Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00159
DATE ISSUED: 6/23/2006
'31,14*- -- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 AD - 01700
SITE ADDRESS: 12600 SW 68TH AVE ZONING:
SUBDIVISION: PORTLAND HEIGHTS LOT: JURISDICTION: TIG
Project Description: Burglar alarm system upgrade. Job #60624808.
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY GROUP FUND 1, LLC PROTECTION ONE ALARM MONITORIN
BY KURT DALBEY 15500 SW 72ND AVE
7125 SW HAMPTON PORTLAND, OR 97224
PORTLAND, OR 97223
Phone: Contact #: PRI 503- 624 -0244
FAX 503- 443 -2927
FEES Reg #: ELE 34- 428CCLE
LIC 116325
Description Date Amount
[ELPRMT] ELR Permit 6/23/2006 $75.00
[TAX] 8% State Surcha 6/23/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 - 246 -6699.
Issued By: ,� L /LPL/ lPermittee Signature: - . , P1
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.
.1J UN. 21 2006Dt 4; 07 PApplication 7) t P. ,,
NO 79 2
- city of Tigard � � xI
v a l ;,, J ' bstoB ( A7 L" ‘ � OL Pain"°,. to ail) 7
2195 Sw Han Btvd..'IsSasd, OR 97223 ` ■
Pam 503.598.1960 I Plan Review
Phone: 503.639,4171 Fa o�u
Inspection Line: 503 639 4175 ;. , Z ) ' °J �� i . DaReady/By: I�bt
Internet www Notified/Method: to tigard Or us
� tit Sea Page afar
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--- �1 " Supplemental Information ,i1 , �( Y,,i s rt.t',11 c; —T,,,, : ! .,-, „ .L.li: r ,, ^...: ,ti,,, I b1„! f I n t l t l :i t4 r If t . , t
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0 New construction '
1:V Addition/alteration/re lacement Please a :.t „ sl! t_ s>� E it�E)sl
Addition/alteration/replacement check all that apply;
Q D emolition o []Service o ver 225 s
Vii .,, � ] amps, coin n'1 Dl3azardous location
Ir 1'I .r �"F,,t .ti + tt titp r } ''� ef8 i :c ['Service
#i is.,,,,1[ js 1 }rl#r I f it, ,r i�1. . t,, biltit'„.66, 1 , 1 t a � 1"o , 320 amps dwellings ❑Hu1ldlagove sq.
till
"s..: J „i.. s .,, ; N a ! '1 ; r ? 1 of 1 - and 2•iamily dwellings 4 or moi'c new residential
❑ 1- and 2- family dwelling A.3. olntnercial/industrial (] Accessory building ['System over 600 volts nominal units in ow structure
❑ Muhl family ❑ Master builder El Other
OBuilding over three stories ❑Feeders, 400 amps or ,Wore
f�t}1 E
{� n, ' ll pOccupant load over 99 arsons
1 1171. YI t(!)t'1� ti � tt 't 9 .,„„,--,1,1,•,,,,,I,, d ti 1
I 7.114 (3 1'r � j4, t 1 1 „ i Ir # , 9P Ii 9 #1 4' t1't'' 4 itl 4 ) j; - T -1 Ll J P ❑ anafaCLUred8tf8Ct11I8S or
„�.. .._ _ ''''''' t a... r t I,,,, r• , �� # 'r I r t ) ' ° P
.. #uf . , r � ! t a J E ji� f r r " � 1
:.d41, t. a d ' , ! U s r a t ' , % ; ,Yt ❑)3gi'E98A Ian RV park
Job no,: ,g (,A , A.i Job site address: / • 6 - «■ ..e,, ❑Iiealoh care facility ❑ Other
Submit 1 sets of plans with arty of the above.
City /State/ZIP: ZS
The above are not applicable to temporary construction service. E
Suite/bldg. /apt Project name: Dp fl t v l' 1).,ii,Lttk1lb_)1y' Slr.1,itt'121`'' t 1, }ti li( t)iltgf�.`.l�l1�il�1)II1t1�1! It i1
Desc
Cross street/directiana to job site: rip e4' lee, Total •°
New residential single - or multi - family dwelling unit.
r Includes attached garage.
1,000 sq. ft, or less 145.15 4
Subdivision: Lot no,: Be. add'l 500 s4, ft. or portion 33.40 1
Tax map/parcel no,: Limited energy, residential 75,00 2
' #1R yy1,, ” 'tr` ; fk4 i I�j t i t t �) t , 1 t x i1 t Limited energy, non dpe
I��E,.�i.t2.)iitS ...: 1ZI Er ,' • , .J i l 7, ', ",'' �Y t'.:t),li iii, :V� t . ,4 , 4, # t ,1 . ".,pl )'t Ij'f t 11q' '# 1r3 B!Y rmo u 75.00 2
.. 1 _ - -- . f r 4 ?4k d. I ) d�!. �E f i! ,. :_t! E . r'[ j r. 1 t ik !.L_ ) Hach mannfactutcd or modular
t . l r��. kA. ` �� ��� i dwelling, service and/or feeder _ 90,90 2
Services or feeders installation, alteration, and/or relocation
r�r; "' ` n It #,c, J L is s t , t N o 200 amps or Ices 80.30 2
I9i it I�it i .:Vi'iiil a l;:' , i T t'tF't I� 7 ) 81 1 { jh t sip 1 #Li� {[ 1 t l �i ly : ,t �t�t1 ,# #t#( t # 11 7 t
Ill. e� —,Lie. , I,,,ne_ ..i, , 1 "a .. ".1 I!, , # ad 1. i Ci fLi, 1t ttl i I,,, . l . # 7F . 1 . 1 t, }! i 1 �1� 4 01 a mp s to 60 0 am _ 1 60 . 60 2
1 c • _ �f.,,l,a r.I 1 gtt1'.,>..,ri f l .t M. :�.��il� .�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: Reconnect only 66.85 2
Temporary services or feeders installlitlon, alteration, and/o
Phone: ( ) I Fax: ( ) relocation
Owner installations This installation is being made on property 200 amps or less 66.85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 670, and 701 not 401 amps to 400 amps 13 2
Owner signature: 401 anus to 600 amps 1333 .75 2
gn Date
Branch circuits —
� Jrt' t ' tt � t tit t ' tit ' t , ..� new, alteration, or extension, per panel
l #isii4fi4f1# )dti t�,i, i ), It 3 {i i t d I ts tt� it 7 q1 i i ' 1� t,' t k( e, 1 r 1 I 3i I (tT 11.. 1
a aa. _ : . �., .... k u , 3v t t t : "nL ) i ilpj lt� �. 1 ! 7 , .,.�. # t , ) 4 ,.; t !{h , ,1 , 1 ; , ..•Z j ' � 1d1, }lee for branch olrciuts with
Business name O, p li I service or feeder fee, each 6.65 2
t V V V branch circuit
Contact name: I ! B. Fee for branch circuits -
without service or feeder foo,
Address: t 0' • . 1� e ach branch circuit 46,s5 2
_ Hach add'l branch circuit 6.65 2
City /State/ZIP: _ t A '7 ' 7 7 j Miscellaneous (service or feeder not included)
Phone: ( C 3) tQ _Li I is Fax:: ( ) snip or irrigation circle 53.40 z
E-mail:
53 or outline li Ming 53 "40
i 1 t '`lllfva: P •>j 4 l l ' i trrd i i , ' 'f. t °' 1 1'V t� It }t Signal Circuit(s) or limited.
11iLnitt 1 r , t 1 7:1 gf h14C,i1tl at 1 {7.f ` t4 i ' pt ( 11' k ,1 s t 4 t I tn !q flit f, r , }. e ner
:,: t.0 „• f, t , .: ._ 1, � ..._ v,,.a. p ,, �si>'t1 r # .; 3t � .t,.l.r � ii it1111t gY Pallet 81teCatlOn, Or
Business name: , . ' p N la � extension. Describe; r Page 2 � 2
Address: — .1., - r ` t - ®Q Each additional inspection over allowable in any of the above
Ci /State2lP: Per inspection 62.50
r r ft t� 47. , "i Investigation per hour (l hr min) 62.50
•
Phone: (c 0 -AV-IL( g a3: ( ) WED-2—'2-7 Industrial •Isnt or hour 73 75
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t �, k r r j m j : t t 7,1
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L io.: X42 43 Ct.E.- CCB Iic. no.: ' (D _ o 0
Supervising electrlcla �`�'� Subtotal ft. signature, required: Plan review (25% of permit fee)
P Stato surcharge (8% of permit fee) • a°
Print nam II7A [v _ e. ] cC Date � Lc 6
Authorized TOTAL PERMII'I FELT'
Authorized permit application expires If a permit is not obtained within 180
days atter it has been accepted as complete
Print Warne: I „ * Fee methodology set by 7Yl- County Building Industry Service nom) J- **Number of inspection pct penult allowed.