Permit •
TY ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00125
TtG'AKD: DATE ISSUED: 5/22/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09646 SW WASHINGTON SQUARE RD G14 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: SWAROVSKI
Project Description: Low voltage installation of burglar alarm.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
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:
INSTRUMENTATION: OTHER: BURG ALARM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC AMERICAN VETERANS SECURITY LLC
BY THE MAC ERIC H COMPANY 4420 SW 110TH AVE
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97005
TIGARD, OR 97223
Phone: Contact #: PRI 503- 808 -9010
FAX 503- 808 -9018
FEES Reg #: ELE 34 -501 CLE
LIC 135086
Description Date Amount
[ELPRMT] ELR Permit 5/22/2008 $75.00
[TAX] 12% State Surchai 5/22/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are se . I . in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.24•.•699 or 1.81i. 3
Issued By: /` ;0 ./ Permiftee Signatur
/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
!
;
Elec tri+cal Permit A � ataon . ` ' . t t ' ` , s . s ,, , � .
' r''r 211' Cit o f Tigard , ' 0.
�� D 5 .A.- 08 PermitNo.: Ek,2o - 9 , 00g - A
'iw 'r: ". 131 25 SW Hal Blvd., Tig }' , OR;t . ' EGON! an R ew tuber Permit:
I " . P 503 - 639.4171 F: 503. Datc /Bv: _ WI ru " Inspection Line: 503.639. M 75 WV 2 2 200$ Date ReadyBy: RI See Page 2 for —
11 .. r }t n , p . Notified/Method; Supplemental Information
{rum Internet: www.tigard .
0 PLAN REVIEW
L. ,1 I Please check all that apply (submit 2 sets of plans w /items checked below);
❑ New construction P. Ad ti tton/a v .�-! t,_ r [] Service err feeder' 400 amps or more ❑ Blinding over dupe stones.
Q Demolition 0 • ' '. _ where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
CATEGO "i � . OF' ,CONSTRUCTION ION less to grouati, or exceeds 14,000 0 Commereis1 -use agricultural •
❑ 1- a nd 2- family dwelling C mercial/industriat ❑ Accessory budding amps far all other installations. buildings.
Other: ['Fire pump. ❑ Installation of 75 KVA or
❑ Multi family [] M er builder ❑ larger separately derived s stem.
El Emergency system. B �p Y
' '
,,;�... ° J08 SITE YNF t�1' • T10N..:AND LOCATION ❑ Addition of new motor lead of ❑ "A" .`>✓" "1 - ". "I ,
+� ` Q' 1001-1P or more. occupancy.
Job no.: Job site ad. i. - ss= ( b S,,,i V4 tt 11 , ' El Six or more residential units. ❑ Racxcati,nai vehicle parks.
❑ Healthcare facilities. ❑ Supply voltage for more than
City /StatelIP:j Gl - 1. �I`I v ❑ Hazardous locations. 600 volts nominal,.
—
Suite/bldg. /apt. no.: ` C } 14. Eg' i ect name: 5 ... fti r o v S K - r l ,s Co O Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
pay „ on Fee. To.r
New residential single- or multi- family dwelling unit.
Includes attached garage.
- r . 1 000 sq. ft, or less _ 145.15 4
Subdivision: Lot no -:
I ,� )~a. add'1500 sq. ft- or portion 33.40 1
• Tax map /parcel no.: _ Limited energy, residential 75.00
�
DE • PTION i W ORK with above N. ft.)
Limited energy, multi- family 7$.00 2
� ._ Le 6 t Lf}12 ` ` . residential with above :... R,
Services or eeders installation alteration, and/or relocation
200 amps or less 80.30 2
I ❑ TENANT 20 amps to 400 amps 106.85 2
:' 'it' PROF'ERTl' OWNER:
401 amps to 600 amps 160.60 2
Name: � 1 1 - 601 amps to 1,000 amps 240.60 2
Address: Over 1 amps or volts 454.65 2
— i ' Temporary services or feeders Installation, alteration, and/or
City/State /ZIP: ! ! relocation
• f
Phone: ( ) 1 F ( ) 200 am .s or Tess 66.85 1
201 arms to 400 amps .111 100.30 2
Owner installation: This installati • 4 is being made on property that I own which is not 401 amps to 599 amps 13335 2
intended for salt, lease, rent, or ere ge, according to ORS 447, 449, 670 and 701. Branch circuits - new, alteration or extension, per panel
Owner signature: ; D ate: _ A. Fee for branch circuits with
above service or feeder fa, a
'`: 0 APPLICANT f '„ � ! ` ❑ .CONTACT 1?ERSON:; . each branch circuit 6.6. 2
Business name: ■ I B. Fee for branch circuits
f without service or feeder fee, 46.85 2
Contact name: first branch circuit
Each add'l branch circuit 6.65 2
Address: Miscellaneous service or feeder not included
City /State/ZIP: i ; Each manufactured or modular ■ 90.90 2
dwelling, service and/or feeder
Phone: ( ) i Fax: : ( ) Reconnect only 66.85 2
E-mail: . , Pump Or irrigation circle 53.40 2
. . ;'- e NYRACTOR Sign or outline lighting 53.40 2 • Signal eircuids) or limited - l . c
Business name: 1 Ar rl t(t c o,_‘.. ',i V€ kk t' .6_y S C�.r• i energy panel, alteration, or
- extension. Describe: Page 2 ki> 2
Address: .91- 2D 5y,i : k 0+ v-, A V - —
Each additional ins • ection over allowable in an of the above
City/ State/ZIP: Q' a,v Q _ c, L ,---, U .7 DC Per inspection 62.50
Phone: ( 3) $ 0$ c1 C: ► O i , lant per hour
Industrial I Pax: ( 5t 3 ) iS o • 9' I Investigation per hour (1 hr min) 62.50
73.75
CCB Lie.: 1 � 61e I. cal Lie.: 34. SULC1 r J Suprv. Lic.: r ELECTRICAL PERMIT, FEES
Suprv. Electrician signature, requi ! d: Subtotal: -15 •`°
, , Plan review (25 % of permit fee):
name: J G fl
Print n ' 1 k e-`�- Date: 5 - 21' g
State surcharge (12% of permit fee): 9 -O
. , -, l TOTAL PERMIT FEE: a' e0 O
Authorized signature: ..- -,� . - � ..
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted 88 complete.
• Number of inspections allowed per permit.
1: 1auilding\Permite\Et .C- Per,nitApp.doc 03/23 /0R
440- 615T(I 1 /05,COM/WEB
CITY ����~�� ������N��������
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BUILDING DIVISION PERMIT #: EISZ20O8'CK)12S
13125 SW Hall B|vd..Tigard, OR 97223 DATE ISSUED: 5/3272008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 630'4175
INSPECTION WORKSHEET FOR DATE: 6/3/200B TIME: 7:0OAM PAGE: 3
SITE ADDRESS: 09G48EW WASHINGTON SQUARE RDG14 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SWAROVSKI
DESCRIPTION: Low voltage installation of burglar alarm.
OWNER: WASHINGTON SQUARE LUC. PHONE #:
CONTRACTOR: AMERICAN VETERANS SECURITY LLC PHONE #: 503
Inspection Request Scheduled For: Pour Time:
Code # Inspection Description . 06nfirrn #`` Contact # Message
\
135 Low voltage 070741'O1 ` 907'P1'O167 N
°« ~
I
Corrections/Comments/Instructions:
N N
\
A / \
i/
PARTIAL APPROVAL El CANCEL pi NO ACCESS
n FAIL 0 CALL FOR INSPECTION __ ADDITIONAL FEES ASSESSED
Inspector: Oe \ °� t 61) Phone #: (503) 718- 2-4 •