Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 1 11 _ COMMUNITY DEVELOPME Permit #: ELR2013 -00157
Date Issued: 07/03/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 15136CD00101
Jurisdiction: Tigard
Site address: 11675 SW PACIFIC HWY
Project: Columbia Bank Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: Security system.
Contractor: COOK SECURITY GROUP INC Owner: WILSAL LLC
5841 SE INTERNATIONAL WAY 834 SW ST CLAIR ST
MILWAUKIE, OR 97222 PORTLAND, OR 97205
PHONE: 503 - 786 -5173 PHONE:
FAX: 503 - 786 -3792
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/03/2013 $75.00
12% State Surcharge - Electrical 07/03/2013 $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 -0090. 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: / 1 Permittee Signature: 6/V '1 ii( /�.
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.
From: 07/02/2013 09:12 #919 P.003/003
Electrical Permit Application - . :. -• • - . - FOR OFFICE USE ONLY • ' ' . '
, .
City of Tigard JUL 2 2013 Received .g. Permit No.Alri 2d 3....e0
11111 • 13125 SW Hall Blvd, Tigard, OR 97224_,.. Plan Review
0 Phone: 503.7182439 Fax: 503.598.Uti Y OF TIGARD Other Permit:
Inspection Line: 503.639.4175 D ate Read 0
T1 eiAR D BUII.DING DIVIStON D / Jut 1 e.I See Page 2 for
Internet: www.tigard Notified/Method: Supplemental Information
T `1 ' ' . :: ' :1'';: 2 - ::';' ' .. : - ' - ;''' 2 ; ]*
0 New construction i: Addition/alteration/replacement Please check all that apply (submit a sets of plans w/items checked below):
0 Service or feeder 400 amps or mom 0 Building over three stories.
E] Demolition ID Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10000 amps at 150 volts or CI Floating buildings.
less to grous d. or exceeds 14,000 0 Commercial-use agricultural
0 1- and 2-family dwelling N Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
larger separately derived system.
' i--'490' .$ 11T- g - ...ME 011 W' ', T9 14 . 1 :- ' --. - • :-...''., ':...::' ,. • i. 0 Addition of new motor load of 0 "A "E", - 1-2". - 1-3 - .
Job no.: c lb / t t 3 Job site address: Ii. ('IS s \61 p t 4 .
c i 100HP or more.
0 Six or more residential units. 0 occupancy.
Recreational vehicle parks.
7 City/State/ZIP: 7,30x,.1 r‘ r. 0 9 irl I•13 a Health-care facilities. 0 Supply voltage for mote than
L.% 2 V a Hazardous locations. 600 volts nominal.
/ 1 Suite/bldg./apt. no.: Project name: Ca-'h al, ?) ta , K 0 Service or feeder 600 amps or more.
'
. ,,;;, .„ :; ....'• :. .:
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less
168.54 4
Ea. add' I 500 sq. ft. or portion 33.92 I
Tax map/parcel no.:
Limited energy, residential
5.00
DESCRIPTION OF WORK
(with above sq. ft.) 7 2
/ Limited energy, multi-family
75.00 2
Lo u Ntok4.3.43e, C-e-1 V NO 0 P S, et CI ( residential (with above sq. ft.)
1 Renewable Energy ... . • .13-See Page 2 . . • , ' . .
Services or feeders installation and/or relocation
...,___.„_
100.70 2
::-.::::'';:',:-:'• 10 fiO)P"Ek r i* - " '0 WNP' --'1 ' 1: i '. : - .'' . .1:; . ,' A .'.....Y "' ..aVEStiAsiT,;': .p,, • T 200 amps or less
.. ... .. . 201 amps to 400 amps
Name: 401 amps to 600 amps
Address: 0)Ct snips to 1,000 amps 133.56
200.34
301.04
2
2
2
""" 0 - oYj)\ Over 1,000 amps or volts 552.26 2
City/State/ZIP: )14-d 601 a
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
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 amps 10 599 amps 168.54 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
",.... . ..:.•*:.]::,.. i ...:: .,. .0. :0 , ..y.... ;,,.. ., A. a F bo ee v f e or brar o c r ir f cuits r w ree ith
Business name: c s erjo s i 13 .(,-pc l "Lne . each branch circuit
1 B. Fee for branch circuits without 7.42 2
Contact name: • .Short r ..p r ov 0 ,4. service or feeder fee, first
56.18 2
`.- . branch circuit
Address: 5 g i. A ., SE olio
Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: rt J ,,, ,. k c el q 9 , . 1 3
Each manufactured or modular
67.84 2
Phone: (s 1 g ta - 5 vi Fax: : (503) / t 6-31i 9... dwelling, service ancVor feeder
Reconnect only 67.84 2
E Pump or irrigation circle 67.84 2
CONTRACTOR : ' .:.,,:' .„ f '.. ,, 1 . .;..:: ' . . ' .- .... ' Sign or outline lighting 67.84 2
Signal circuit(s) or Iimited-energy See ,,, „,„
Business name: C v, s ,.. c ,.. .
panel, alteration, or ext I ension. Page 2 - I.D. 00 2
Address: Sgl..I ( S' TA MI ifylA.0 t),10.-Lt Each addidonal Inspection over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: 14 i it)o t:e A R ci naa..g. ‘1
Investigation (1 hr min) 66.25/ hr
i v
Phone: ( 5(3 ) 9 g c - 5 trt3 Fax: (6I)5) 1 t t - 'i I 2., Industrial plant (1 hr min)
78.18/ hr
e specifically floiartedwh(icshbnromfiere h
) is _ 90.00/ r
CCB Lic.:15 I 1 s Electrical Lic.3- 5t4 1 clE Suprv. Lic.1 EA , •
A At
pi
_ ... • . . ELECTRICAL- PERMIT FEES
S ' ' .'. .,- ..
Subtotal: 1 ., . no
Electrici s atre, require . /
Print name: -. 6 r tc,v, e-ook. Date:' ..3, ..i3 _ Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized sii ., . TOTAL PERMIT FEE: 8 00
This .
is permit application expires if a permit is not obtained within 180
Print name: --- k lortavk e oo& Date: ,' _ 2 _ 13 days after It has been accepted as complete.
• Number of inspections allowed per permit.
1ABuilding \Permits \ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440.4615T(11/05/COM/WEB
From: 07/02/2013 09:11 #919 P.001/003
C O O K S E C U R I T Y G R O U P
Cook Security Group Inc.
5841 SE International Way
Milwaukie, Oregon 97222
503 - 786 -5173
503 = 786 -3792
FAX
To: ��a (�1� VY11t � .Q � From: S C h e CSC
Company: ei4 oc �i O, d Phone: 503 - rig to -5 V 3
Fax: 503 - 5 9' . 1°04,0 Pages: 3
Subject: E leek t ea i Asa% py Date: I- 2_ 20 LS
,10.
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11675 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-11-18 00:00:00
ELR2013-00157
PASS - No C of O
Violation Summary:
Inspector Contractor