Permit p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' "+ ! # • COMMUNITY DEVELOPMENT Permit #: ELR2013 00320
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2013
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 355
Project: Spec Space Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: Low voltage for fire alarm
Contractor: STANLEY SECURITY SOLUTIONS INC Owner: PACIFIC REALTY ASSOCIATES
15495 SW SEQUOIA PKWY STE 100 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/17/2013 $75.00
12% State Surcharge - Electrical 12/17/2013 $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: 1
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape /Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 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 ' ran 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. TTENTION Oregon law requ' - . you to follow the rules adopted by the Oregon Utility Notification Ce. - Those rules are set forth in OA'
95 01- 0010th gh OAR 952-001-6; • 0. You , obtain a copy of the rules or direct questions to OUNC by calling ' -. 2.1987 or 1. •00.332.2344.
sued By: / _
y: 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.
Electrical Permit Application FOR OFFICE USE ONLY
C of Tig Blvd. ard , T ECEI • 1.eceived . : .Pio ew /ii / /7 //J 4L Perm" No
1 w�v� 3
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" 13125 SW igard, Plan ,CP��o 3 8
Phone: 503 . 639 . 4171 Fax 503OR . 59897223 . 1960 DEC 17 2013 D ate BRev y: Other Permit: / -`C n/ f
TIGARD Inspection Line: 503.639.4175 Date Ready /By: Juris: H See Page 2 for
Internet: www.tigard or.gov CITYnFrrARp Notified/Method: Supplemental Information
TYPE OF W6Ri: 1'1 1N REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ® Addition/alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling Z Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: 6650 SW REDWOOD LN 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZiP: PORTLAND, OREGON 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 355 Project name: PACTRUST ❑ Service or feeder 600 amps or more.
, •' FEE SCHEDULES ,A u
Cross street/directions to job site: Description I Qty. I Fee. Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
INSTALL (1) STORBE BREAK ROOM TO EXISTING FIRE SYSTEM residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: PACIFIC REALITY ASSOCIATES 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 15350 SW SEQUOIA PARKWAY Over 1,000 amps or volts 454.65 2
City/State /ZIP: PORTLAND, OREGON 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)624 -6300 Fax: (503)624 -7755 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: STANLEY SECURITY SOLUTIONS B. Fee for branch circuits
Contact name: GARY TAUSCHER without service or feeder fee 46.85 2
first branch circuit
Address: 15495 SW SEQUOIA PARKWAY Each add'/ branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: PORTLAND, OREGON 97224 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 968 -3355 Fax: : (503) 968 -3398 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: STANLEY SECURITY SOLUTIONS Signal p a nel t(s) or limited -
energy panel, alteration, or ce
Address: 15495 SW SEQUOIA PARKWAY exten n. Descn S
! Page 2 7 • 2
City/State /ZIP: PORTLAND, OREGON 97224 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 968 -3355 Fax: (503) 968 -3398
Investigation per hour (1 hr min) 62.50
CCB Lie.: 161567 Electrical Lie.: 37 -1054C Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 75 - «7
P g A Subtotal:
Print name: TIM HUNGATE Date: 12/17/2013 Plan review (25% of permit fee):
�^ State surcharge (12% of permit fee): 9. e e
Authorized signature: n TOTAL PERMIT FEE: cc/ .0e)
This permit application expires if a permit is not obtained within 180
Print name: GARY TAUSCHER Date: 12/17/2013 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I: \Building\Permits\ELC- PermitApp.doc 05/23/06 440- 46t5T(1 l /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
E l Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
E l Boiler Controls
El Clock Systems
El Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
E l Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 03/23/06
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
6650 SW REDWOOD LN 355, TIGARD, OR,
97224
Commercial - Electricial Limited Energy
199 Electrical final
2013-12-24 (null)
ELR2013-00320
PASS - No C of O
Violation Summary:
Inspector Contractor