Permit (4) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
Ir'- COMMUNITY DEVELOPMENT Permit#: ELR2013-00256
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/15/2013
Parcel: 2S102BA00600
Jurisdiction: Tigard
Site address: 9730 SW TIGARD ST
Project: Data Safe Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 60
Project Description: Low voltage for access controls
Contractor: PHILLIPS ELECTRONICS Owner: MULL,GREGORY S AND
3247 NW 29TH AVE MULL, GEORGE E
PORTLAND, OR 97210 19350 SW POMONA DR
BEAVERTON,OR 97007
PHONE: 503-222-5083 PHONE:
FAX: 503-227-4992
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/15/2013 $75.00
Type of Use: COM 12%State Surcharge-Electrical 10/15/2013 $9.00
Class of Work: OTR
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: 0 Other: 1 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 acc• :. 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. ATT ' ION: Oregon w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0110 through OAR 952-0r -•=°: You may obtain a copy of the rules or direct questions to OUNC • — J:y `. •87 or 1.800.332.2344.
Issue, By: , 7.441 • / Permittee Signa r
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.
10/10/2013 11:34 Phi I I i ps Electronics (FAX)5032274992 P.002/003 rTh
Electrical Permit Applicat 1-L-- \ �
- FOR OFFICE USE ONI X
City of Tigard n Received .o//y /3 �i , Permitxo.: E4-416/3-£Oa 5(0
N.,_. 13125 SW Hell Blvd.,Tigard,OR 972Y3C T I 0 2013 Plan Review Other Permit:
Phone; 503.718,2439 Fax: 503,598,1960 Date/13
TI t. A it n Inspection Line: 503.639,4175 Oily alf-_: ;i6 AHD Date Ready/By: 55 Sea Page 2 for
Internet: www.tigard-or.gov ;-_, N1r �t Notified/Method; Supplemental Information
. 0 rf
TYPE'OF W RKL;..,. ,:I;'i. 1',i '1.,, ,PLAN REVJEW: .
❑New construction (Addition/alteration/replacement Please cheek all that apply(submit I sass of plans w/lteom checked below):
❑Service or feeder 400 amps or more L1 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
. ' ' CATEGORY'Or'CONSTRUCTION'':'rri. I.. .','''';,;:,; •',,L'';'i' emends 10,000 amps at ISO volts or ❑Floating buildings.
less to ground,or axeaeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/Industrial ❑Accessory building amps fbr alt other Installations, buildings,
❑Multi-family ❑Master builder ❑Other: ❑Piro pump. ❑Installation of 150 KVA or
in Emergency system. larger separately derived system.
. ' JOB.SITE'INFORMATION,SAND:,LOCATION;j'',ii.,'i• '.1', ' ❑Addition of new motor load of 0"A","a","1-2","1-3",
q 100HP or more. occupancy.
Job no.: Job site address:
17� SiL 1 YI$nr r� S ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: - ❑Health-care facilities. I:1 Supply voltage for more than
l��O�rt� Pe�� 1,721s Cl Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Wm,s c. ❑9orvie0 or feeder 600 amp,or more.
'' ..'FEE''SCHEDULE
Cross street/directions to Job site: bra � nrs n-- i otv. I Ere. I Tot. I •,
New residential single-or multi-family dwelling unit.
_ Includes attached garage.
Subdivision: Lot no.: 1.000 sq.ft or less 168.54 4
Ba.add'I 500 sq.ft.or portion 33,92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
'' !,DESCRi'PTiON'.OP;:WORK;? r,`.;': r,,;i;.;1,,i�'*�;;;I;I:i I (with above Sq.ft.) .
I Limited energy,multi-family 75.00 2
�W- 1/0f k r Le 1.5 Cean�ole residential(with above sq.ft)
Renewable Energy.: , ❑ See Page 2
Services or feeders Installation,alteration,and/or relocation
. ❑'PROPERTY'OWNER'. .' ; 200 amps or lass W 100.70 2
is..I
' 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 2
City/State/ZIP: Temporary services or feeders Installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 I
Owner Installation:This installation is being made on property that 1 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. 401 amps to 599 amps 168.54 2
Owner signature; Date: Branch circuits—new,alteration,or extension,per panel
0.APPLICANT'..'. ,.;❑i GONTAC'P;:PERSON:,;.;r`::!h A.Foe for branch circuits with
above service or feeder lee,
Business name: cach branch circuit 7'42 2
13.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
branch circuit
Address; Each add'l branch circuit 7.42 2
City/State/ZIP: MiscellaneousJaervice or feeder not Included)
ry Each manufacturod or modular
Phone:( ) Fax::( )
dwelling,service and/or feeder 67.84 2
Reconnect only 67,84 2
E-mail: _ Pump or irrigation circle 67.84 2
. CONTRACTOR all:'I", ;1!i' il,';6i Sign or outline lighting 67.84 2
Business name:Master Alarm LLC dba Phillips Electronics Signal circuits)orlimited•energy See r� tiO
panel,alteration,or extension. 1 Page 2 /.s 2
Address: 3247 NW 29th Avenue Each additional lnaJteetion over allowable In any of the above
Additional inspection(I hr min) 66.25/hr
City/Statc/ZIP:Portland OR 97210 Investigation(1 hr min) 66.25/hr
Phone:(503)222.5083 Fax:(503)227.4992 industrial plant(1 hr min) 78.18/hr
Inspections fbr which no fee is 90,00!hr
CCB Lic.: 125364 I Electrica Lie; 6213CLE Suprv.Lic,' (,f 1 specifically listed(j4 hr min)
3 ;'i; I':'ELECTRICAL'PERMIT FEES s-
Suprv.Electrician signature,require,/ i I , Subtotal: '�
Plan review(25%of permit fee):
Print name: w ,e 9� CC) Date: /0.,..)0•13 State surcharge(1296 of permit fee)_ _4 9 vu
Authorized signature; TOTAL PERMIT FEE: 84"
Print name: [Date: This permit clays after It has eers a cepted as complete.
within ISO
• Number of inspections allowed per permit.
1;11s uUdl,g■PenohstELC-PennitApp_Rt.R_RREdo,Rev 0501/7013 440.461 ST(11/03/COM/WHB
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Electrical Permit Application—City of Tigard
Page 2--Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY:. :.. .
... .. :FEE SCHEDULE '
Fee for ill residential systems combined ... $75.00 Deedptlon I QM I Es I Tom I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100,70 2
❑
5.01 to l5 kve 133.56 2
Audio and Stereo Systems*
15,01 to 25 kva 200.34 2
El Alarm Wind generation systems In excess of 25 kvat
25.01 to S0 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 We 552,26 2
>100 kva(twin accordance with 552,26 2
❑ Heating,Ventilation and Air Conditioning OAR 918-3094040) •
System* Solar generation systems In excess of 25 kva:
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
charm)at an hourly(1 hr min)
Inspections for which no the is 90,00/hr
specifically listed(K hr min)
COMMERCIAL WORK ONLY:,, . ELECTRICAL•PERMIT.,FEES ,
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit the):
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 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*
Z-.1 Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
l:lauitdtniptrmtte\El.CJcrmItApp t:RE.doo Revosn1RO13
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
9730 SW TIGARD ST, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-11-01 00:00:00
ELR2013-00256
PASS - No C of O
Violation Summary:
Inspector Contractor