Address: - _..._,. --- —.._-
.A. -, •- Ivliscelianenus service or feeder not Included
C Ity /State/L.IP: Cinch manufactured or modular
. �- _. dwells: , service and/or feeder 67.84 2
Phone: ( ) f Fax :: ( ) Reconnect onl -- Z "
-- ...... :. :......... -.. _._. W.. y 07 :84-..x,......,.
E -- Pump or irrigation circle 2
�+ � ai 16��i rr lq >i"a',e'vl r +R � t �? C � w+ vg a p� Sign or outline li 67.84
l,tli9 na . �l< r,E�'4it�' p„e�>•k1f7N'.7k','i.,, l5 ,` r ,,, `d rf,a illiiPn�{F�aV1 EM �k 0 ,'1 „ �! : J, •, 5 2
” � Signal ctrwit(s) or hmited•otiel� .,
Business name AD7' LLC panel, alteration or Onionskin. 0 2 75,00 2
Each additional ins --
Y „.,., ._ • , „. . -. peetlon over allowable in an of the - hour.
Address: SW 1S3' Dr Additional inspection (1 hr min) �� 66.25/ hr ,m
City/State/ZIP: Beaverton, OR, 97006 " �� lnvestigatton (t hr min) �.. 66.2 NMI
w..,
Industrial plant (E hr min) 78.18/
Phone: (503) 469 - 7241 I m x: (503) 4169"71.1() Inspections for whic h no feo is
”` r M _
-'— - -+ ___. _ -_., _ .... s• rticall listed 16 hr min
h
CC B Lie,: 196560 00W hr
Electrical Lie,: Cl CLE3I Su rv, Lie,: 4 2S2LEA t.W.4 , i ?'' {t w r I
- . p k,!!. rW!tr't %t r ��,,� i�'{' ° r �.. 4 r ' r r U zi
5uprv. Electrician signature, required: /' Subtatal 75.00
- - ` Plan review (25% of permit fee):
Print name Eric Willard _• Date_5 /2/13• " '"
Suite surcharge (12% of permit fee): 9.00
Authorized signature: _ _ TOTAL PERMIT FEE: - 84,00
-•--- w. -••... W — fall Mink apNieation mires if it permit is am 44104 within 150
Print nalltei days after it hits been accepted en tomplere,
Darr: • Number of
,,,..._ — �.,�,,,,.- ,.. - , W ., inspections allowed per permit.
ti$ uildoVerrear1?t Pcoull App. doe 07/01/10 4411d611T(11105ICOM/WEd
05/02/13 02:1OPM HP LASERJET FAX p.02
r lectricai Permit Application .. City of Tigard
Page 2 . Supplemental Information
LIMITED ENERGY PERMIT FEES:
; . {l to diga6Mvakla)id iSa 4 r'i0ALMa cM
Fee for a 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: ,
!.1h �� �.� {{ ; � e<' f�ir�{D� qp �1 p �p' �t S '46 rt iM�'��^li' �'�t� k t +k r� 1,
} R kn �..�.�,� � nl.�w. +�1�. �..@ b, 4 , n`la.�1a �r R4�.in4 wJfi P�h� 1N�, ie �t . b,J'1'4�h!!u '0 �.. f�, „J��. .
Fee for each commercial $75.00
system
(SEE OAR 918 - 309 -0000)
Cheek 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
Total number of commercial systems: ,—
*No licenses arc requited. Licenses are required
for all other installations
f:1I3u i ldingTtrml∎Atl.,C- PermiUpp. dlu: O7l01110