Permit IL n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
rl COMMUNITY DEVELOPMENT Permit#: ELR2013 -00147
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/27/2013
. Parcel: 25101 DD00101
Jurisdiction: Tigard
Site address: 6975 SW SANDBURG ST 150
Project: Pacific Marketing Subdivision: TECH CENTER BUSINESS PARK Lot: C
Project Description: Burglar alarm.
Contractor: ADT LLC Owner: WESTON INVESTMENT CO LLC
2815 SW 153RD DR 2154 NE BROADWAY, STE 200
BEAVERTON, OR 97006 PORTLAND, OR 97232
PHONE: 503 -469 -7219 PHONE:
FAX: 503 -469 -7128
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/27/2013 $75.00
12% State Surcharge - Electrical 06/27/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data & Telecommunications: 0 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape /Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 1 Other: 0 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 952- 001 -00• I 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: I itiSstirrz/Ar Permlttee Signature: # 4
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 603.639.4176 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.
06/25/13 08:45AM HP LASERJET FAX 5034697139 ' p.01
UCEIVED
Electrical Permit AppttCD l {)li 01:1-1( E 1'St; ()NE,N
9,1 Received ' 4 , . o -// /L/ •
City of Tigard , U 2 5 2013 Re eived a? /3 •, m„trl�,:
s 1 3125 SW Hall Blvd , Tigard, OR 97223 Plan Review elder Permit•
0 Phone: 503.718.2439 Fax 503 �GA�
p� VF Date/B
Z. ._ — _.J...,..-- .._.._- ...._._ "w i21 SeePag ...�.,,..._
eYfer
'1' t C.; A I. U Inspection L ine: 503 639.4175 Date Ready/By _ 6, Internet: www.tigard- or,gov BUILDINGDNISION Notitied/htethod, ,- S u temente' Information
u L, nv , a yu a ,:r • s lr. ,, +a + q . 7 u ;[ i : 'r 7 ' 7 , .. ,1 1i 14 +U r t fthq t R 0 'w ,'a art+ 1; ; `) l yJi!" rail r i j7 r pl
e l li 'sy - �} l vc gr B, x � l Il iul lnp�� .}} .i• .3., ,l. S. ,Yal ( i a riljt7ra "¢+ •! il l i � � i d J ( }Ii'' .t , ... i rP : 4 1V i.•; 'ty' �'li1 lii �'S
Ii,,I :f I10 "6, I�'I'tkI ' / d11,hlt .. c r � 4i Si y I k�l ' I` J l ti , r at i � ll `` r(,,1b , I 1J, �., ,,;', 1,4 i i a !1 ft 3 a {, 11 i .:
lad': Ir.'xJA7, U I r I r .� 11l•4, i.o i1e 11�iti�i'ftl •Y7� Lr.GI 4,ai0.ln n,t "dY,n 1rRi, th r�n1,tl �.a.�'�',� iY.�,:*S•.°Ili�• � ���' "�I„�i+�� lsi;l�)�ik� ,N��Id ,,,rn,..,i_ „ i.a i'n �H,fv� ,. I alNa: ...f .� ��P7
0 New construction Addition /alteration /replacement Please check all that apply {v lbmit 2 sets of plans wlitems checked below)
r ❑ Scrum or feeder 400 am , S or more ❑ Buliding over t stems
0 Demolition L. on Other: whom the avatleble fault ' warren 0 Marines and boatyards,
7 t• ' '6'ti;' , . °((' I ail , 14 r l� nu ,l ,i * `i ` im 0 �{�`lo'r 'l' atrpy SFr { r ll'�s n +i T '1 Vf71110 { t
, 1Rili y'�fy satin exceeds 10,000 amps at '1 •0 volts or 0 Floating buildings
ttfii� l ill ,,I kl„1IA !tali l f+la1 dal., p ti iiiie 10.11 r14 tS:Alirr�hi; I 'ihtratuy.ef: lAelUi5, i II 116,giSil G Ili i i lily. Oh 1114
loss to ground, or exceed 14,000 d Cnmmerctal•ulle agricultural
0 1 - and 2- family dwelling ® Commercial /industrial 0 Accessory building amps for all other Instaltn ions buildings -
0 Multi family 0 Master builder 0 Other: a Firs pomp 1] installation of75 KVAor
i.:Tfi ,)wa it iyo:' tir<t,55u aly r 'I ' w t �l' r 1s `wiaiaR ' i i+rl >' 4 rU $ l';ivaJ ul ari {gglili `'fi , 4 AR 0 Emergency system larger separately derived system
4+rFi( p 1>d'F�[t ia ;;;0 1i lal wa
iili,1 t1, ifi�,1a;71 b,1,i.:ly IJ Ala laa !ai1�;�f�Alle ittrsLlu'Idhttls l lkl �fl iifi l l'�51}Jl)F� iii t i,d Wig 0 Addition of new motor 10 d of 0"A~ ,"E", "I-2". „1,3,r
100HP or mare ocaipaucy.
)oh no.: 083 -27676 !Ob site address: 6975 SW Sandberg St 0 Sig or more residential u its L1 Steereauonat vehtctt parks
,,,,,.,„, —.--- ,,,. ,w... -„ .... . — . ......_..........,,.,,......._.
City /State /ZIP: Portland, OR. 97223 0 Health -rare. facilities. 0 Supply voltage for more lima
,,,,,„ -„,. , _ -,,,.„ 0 ila irduus (Ocatloili 600 votes nominal
Suite /i>Id la t. no.: Ste 150 Pro name: Pacific Marketing 0 SeMee or feeder u00 am s or more
,.,..w,.., P . —� .... - ..�..- .w.....,._ 015,59 ffii , BNB ut 5 1P , 1,1y „ t „I 1`. J 711151x411 ` + p 1 11
m.. v _ }IfIV P 11 t Aif;nigi li1 l l {to ,,/ , r t , � rt 1 11„'lrll ltil7itAgu : 41�
Cross street/directions to job sitar: u molo IMO ..__ Fee, Tote •
----, - - . - -• , - ' - • - . -- ' - • ° - - . - New residential single.. r multi family dwelling unit.
Includes attached gore. e. _
Subdivision: Lot no 1,000 sq It or Icss 168.54 4
... ""_ � - -•-- T --- _ -•° ° ^ Ea. add't 500 sq f, or po i i�
Tax map/parcel no.: Limite en er�v, residentta
is.'! ; :41.l i'ilir :,',,,-,;'1,-,,:i.`' 'i:it'.'. 1'0iI,•i ; r`c6 <'Yirn°r'iCio'�P'9.J.?"`1' ''' Xig! fhtJ ii:,! i.,' V, g,V111}I}Il19,,li� Wnh above III .- 7300
'3 „I i1i1'•)l:,,,,,, Ih7„,,!*IL,irrGll�,,,, „: l`�1�LF „,, , „,!„, I ih ,d ..,,I,.,„, A l hit'U�r3 S iii�l��i Sliltld>'>t, r,.�li�iii �'/i ) _
Limited energy, multi -fa l y _ 7500 GI
LOW VOLTAGE BURGLAR ALARM realdesmal with abovv+• ft .
-.. - • - - -'---- Services or feeders ins 1Tfl tttr I fii •tallniiln to DI.; i MANI
m -., .:. ' ;111:; '',i:.i:::,i_ :,,:,.n c „ ili5lti!,,.j .. r: ,; • o ?: „ 1,7,.. ':: I' •�sn„ ,.: I',,, n xr� •"{I(14 P, ;1'il ' � amp to 400 amps 1 __ el
200 a
1 l � I i 1 1 ' . .,
i °,i °• l. t I C I , jl ,1 11, 1, , ,1:1 5,',' ��i II � I,i ! i Yi r k . , w qr ql'l J L ira , 2UI amp _ D
r yy �JJ UN 1
i. ,i ,,,,, ,�,� , � .... _ . ,. , u_,,It )AVIf .:i i'311 aa, . JIA..4 ; 41',,., .,i.,, ,. iL , n1 ,L. il,lr�,u +l,ri. 7,flrili . 200,34
401 amps to 6W amps -- M _,,,,, ^a• ^ _
Name: __ 601 amps to 1,000 amps 301.04
Address: Over 1,000 amps or volts _ .. 552.26 - MT 2
, . m_ - - — - ,, - - "� M Temporary services of fe installation, alteration, and /or
City /State /ZIP: ,. ,,,_ relocation � n _„�, �,
~-~-. .„ , . r _. "_" _” _ ". 200 amps or loss 5 9 36 Q
Phone: ( ) w_____� Fax: ( ) —.-W ,, d
201 amps to 400 amps - 125.08
Owner installation: This Installation is being made on property 1 own which is not 401 am __ -
ps to 599 amps 168 5 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. Branch c ircuits- new alteration, or extension, per panel
Owner signature: _, Date; -... A. Foe for branch circuit with
„• ; ,i;4 i ;t tl ncr :rr;Vf;1111i,‘ 'r' ; :, ,, above service or feed fee,
: , 0,,,,,..,,,,,.,;,;,,, I, ,,,, y ll, ll , ,
,r ,Il l ; s� 1 ; a-s { : I l b v i � �,1 ' ' . 04' , rl . 4, fp i I .i � l 742 .— 2
11
I,•.� �''•1 T..' '� I,. ..I�! l,(,/ e `l.,�e` i.,., „stl_ ,6.f,i :,.v,I i � +1',' each .- ._._ -,___
0 Fee for branch circuits without - -� ii
Business name: _ .. service or feeder l ac, rat 50.18
__,..T
�""-� - branch circuit _
Contact natttc:_ OM / ,42
__ _M�. �__ __..._._ ,_ _.� -.-. Fnch edd'i hfanch circuit
..____
Address: Miscellaneous (service or feeder not included
•-• - •••--- •• -----_ °•-'-`- ”- '-- " "•"' - -- ' " loch manufactured or rA'Mar 67 84 III
City(State! ?.IP: _ __ eder _
r _ . _ _...,,.... — ..._- ry l o . nc ctrl only
on ctrok 67.84 1I
dwelling, service an or'
t {`"I - —� Reconnect only
Phone ) ,.. —.._ _.._. _. - � ) .., W �._ � ' p __ 67 84 _ . w.. 2
E n j `` }h�� y Sign or outline lighting _, „ 67.54 „� 2
r i t :I 1 Jl I ' i I' `i' Ellitf 1,1,;L „ ; illi,}J,IM.,,tl�t11.1J ∎ liar' 1 lilF,+l ll�llelln, e tNki !'I ;l 1 (l $I W Or a l ma - ^e
li R, i o , !I :, 1 71,, I:.:' I,,, , 75 00
_panel, altcratian, or extoi ion. _ i Pa 2 2
Business name: ADT LLC Each additional Ina ire lion over allowable In any of the above
Address: 2815 SW 153 Rp DR - ~W' — M —�V- Addkioliat inspection (1 r mm) 66 66,2 251 hhr r
-- •--- •- °- •----- -_--- '�`-'- -- "" Investigation (1 hr min) _S1
Cary /Stull /ZIP: 13EAVERTON, OR 97006 � - , - T Industrial plant (1 ht mi 1 . �_ 78,181 hr
469.724 Fax: (.5 03)
Phone: (503) 469 Inspections or which rill Mill 90,00i hr M.
_ - si ificatl listed 'h hr I
4 .' n n i ai lgli'a� n • j'; 17 ,dill;'�4.* : : r i : i :T.''!'1.'.' l lit'`! iii; '-', ;:. '.! :V
CCB Lie.: 196560 Electrical Lie.: CL 317 Supry .is.. 4252LEA r y ) ,all ;p{r,�lwr,:b.,al ; ,4,r'f i , ,, .1.,,,r J.:,,11 � r ''
_
- Subtotal: 75.00
Suprv. Electrician signature, required: - �-' w`T m Plan rev •w (25 %ofpermit 1!e): -
_------.
”- �- ' 1e-00 J , 2 I -,,�
Print name. ERIC WILLARD ., ( T S ---'-- - --
tate sort qe (1256 01 permit fee): 9 00
' TOTAL PERMIT FEE: 84.00
Authorized signature: — ry Tbls perrufl epplic■ tin , expires If a permit It not obt obtained wilhih 180
. -• �— - • days afier I has been accepted as complete,
Print name: Date: 4 tgwnber ofinspection%allowed per permit
i. litundie sffermtalL't.l:- PermrtApp,doe 01/01/10 440.401S7i11/os /CPM/WEn
I
06/25/13 08:45AM HP LASERJET FAX 5034697139 p.02
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
'� l+�.C3 .; 4:., nF � 7 ,* ti�J'ta t f\: rS��F,t11ill , s c;
ll w4: � I, M'� �•��, V ,�':, � a;. � GS!%� r� tV4r.),�A�`.
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:
yy a ' r �yy�� 1�1�Nd �? �
il ; OEM
)���r3�:�a } „��` .7F�'>t4`!i�2�:k1���44�m r� dti�•
Fee for earl commercial $75.00
system
(SEF, OAR 918 - 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
Ej Clock Systems
❑ Data "Telecommunication Installation
❑ Fire Alarm Installation
HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control's
•
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
t 18u tdmsl?crmualELC•Perni tApp.duc OfNUIU