Permit (21) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•'1 ° = COMMUNITY DEVELOPMENT Permit #: ELR2013-00143
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2013
Parcel: 2S102AB01902
Jurisdiction: TIGARD
Site address: 9386 SW TIGARD ST
Project: Northstar Subdivlsion:RTH TIGARDVILLE ADDITION, AMENC Lot:
Project Description: Burgler alarm.
Contractor: PHILLIPS ELECTRONICS Owner: ALLRED LIMITED PARTNERSHIP
3247 NW 29TH AVE PO BOX 23144
PORTLAND, OR 97210 TIGARD, OR 97281
PHONE: 503 - 222 -5083 PHONE:
FAX: 503 - 227 -4992
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/25/2013 $75.00
12% State Surcharge - Electrical 06/25/2013 $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 952-0 1 -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: /d Permittee Signature: ON /e
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 603.639.4175 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.
t i,EC,,EN),D
Electrical Permit Applica '0 — — 1.01z 01 F. usE ()
City of Tigard JUN 2 4 2013 Received
listeiBr: / / ei''. Permit No. 67„./2/__,/ ---e;70/
II --- ° 13125 SW Hall Blvd., Tigard, OR PIM Review
' I: Phone: 503.718.2439 Fax: 503.5 9iNeff OF TIGARD Da . : , Other Penult:
Tit 4175 n Line: 503.639
I sP action . 303.639.4175 BUI LONG Di VISION 1
Internet: www.figarel-orgov - li' i /. El sce Page 1 for
Inter
-ft K s
_upolcinentol Igen:Wean
- 7iE OP WORK - • •,` *- • , PLA4 REVIEW
El Now construction Addition/alteration/replacement Please cheek all that apply (submit 1 sets ofplana w/itema checked below):
0 Service or fbeder 400 amps or mom 0 Building over three stories.
0 Demolition El Other: where the available Built currant 0 Marinas and boatyards.
.i..:;,t.:: ';' it.i .......... ....7 ':. 7,:pk,CONSTRUtreiti;".4 : v .. •-;. v;;,
9116 exceeds 10,0oo amps at [so yeas et 0 Flaxe gs
n/buildin.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
1:1 I- and 2-family dwelling OljtoMMerCial/Industrial 0 Accessory building amps fbr all ether Ingellation& Widin.
0 Multi-family 0 Master builder 0 Other 13 Fire pump. 0 Installation of75 KVA or
.i :' : ;,:),; •„ :: ''' JOD;IBITE AND ,LeATION :;:;:,:, - ; ' -, , . :i;' :.,'; ', :' 8 Addon of InOtor load of 10"A" " 8 11" 61111 " 121i 1-2 131 " Y "1-3 "11 "
Job no.: Job site address: • 4 , 1-1 . 1 ....., - if ;4 10014P or more. occupancy.
CI 81% or more residential units. 0 escreational vehicle parks.
City/State/EP: - 01,., ..0 13E011th facilitiee, 0 Supply voltage tbr more than
a'...ca 1:IHazardous locations. 600 volts nominal.
Suite/bldg./apt. no.; - Project name:ifii - 4,/resc ek2arl.c.r 0 Service or &der 600 amps or more.
nl.',." Z.- ": • . - 7 '''''. t: - ,.
Cross street/directions to job site: DeirrIption i ore. I re. I row I -
New residential single- or multi-family dwelling unit.
_ In t at a ta r e icu bed garage.
Subdivision: Lot no,:
. .
168.54 . 4
_
- - Ea. add'1500 sq. R. or portion 33.92 1
Tax map/parcel no.: .
Limited energy, residential
75.00 2
•,,,y,,,,.:',.,_15*tat,015141:0F,SVoRis§-1:::i.:::-/!-i.:i-1:-7:::::'-',:iii:;:?.;7:•:i (with above sq. IL)
Limited energy, multi
75.00 2
. 41.61 C 4frotilA 6r) kt PC4 PUel _S /LPA /0 L.e..4 residential (with above sq,11)
Services or feeders instaliation and/or relocation
200 amps or less 100.70 2
: -,;',. ::. ::',.\.'d - .: , .. ,.., , ::,:,,,::,,,,-,-..,: , 201 amps to 400 amps 133.56 i
401 amps to 600 amps 200.34 2
Name:
601 amps 10 1,000 amps 301.04 2
-
Address: Over 1,000 amps or volts 552.26 , 2
Temporary services or feeders Installation, alteration, and/op
City/State/ZIP:
relocation .
Phone: ( ) I Fax: ( ) v 200 amps crime . 59.36 1
2 to 00 125.08
Owner installation: This installation is being made on property that I own which is not amps 4 amps
401 amps to 599 amps _ 168.54 2
Intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Breach circuits' - new, alteration eitenslen, per panel
Owner Signature: - Date: A. Fee Ibr branch circuits with
'■:,',". . .. ,:'-: 0 APPprANI;;;.":4. ' .-'0 ;CONTAtl''PEESOP17 ' : '', : above scrvico or focdor lb;
each branch circuit 7.42 2
Business name: B. Fee for branch circuits witiour
.L service or feeder fee, Brat
56.18 2
Contact name: branch circuit -
. Each add'I branch circuit 7,42 _ 2
.
Address: Miscellaneous (service or feeder not Included) ,
1—
Each manulbetured or modular 67.84 2
City/State/ZIP:
.
&oiling, semi= andtor feeder
Phone: ( ) j Fax: : ( ) . Reconnect only 67.84 2 . Pump or irrigation circle 67.84 2
E
outline lighting
y. .:.:1',;':;,- !....,; ■-...,'/.. - - v Sign or - :'''..'; Signal circuit(s) or limited-energy. 1, 67.84 2
,.:.v./; . '- v.!...,"..::‘,:i .,,,, - . ., CONTRACTOR: ..., ,.: v v
panel, alteration, or cottenalcm. Paa02 _ 75
Business name: Master Alarm LLC dba Phillips Electronics
- Each additional inspection over allowable in any of the above 2
-
Address: 3247 NW 29th Avenue Additional inspection (1 hr min) . 66.35/hr
V investigation (I hr min) 66151 br
City/State/ZIP: Portland OR 97210
_ , Industrial plant (1 hr min) 78.18/ hr
/ Phone: (503) 222 I Fax (503) 2271' 92 Inapoctions for which no fee is 90.00/hr
specifically listed en hr min) ,
CCB Lie.: 125364 I Electrical Lio.: di LE s , / ' prv. Lia.: - 7,7-77-77. 1 :•:„.:
I ' Subtotal: •z5 ,00
Suptv. Electrician signature, required: / I - 41K lot' I
/ ' Plan review (25% of permit fee):
p
State surcharge (12% ofpermit fee):
Print name: _.,..\ e „Rz.g._ s • Date: (01914 ( y3
TOTAL PERMIT FEE: -
Authorized signature:
This permit application expires if a permit Is not obtained thin IN
days after It has been accepted as complete.
Print name: I Date: • Number of inspections allowed par permit.
1:113ulldhinTertnitABLC•PerrollApp.dat 07101/10 ) 44046isTo 1/05/(OMAlinn
1/14 V7.6 pr
600 ./00 d Z66bLZZCOS(XVA) so 1 uo_q.oa ID sd ! II ! I-Id 9£ VI - CLOZ/VZ/90
Electrical Permit Application – City of Tigard
Page 2 – Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORKDAY • 1 . • '
,.•. , i` •:':•`: :F'EE , 9CI•IEDUt;E; •;• •
Fee for all residential systems combined .. $75,00 Description > 9771 Fee I T1•! f
Renewable dtctrical energy systems:
Check Type of Work Involved: 5 kvo oriels 100,70 — 2
El Audio and Stereo Systems* 3.01 to 15 kva 133,56 2
15.01 to 25 kva 200,$4 2
[] Burglar Alarm Wind generation systems In excess of 25 kva;
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
❑ Heating, Ventilation and Air Conditioning OAR 918. 309.0040) 552.26 2
System* Solar generation systems In execex of 2s Icva:
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 - -
charged elan hourly (1 hr min) 66 251 hr 1
• Inspections for which no the Is 90.001 hr
COMMERCIAL WORK ONLY.i ''''.:%, specifically listed 04 hr min)_
Fee for each ' "1 ' :PERMIT 'FEES'
ch commercial system $75.00 subtotal:
(SEE OAR 918-309-0000) Plan review. if required (25% of permit (ee):
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 lea
❑ Audio and Stereo Systems da after it her been accepted se complete.
• Number of inspections allowed per permit.
❑ 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*
4-P-r otective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1, 19u llding1PermiutsLC)erm!tAPP_ELT doe Rev 0541/2011 .
600/£00•d Z661PLZZ£OS(XVA) s0!uat }0al3 sd! I I !Lid 9£:bL £LOZ /trZ /90