Permit CITY OF TIGARD
~ , 3 ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00264
TIGARD! 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/16/2008
PARCEL: 1 S135DD -05200
SITE ADDRESS: 11708 SW WARNER AVE ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.2 LOT: 035 JURISDICTION: TIG
PROJECT: MIRAGE MINI STORAGE
Project Description: Intercom, protective signaling and CCTV systems.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: CCTV X
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
MIRAGE STORAGE LLC ENTRANCE CONTROLS INC
9055 SW BEAVERTON - HILLSDALE HW 1923 E 5TH ST STE D
PORTLAND, OR 97225 SUITE C -100
VANCOUVER, WA 98661
Phone: Contact #: PRI 360 - 256 -4416
FAX 360 - 256 -4939
FEES Reg #: ELE CLE140
LIC 179165
Description Date Amount SUP 3610LEA
[ELPRMT] ELR Permit 9/16/2008 $225.00
[TAX] 12% State Surch 9/16/2008 $27.00 REQUIRED ITEMS AND REPORTS
Total $252.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.24... *9 or 1.800.332.2344.
Issued By: 0 - ermittee 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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
.. ; r " x „ r i t s . ,y 1 -
Electrical Permit Application ,.-.7.,,i. t -., 7
s `i 4 'FOR?.OFFICE ` USE''ONLY" � t
,
{�. q
'''r of Tigard �+� Received V /} � r (5 6/ / 4� O )a6 l
' ' ' ' City � D 1 , , Date/By: / Permit No..
� Plan Review
0 13125 SW Hall Blvd., Tigard, OR 97223 7VV Other Permit:
Phone: 503.639.4171 Fax: 503.59:',9 : Cj Date /By:
T A R Inspection Line: 503.639.4175 ^oo� Date Ready /By: s. ® See Page 2 for
. : a l Internet: www.tigard- or.gov 1 6 1. Notified/Met p Supplemental Information
`Q
TYPE OF WORD 110.0 �` - PLAN REVIEW •
New construction ❑ Addition /alteratit �v�s Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition El Other: Q` \ 0 where the available fault current ❑ Marinas and boatyards.
CATEGORY', OF CONSTRUCTION ' ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' JOB SITE INFORMATION AND LOCATION' A
❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
y� Job site address: f j 10OHP or more. occupancy.
Job no.:
P'P1E0� ‘666 C ` 7 �'� t J"' ""� 4.4 t ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: p/►� 6 ❑ Health -care facilities. ❑ Supply voltage for more than
�. , ❑Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: jvv; I Se( 5 / E1 ❑ Service or feeder 600 amps or more. 7 e FE E SCHEDULE , .
Cross street/directions to job site: (i eI y _ tars/ of ,)-(7 Description 1 Qty 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION' OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
.11 wee. .. (C T V A.,(1 1 (A-re (A-re liece53 e A112 4 1 residential (with above sq. II.)
/ / y / Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY .OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ "APPLICANT ❑ CONTACT. PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Si gn or outline lighting 53.40 2
Business name: C 4 Signal circuit(s) or limited -
% nr.~,� t ✓ energy panel, alteration, or
Address: `l� J p E. pi& s:( s' ,1-G -I) extension. Describe. Page 2 2
Cit /State /ZIP: t ,,, /} C5'64. i Each additional inspection over allowable in any of the above
� " " r te / / Per inspection 62.50
Phone: (AS ) a { . L ' j Fax: ( Ito ) ;54. L l g 19 Investigation per hour (I hr min) 62.50
CCB Lic.: /7q 1 6 s Electrical Lic.: 6/E_1 L( J [uprv. Lic.: .)))5-' B Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 4.1e;
Subtotal: t "
Print name: �,� a ,,��� Date: -le-08
State surcharge (12% of permit fee): g Plan review (25% permit fee):
" .---- g7
Authorized signature: TOTAL PERMIT FEE: tea„ --
This permit application expires if a permit is not obtat ed within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440 -4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page. 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
; RESIDENTIAL WORK ONLY:'
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:'
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n Nurse Calls
n Outdoor Landscape Lighting*
lg Protective Signaling
Other CCTV
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2000 -00264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16/2008
Phone: (503) 639 -4171 . gp i11
Inspection Requests (24 Hrs.): (503) 639 -4175 �.� '__..
INSPECTION WORKSHEET FOR DATE: 1 0/31/2008 TIME: 7:00AM PAGE: 42
SITE ADDRESS: 11700 SW WARNER AVE CLASS OF WORK:
SUBDIVISION: I IOFFARBER TRACTS NO .2 LOT #: 035 TYPE OF USE:
PROJECT NAME: MIRAGE MINI Si ORAGE
DESCRIPTION: Intercom, protective signaling and CCTV systems.
OWNER: MIRAGE STORAGE LLC, PHONE #:
CONTRACTOR: ENTRANCE CONTROLS INC _ 650 PHONE #: 360 - 256 -44'16
Inspection Request Scheduled For: Date 10/31/2008 Pour Time:
Code # Inspection Description «onfirm_# Contact # Message
135 Lover voltage 77432 -01 503- 490.1969 Y
Corrections /Comments/instructions:
P 4
•
t .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑r ADDITIONAL FEES ASSESSED
• Inspector: G N 66 v tie ----
Date: 0 l I 01) Phone #: (503) 718-
,
7
CITY OF TIGARD .
,
BUILDING DIVISION PERMIT #: ELR200&,002&4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91161 0(113 I
Phone: (503) 639 -4171 11,r�_IlI
Inspection Requests (24 Hrs.): (503) 639 -4175 _.
INSPECTION WORKSHEET FOR DATE: 10/3W2008 TIME: 7 :00AM PAGE: 32
SITE ADDRESS 117013 SW WARNER AVE CLASS OF WORK:
SUBDIVISION HOFFARF3ER TRACTS NO.2 LOT #: 035 TYPE OF USE:
PROJECT NAME: MIRAGE MINI STORAGE
DESCRIPTION: Intercom, protective signaling and CCTV stems. .
OWNER: MIRAGE STORAGE LLC, PHONE #:
CONTRACTOR: ENTRANCE CONTROLS INC PHONE #: 350- 255.4416
Inspection Request Scheduled For: Date: 10/30/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 077302 -01 503.490.1969 N
Corrections /Comments /Instructions:
•
❑ PASS ❑ PARTIAL APPROVAL A CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V r 0())(61.-E Date: 0 3 Phone #: (503) 718- 04)