Permit (13) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2012 -00023
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/03/2012
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY
Project: Tigard Towne Square Subdivision: 1994 -028 PARTITION PLAT Lot: 2
Project Description: Install radio communicator to monitor existing system. Panels in riser rooms located behind Albertson's, Dotties &
Dollar Tree. Job No. 191, 192 & 193
Contractor: PROTEC INC Owner: SN PROPERTIES PARTNERSHIP
720 NE FLANDERS ST 1121 SW SALMON ST
PORTLAND, OR 97232 -2763 PORTLAND, OR 97205
PHONE: 503 - 235 -4000 PHONE:
FAX: 503 - 235 -0363
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/03/2012 $225.00
12% State Surcharge - Electrical 02/03/2012 $27.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 3
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: Y
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $252.00
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- 001 -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. /'�✓t 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. 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.
FEB -03 -2012 09 21 PROTEC INC P.03/04
• Electrical Permit Application ® Kell 0141('i ' i;`,1 i
1
City of Tigard g ' n r ° .: 1 � � �� oia -�3
1
1 ..' ■ 13125 SW Hall Blvd., Tigard, OR 9.772 2 „sl- "h'
i hone; 503.718"2439 Fax: 503,5986 0� esi,,
I 1 i I . Inspection Line: 503.639,4175 C[8 . a gat e Ready/13y: earls El Soo Paco 2 for
Internet: www.tigard-or.gov • r4 \ C? y ,,No Supplemental Information
.ta Il1.,i. h i ' , ; , i ' 9 ',�{ '°' u u rj°f(i,�a� �'s� 19!p r � s W I i .
.-i +(•y., di 11 : ' .
��y�I�d ¢� i N c� 5'g G.*011311' . t yy ��,,�� } 'tlpI Z' " u �mrgstcy ®� n i C y`.�] +Q F^�ul WS "'•'I_,
MN' i �A. - .u, f .' ViWJ 9t IiNU's,u 71 •:,TSr:� 4111 r`. !," '.:',.
�, S4' &�� � ''Vf ^I171C� jrAi'cul. 4u�t U4tCil. li 6il�F INCtill'�' ', '� h i?
❑ New construction Addition /altcration/rcplacc Cut Please check all that apply (submit 2 acts of plena w /items checked below)!
❑ Demolition ❑ Other: O�� ❑ Service or feeder 400 amps or more ❑ f3uildirl peer three FtOr1C5.
y9y ,y _ where the available fault current 0 Marinas and boatyards.
v, p 1, is and dl , a„ Iw u1 i� H „„ ,J` �ua y k_6, l di ; r i a 4 , I� exceeds or feed amps at 150 volts or 0 Floating buildings, r
i i a s . e+ r :rr9 . 1' ' `� a i u °ilt� �" ri u A
less to invalid, or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling Commercial /industrial ❑Accessory building ;imps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. CI lnstulluti in of 75 KVA or
h ;,i ,: ?'..- '" min aria �"!rm 7 st f „ ❑ Emergency system. larger separates derived system.
s a I ' 1, ,4 i e• n a i " a iu i gn r$ J ' t r, :, i. Y
r� rev ,' • u ,I Y.,' JwwtuatY } a) d�x�au� „ �<a p � „dt, ��Fta� �� irJ�rr ��n..el���� , :�1�1+�6 ❑ Addition of new motor load of Q ` .. E•'...1.�.. °1.7••,
M '
r ; n0,: 191 & 192 * • ob _ to address: 116200 SW Pacific Hwy 100HF' or more. occupancy.
❑ Six or more residential units. Li Recreational vehicle parka,
City /Stet 1 . : r, OR 97224 ❑ 1•leelih•eare facilities. O Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Tigard Towne Square ❑ Service or feeder 600 amps or more.
■ � - Tli�� �I,���rlt�r7.'lWf�l r.., f i� � t L. �` :w�r� It;fi�V4''�;�'r�
'll�a u� f u rrl kil?.. .1' I",%u` �, ' ! j 11l li tllat� t f:iti�� 1: n ' ' _11 f :: ?I �Cr
+ s i n I Qty. ) xar. E T
�, �� � �lr;,.:�: c ogii h, .:.: :
Cross street/directions to site: S outh of SW Durham Rd Description nral
- New residential single or multi - family dwelling unit.
_ Includes attached garage. .
Subdivision: 7 Lot no.: 1,000 sq. ft. or less 168,54 — 4
_. Tax map /parcel no.: Ea, add'1500 sq. R. or portion 33.92 1 �
Limited energy, residential
7500 2
( ;,:.. q� �:a_ .x:r�. ` a; ''i M !'�n:g�, 7•_ i� l : ��.r, : •. t .r� ., �; ..� t1 y o d' E II;;:' -io..'41 �^II��. ir,. .� n r } f 5 " � a ��rr
� . t.i. trl.4. -i,.1 •I t �,.6 ,11 Ri (!rlilil � . rNU Jima ukl . 9. ', 1, irl: � rr,'Ii� , I tit t, # 1 1 11 I , : i " , (with about: aq. fl:.) —
Limited energy, multi - tinnily 75.00 2
Install radio communicator to monitor existing fire alarm system, residential (with above sq. it.)
n Services or feeders installation, alteration and/or relocation
P t _ . ,, 4 A ` ,/ i / tO n4 I / , a j 200 amps or less 1 '
4 ry °' •:,.. is Dil ' ' a. n.: I'i trl :' ,. ?,l
1 i`' T,•! r ' �w: d' i A �$ 'i II b ��i k ,�.' 1 �, FJ , , '.rr;11 1 i 01�r�, hr 'i' ,a ,ii „ t" r r , I 201 amps to 400 am p.
s -.. 2
w..:I , ` � d. Yk7 tl ;pr
�7 401 amps to 600 amps 200.34 2
ame:
601 amps to 1.000 amps 301.04 2
c i ddress: Over 1,000 amps or volts 552.26 2
City/State/ZIP; Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) t Fax' ( ) 200 amps or less 59,36 I
Owner installation: This installation is being made on own 201 amps to 400 amps 125.08 2
g property rh' that I wn which is not 401 amps to 599 amps 168,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, ,449, 670, and 701. Branch circuits 10 599 - new, alteration, or extension. per Panel
M Owner signature: Date: A. Fee for brunch circuits with
-1!`� 1lfl� ; ik f� d:. `?r �'-Slp 1i�!'i
' r� ; %3 rl'`!'� tY : ; iii ;�I r 4 P�t rl / Y a n R `♦' '1!' ' i above service or feeder fee,
a .(. ^h;ilbi.i,.. >i, f,ri$I4r, ?.,, . Nut qq ' ae,°(,. I °um� '1)',au';, each branch circuit 7.42 2
.J 4 I' {.:�i r� ^�:� r. �IWIaDu pis ' �9 l �I� r.n *,ill ,. ;
13usiness name: Protec Inc. B. Fee for branch circuits withoza
service nr feeder fee, first 56.18 2
Contact name: Heather Hill branch circuit
.. Each add'/ branch circuit 7.42 2
CI Address: 720 NE Flanders St Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 97292 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 235-4000 I Fax: : (503) 235 -0363 Reconnect only 67,84 2
E -mail: heatherh @protecsecurity.com
Pump or irrigation circle 67.84 2
1,
:`�S .g! lit rl d!'r , IMP , litTu`w14Y n .i1�20R �� ���Nt�h��nA ! N`:i (l t���t lliit,tii:. Sign oraugineligrtli 67.84
• 2
� "" � � Signal Cvcuit(s) or limited- t:nergy
Business name: Protec Inc.
panel, alteration, or extension. Palo 2 1(1 2
Each additional ins , colon over allowable in an of the above
Address: 720 NE Flanders St Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66,25/ hr
City /State /ZIP: Portland, OR 97232
- Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 235 -4000 I Fax: (503) 235 -0363 • Inspections for which no f ee is
`. C13 Lic.: 55414 s ificall listed Yz hrmin) 90.00/ hr
Electrical Lic.: 34215CLE Suprv. Lic. f2 �� i _ P R,,
P =/ il.�t b1.,u.. 7 y"°' furl ur1P'b,E i
Suprv. Electrician signature, require "�',�j/ _ Subtotal: Rj{i `:
c'6 f/ l'� - _. Plan review (25% of permit fee): m 0
Print name: lack Chilson Date: State surcharge (12% of permit fee): o'
A uthors cod signature: ! � - TOTAL PERMIT FEE: f
- / _ - . _ This • permit a pp li cation ,ixpirat its permit is not obta nod within too
Print name: Heather Hill Date: 2/2/12 days After it has been accepted as complete. e
Number of inspections allowed per permit,
I;t lBai lding0'ermita \ELC- PannitApp.doc 07/01/10 440