Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2013-00201
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/13/2013
Parcel: 2S 113AB00500
Jurisdiction: TIGARD
•
Site address: 16083 SW UPPER BOONES FERRY RD 310
Project: Sterling Bank Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Low voltage for security alarm and CCTV system
•
Contractor: ALLIED FIRE&SECURITY Owner: G&S FC LLC
•
530 NE COUCH ST 16083 SW UPPER BOONES FERRY RD,
PORTLAND, OR 97232 STE
TIGARD,OR 97224
PHONE: 503-231-9550 PHONE:
FAX: 503-231-9551
FEES
Description Date Amount
• Specifics: Restricted Energy Permit 08/13/2013 $75.00
Type of Use: COM 12%State Surcharge-Electrical 08/13/2013 $9.00
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: 9 e•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010th • gh OAR•52-00 t 090. ou may obtain a copy of the rules or direct questions to OUNC by callin. 0 . -2.1987 or 1.800.332.2 44.
Issued By = L.A.�'I � Permittee Signatu •� i•ij,i . _
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.
From:5032319551 08/08/2013 17:12 #144 P.002/003
Electrical Permit Ap . '1' : �,' roll 0 FFICE l Sl ONl.i
City of Tigard 13 R"e1Ved p Permit No.:
13125rSW Hall Blvd.,Ti:: OR 23 D 1.O Plan o® '� g''�/ 3-er,,
Q Plan Review q
Phone; 503.718.2439 Fax: 501 8'i 960 0.0 Date'B : Other Permit: _ /"�,. ���i,
I c n I:t Inspection Line: 503.639.4175 1C Ci?`,(gyp\ Date Ready/By: Jr :u's El See Page 2 for
.����?j,T`� Internet: www.tigard-or.gov l `vl`S�V`" Notified/MMettho[dd`: �-F., Supplemental Information
N" $�'" is `. . ;.a .'F Fhto-fi.- V 4i ¢f -4 ^ '.- .P:S✓zL ' -79�7 c• .r'AM1� °''3_ '� '.
❑New construction ❑Additio'r a teration/replacement Please check all that apply(submit F sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: _ _ where the available fault current ❑Marinas and boatyards.
-_si.-=- Fa__ _ 017';. e a"• 0-5-`l p "�;�3 G,t e �^'�" rAM exceeds 10,000 amps at I50 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ['Fire pump. ❑Installation of 150 KVA or
4,, q B }r._^�-Q V 0 e - � '4 El Emergncy system. larger separately derived system.
, ,,' t = ..;_..j_ ' ! . f �
❑Addition of new motor load of
i 9p'j — 00.0510 Job site address: 1(0 0 gJJ U e- v �trl(t� I OOHP or mote. occupancy.
_-�Y R;I, ❑Six or more residential units. ❑Recreational vehicle parks.
City/$tflte/ZiP: 1(„ ,� , n a ❑Healthcare facilities. ❑Supply voltage for more than
1 sw 1f.• C�1� ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:.4 D Project name: ❑Service or feeder 600 amps or more. f(A it
417 Cross street/directions to job site: �l2 ,J , 6,9,01‘, `sc I To°=
� Dacrtptba Qlv. Fee. Total •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.fl.or less 168.54 4
Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 1
: Limited energ y,y,reside
ntial
ais rt, z Y � #�Y���qG� x � ti y "�.�K` ... —�� (with above sq.n.)
75.00 2
Limited energy,multi-family 75.00 2 L v&r e" i ^ fiy►n 4 (v i � _residential(with above sq.ft,)RneWablanCfst gM i
CDiSCi'PiifiV s'- -SP4 : `.'i?.:
Services or feeders installation,alteration,and/or relocation
amps or less 100.70 2
Samoa; 201 amps to 400 amps 133.56 2
Name: cal Vl S r(/�4lL. 401 amps to 600 amps 200.34 2
Address: 1�Q3 CA� n sp�/J F3ny�oe riRi 601 amps to 1,000 amps 301.04 2
ty p YD� "�'rD��C,'7�Y+r."14 Over 1,000 amps i volts 5,alte 2
Ci /State/ZiP: Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax:( ) reiocation
200 amps or less 59.36 I
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 to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension, er panel
'W tips E -`. C °:v'3 - I ? ' _ g�Q e , y' }a ;" A.Fee for branch circuits with
°1 i ` above service or feeder fee,
Business name: ( k l a r each branch circuit 7.42 2
I •
B.Fee for branch circuits without
Contact name: Ar �`^ service or feeder fee,first 56.18 2
J r , branch circuit
Address: 5 9 j Each add'I branch circuit 7.42 2
GiryiState/ZIP: p �+ �jy ,,,{ n 1 2 Miscellaneous(service or feeder not included)
VLs 'S Wl/r lid 4 O . "1 1,)-J� Each manufactured or modular 67.84 2
Phone:1o.3)17 ,..ti 3(4', I Fax::603) D3i ei5s1 dwelling,serviceand'or feeder
Reconnect only 67.84 2
E-mail: NIA C21.2..1,1.12....y— ae Q L-IA e:(7 See..0 • Cp,)y) Pump or irrigation circle 67.84 2
>; 1 _ f 30F aS Co aN:,. �` Sign or outline lighting 67.84 2
/ ��� l
Business name: ✓T`kec ; �..: 4 ignal circuit(s)or limited-energy See
� panel,alteration,or extension. � Page 2 1 2
1,l Address: 6.30 � . ,.� in%� Each additional Inspection over allowable to any of the above
UJ�J" Additional inspection(I hr min) 66.25/hr
City/State/ZIP: Q { (� e. a Investigation(1 hr min) 66.25/hr
Phone:(503)17, Ali 30 Fax:4r5o3) a3 L cl 51 Industrial plant(I hr min) 78.18;hr
inspections for which no fee is
CCB Lie.: 6944(05 Electrical a �a,,f3CLE Suprv.Lic.:{ s. ificall'listed h hr min 90.00/hr
��.
Suprv.Electrician signatureatiju.ired: __ Subtotal: 16,Cp
Print name: i r (0 Date: VArli 3 Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: g r CP
d This permit applkadon expires If a permit is not obtained within 180
Print name: MPS ` ^ Date:f7 3� days after It has been accepted as complete.
• Number of inspections allowed per permit.
I:ii3uiieing\PermitaLC_PernitApp_Et.R_ERE.doe Rev 0521/2013 440-46157111,05/COM'WEB
From:5032319551 08/08/2013 17:14 #144 P.003/003
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
n_ _ :7y T, 'C9p. 07 '3 ' '.�'.k'°.' t s`-� mgr-Gi9e ..' - aer+aJ• 6�• t ... `ry €- �` b
Fee for all residential systems combined ... $75.00 Description Q5. Fee Total •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
Wind generation systems In excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
%100 kva(fee in accordance with
El Heating,Ventilation and Air Conditioning
OAR 918-309-0040) 552.26 2
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00:hr
,a ,
specifically listed A hr min)
oo r__:8 W .4.A..� e REAR.�.a�N.R✓�1r 004 td l ..'a':ftt r?'o g .. fi yam.i i ._':a
. .v tea. qq��tt��,pp aa,,��;� .
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
n Audio and Stereo Systems days after it has been accepted as complete.
Number of inspections allowed per permit.
El 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*
E; Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building'`Perm its kELC_PermitApp EIR_ERE.doc 05'21.12013