Permit p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
: COMMUNITY DEVELOPMENT Permit#: ELR2014-00212
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2014
Parcel: 2S 101 DC03800
Jurisdiction: TIGARD
Site address: 7190 SW SANDBURG ST 10
Project: Burkhart Dental Offices Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Low voltage for security
Contractor: SONITROL PACIFIC Owner: MCCORMACK PROPERTIES LP
8220 N INTERSTATE AVE 7190 SW SANDBURG ST
PORTLAND, OR 97217 TIGARD, OR 97223
PHONE: 503-223-5822 PHONE: 503-624-4649
FAX: 503-973-7773
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/24/2014 $75.00
12%State Surcharge-Electrical 09/24/2014 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
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: 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 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 gh OAR• -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 2344.
as...,....
Issued B �_�L ii Permittee Signature. ,o rcA------
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.
Sep. 24. 2014 10:29AM Sound Securit Inc. No. 6093 P. 1
Electrical Permit Applica CEIVEP FOR OFFICE 1!sl.ONLY
City of Tigard Received r�
DaleBy: cf 0—f ' ' . ' Perm4119.: fAL,,I II-oo/2/�
Ill/ 13125 SW Hall Blvd.,'I'ienrd,OR a O2 4 2014 Plan Review hit/7 /17400/F5---
Phone: 503.718.2439 Fax: 503.5 2 Date/By: OlherPermil: /
T 1 C A R I) inspection Line: 503.639.4175 r / p`' Date Ready/By: kris: ' t� See Page 2 for
Internet: www,Iigard-or,gov CITY OF TIGARD Notified/Method: Supplemental Information
TYP `PLAN!.REVIEW
�8�>i D'lwlSlO�
Please cheek all that apply(submit 2 sets of plans w items checked below):
❑New construction Addition/altcratiorJreplacemenl []Service or feeder 400 amps or more ❑Building over three Stonet.
❑Demolition Other: where the available fault current tJ Marinas and boatyards.
.• CATE ORY OF CQNSTRTJCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
loss to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings,
❑Multi-family Master builder p Other; Q Fire pump. ❑Installation of 150 KVA or
' JOB STYE INFORMATION AND LOCATION ❑ derived Emergency system. larger separately deed system.
El Addition of new motor load of ❑"A","E "1-2","1-3",
Job no.: �( Job site address;7)�D £ I'\C r I/� ix or or erro, occupancy.
[]Six or more residential trails. ❑Recreational vehicle parka.
City/State/ZIP: Yc , Cy q 1 1]� ❑Health Caro faciliries. ❑Supply voltage for snore than
`J"_ Y ��� l/ Q Uasardats locations. 600 volts nominal.
Suite/bidg./apt.no.: ` Project❑amC � h 1 1�✓ El Service or feeder 600 amps a moro.
—FEE SCHEDULE
Cross street/directions to job site. Deadpan 1 Qry. I Pea. I Tend I •
New residential single-or multi-family dwelling nnil.
Includes attached garage.
Subdivision: 1 Lot no.; 1,000 sq.ft.or less 168.54 4
Pa,add'I 500 sq.R,or portion _ 33.92 1
\ -'ax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION:OP-WORK (with above sq.0)
--- Limited energy,multi 75.00 2
/ ` �A residential(with above sq II)
(*4. v Renewable Etter' -_ E_See PSEe 3 ,
rJ
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY.OWNER - ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 —17
City/Stale/ZIP: Temporary services or(ceders installation,alteration,and/or
Phone:( ) I Fax:( ) relocation
200 amps or Ices 59.36
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. a01 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension, cr pnnel
APPLICANT I 0 CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7_42 2
Business name: _ each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,fist 56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
City/Stale/ZIP:
Miscellaneous(service Or feeder not included)
Each manufactured or modular
67.84 2
Phone:( ) I Fax; ;( ) dwelling,service and/or feeder
Reconnect only _ 67.84 2
E-mail: _Pumporirrigationcircle 67.84 2
T CONY OR Sign or outline lighting 67.84 2
rC t 1 p'\ r 0 I Signal-circuit(s)or limited-energy See
Business name: (, 1 n/U 1 t r panel,alteration,or extension. I Page 2 75---1 2
Address: g� T �-q,.� • Each additional inspection over allowable in any of the above
/ Additionalinspection(1 hr min) 66.25/hr
City/State/ZIP: O&M a n r ! i Invostigalion(l hr min) 66.25/Irr
Phone Z a,',3-- , Faxr) 973, -- 71 3 Industrial plant(1 hr min) - 78 18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 63535 Electrical Lie.: -3'�b Suprv,Lic.: 3507 2� speciRcallylisted(4hrmin)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: , M , Subtotal: '7b .e
Plnn review(25%of permit fee); 0—
Print name: C-�oyd. u GC Date: 9�y pi
!!!!
Slate surcharge(12%of permit fee):
Authorized signature: _ ,1) �'] 'l TOTAL PERMIT FEE; Ij�—j
d l e tG k.. 1� !/4' 1 l, f
This permit a aye after ii at∎e it s permit is not obtained r+ithin 180
Print name: Date: ,r 7 days after tit nos been etceplM as coMptete.
• Number of inspections allowed per permit.
PtaondingsPermtttt I.CJ'ermhApp_ELRJP6 doe Rev 05/2112013 a40-4615T(nros! ainatE 3
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7190 SW SANDBURG ST 10, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
198 Low voltage final
PASS - No C of O
ELR2014-00212
Jeff Grove
Violation Summary:
Inspector Contractor