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Permit (8) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT C , COMMUNITY DEVELOPMENT Permit*: ELR2013 -00144 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2013 Parcel: 2S102AB01902 Jurisdiction: TIGARD Site address: 9398 SW TIGARD ST Project: Northstar Subdivision:RTH TIGARDVILLE ADDITION, AMENC Lot: Project Description: Burglar 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: Restncted 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 9 2-001-00•0. 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 Permiftee Signature: e/ /7-60t/6.9--/ / OA 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. ECE VFD Electrical Per A, Mica n o PP JUN 4 2013 ..., OFFICE 11Sl ON1.l' City of Tigard n t ® / 3 49 r 7 Permit No.: , 1 2 . 2 0 - 482 43 / Yy a 13125 SW Hall Blvd" Tigard, ORy Plan Review - Phone: 503.718.2439 Fax: 303 398 �I g ��p 11 Dato/Bx: Other Fannie TVCiA.HD Inspection Line: 503.639.4175 p pip ry N 9. ie Internet: w►vw.ttgard - orgov �U86 ®1tV� DIVISION Date Rea r ` NotHOed!M tit d: Jul - 1 i � Supplemental lInr / 5upplcmentoltformatlon ';o2Z1' ":.:. ,, •-. ?;; , .';' ,.,.., :�•'.;.7,''r''' -4 -� _ • ,;',1.! 4: "ter•:• .•;;`,,..,1,.:'.T .., : 12T\!I1;W, ?, -.,.. 7 •.; ;':. •.: '1,r'?: • ❑ New construction Addition/alteration/replacement PlC check all that apply (submit j, seta [Widens whams chocked below'): 0 Demolition 12 Other: Q Service or Roder 400 amp; or mole CI Building over three stories. where the available Nutt eumott ❑ Marines ad boatyards, k T " 4 . ' r' -, • , J r : : . :f: r •- i s •' CATEG =OF - CONSTRktCf1Ofit " - : • 1 . r - ! Z r 1 , r . ' . ; : : ; , exceeds I a,Oa0 amp. an 150 vole or ❑ Planing buildings. 0 1 - and 2.family dwelling Commercial/industrial ❑ Accessory buildirtg l ess togrotmd,or exceeds 14,000 pcommotereaweagrleuiWlet mil mite tar all other Installations. building. Multi - fa ❑ le y ❑ Master builder ❑ Other. Cl 0 Phe pump. ❑ Installation of75 KYA or ::::::;:-.7.;',.;''' '%':::. ' - JoifiliTE;1IVFORMA'1'ION : , AND 1LU, ATION , - , ; ; ;i • ' Ci lkwaenoy system larger separately derived system. • • ■ ❑ Addltlaa of new motor load of © "A ", "6", "t4 ", "1,9 ", Job no.: I Job site address: T39' �'&' .. � e d 100HP or more. oeeapancy. ❑ Sbt or mote realdendel unite. Q Rooreadonal vehicle parka City/State/21P: r f , r v &-,' . ❑ Heoilbrate !Militias. ❑ Supply voltage for more than f' / ❑ Hazardous locations. 600 volts nominal, Suite/bldg/apt. no.: Project nome:iyeritissiert, laic- cz . ie s CI Service or Ibeder 600 man or more. Cross street/directions to job site: I nnntetlen m.i ,.: • - Now residential single- or multi- fhrnlly dwelling unit. - Includes attached garage. Subdivision: Lot no.: 1.000 aq. B. or lose 168.54 4 Tax - map/parcel no.: �..... Be. add'{ 500 sq. ft. or portion 33.92 1 Limited energy, residential - - ,,; ':DESCRIPTION OF: WOR(Ci-:;c,'t, ` ' ' . • , '',' . (with above sq. /1, 75.00 2 c'•∎ r 7 t�lllf' tGN �t�'� 6�9t'� ��W ` t7Gt Limited energy, marls -t sq. (i((/!� residential (whit above aq. ft,) 75.00 1 ��/J �/ l Services or feeders hntallatlon and/or relocation 200 amps or Ices 100.70 2 � ; , . O PROPER1 tf yOWNER - . , :; =I :', : + ' , �;0 FENAN'1(' , "" , _ x01 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Addroa9: Over 1,O0D amps orvolts 56226 , 2 City/State/ZIP: Temporary services or feeders Installation, alteration, and/or _ relocation Phone: ( ) I Fax: ( ) 200 amps or ices T 59,36 _ 1 Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amp 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 - Branch circuits.. new, alteration, or extension, per panel Owner signature: Date: A. Fee Ibr branch circuits with _ , .. C APPLI0AI , „ ' , O',CONTACT PERSON, ' ' above aesvlco or (coder fee, 7A2 2 each branch circuit Business name: B. Fee for bmnch circuits without service or feeder the, first 56.18 2 Contact name: branch circuit Each add'1 branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Bach meauf enured or modular City/State/ZIP: dwelling, service and/or feeder 67 84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Iii Pump or Irrigation circle 67.84 2 : CON TRACTOR' - Sign or adieu lighting 67.84 2 :.; r' . - , •,' ' `, ;: .: , ;', , : ,. - ,'r;;' - -. ±, *' • A •'. ': Signal ciretnA or limited -onergy i Business name: Master Alarm LLC dba Phillips Electronics panel, alteration, or extension. Paget 7s 2 Each additional inspection over allowable In any of the abov Address: 3247 NW 29th Avenue Additional Inspection (1 hr min) 6625/ hr City/Statc/ZIP: Portland OR 97210 Investigation (1 hr min) 66.25/ hr lndusalal plant (1brmin) 78.18/hr I Phone: (503) 222.5083 I Fax: (503) 227.4992 Inspections lbr which no fbo la 90.00/ hr 4 ' specifically listed 04 br min) CCB Lie.: 125364 I - filectricalLie. 2 3CLE uprv.Lie 10 , ,:,,, �ti° :ELECTRICAL PERMIT"FEESt ; +�f := Subtotal: �: Suprv. Electrician signature, required: Plan review (25% of permit feu): Print name: e .p. 5 / I Date: 41x1,1 i 3 State surcharge (1.2% of permit fba): 7', } f( TOTAL PERMIT FEE: ',51: Atlthorl2ed signature: This permit application aspires Ira permit is not obtained within 160 Print name: I Date: days after It has been accepted as complete. _. _ - Number of Inspections allowed par permit I Wuildies1Poodi IELGPemnhAppdoo 07101/10 44O415'r(II1a1/t:OMAvan I 600/S00' d Z66bLZZ£OS(XVd) so 1 uo.qoa 1 g sd i I I i Ud 9E: bl ELOZ /bZ /90 Electrical Permit Application -. City of Tigard Page 2 — Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESI(DENTL4L WORK ONLY; •r Fee for all residential systems ... FEE;'SCBEDULE y s combined $75.00 .Jpecdption r otv. 1 Pee r Mal I • Renewable electrical energy systems! Check Type of Work Involved: s lira or less 100.70 2 5,01 to 15 kva 133.36 2 El Audio and Stereo Systems* 15.01 to 23 kva 200.34 2 • ❑ Burglar Alarm Wind eaeration system In exces of 2 5 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 60.01 to 100 kva 552.26 _ 2 >100 kva (fee in aecorden= with El Heating, Ventilation and Air Conditioning OAR 918409-0040) 552.26 2 System* — Solar generation systems is excess of 2S kvat 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 (1 hr min) Inspections Ibr which no fee Is 90,00 / hr COMMERCIAL WORK•,ONLY specifically listed (l4 hr min) . " y':;I' o . n l: , �'r:,' r• ELECTRICAL PERMIT, FEES.. • Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-300-0000) Plan review. if required (25% of permit fee): State surcharge (12% of permit fee): Check Type of Work Involved: TOTAL PERMIT PEE; This permit application expires If a permit Is not obtained within 180 ❑ Audio and Stereo Systems days after It has been accepted as 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* otective Signaling i El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations !Atuad;neramthaLC„ PmahApp .ELl.RE,doa Rev 05/2112013 600/900' d Z66t+LZZ£0S (WA ) so i uO.14.08I sd! I I ! LId 9C:171. £LOZ /17Z /90