Permit q CITY �� 110'� ELECTRICAL RESTRICTED ENERGY PERMIT
'' ' COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00226
TIGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/25/2008
PARCEL: 1 S 135BC -01100
SITE ADDRESS: 11117 SW GREENBURG RD ZONING: I -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: MATERIAL FLOW
Project Description: Installation of low voltage for fire 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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
E. LEE & EVELYN L. ROBINSON NORTHWEST FIRE SUPPRESSION, INC.
PO BOX 91305 15385 SW BEAVERTON CREEK CT
PORTLAND, OR 97291 BEAVERTON, OR 97006
Phone: Contact #: PRI 503- 644 -7720
FAX 503- 644 -8289
Reg #: ELE 34- 517CLE
FEES LIC 88629
Description Date Amount SUP 4273LEA ,
[ELPRMT] ELR Permit 7/25/2008 $75.00
[TAX] 12% State Surch 7/25/2008 $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 set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direc = • - o OU - =t 503.246.6699 or 1.800.332.2344.
Issued : I 1 /" Permittee Signature: !(' ..�
� O ` - WNER 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:
Cali 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.
Electrical Perm Applicatio FOR OFFICE USE ONLY
City of Tigard
Date/By: d Permit No.: / /0'0 , i, ,1*
- '� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review " �'
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
TIGARD p N otified/Method: Su
Internet: www.tigard- or.gov pplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ l3uilding over three stories.
❑ Demolition ❑ Other: 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
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A "f:', "I -2 "I -3 ",
Job no.: 08 -056 Job site address: 11125 Southwest Greenburg Road IOO or or amore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Greenburg Space Center ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtr. I Fee. 1 Total I '
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'l 500 sq. fi. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Installation of Fire Sprinkler Monitoring System residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: GVA Kidder Matthews 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: One SW Columbia Street, Suite #950 Over 1,000 amps or volts 454.65 2
City /State /ZIP: Portland, OR 97258 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I 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 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Northwest Fire Suppression, Inc. B. Fee for branch circuits
Contact name: Randy Ehrhard
without branch service or feeder fee, 46.85 2
Y first branch circuit
Address: 15385 SW Beaverton Creek Court Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Beaverton, OR 97006 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 644 - 7720 Fax: : (503) 644 - 8289 Reconnect only 66.85 2
E - mail: randy @nwfire.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Northwest Fire Suppression, Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 15385 SW Beaverton Creek Court extension. Describe / Page 2 ..
• 2
City /State /ZIP: Beaverton, OR 97006 �� �� Each additional inspection over allowable in any of the above
k oCi Ph one: (503) 644 -7720 A Fax: 03) 644 - 8289 I 1 Per s ti ga tion 62.50
l� Investigation per hour (I hr min) 62.50
CCB Lic.: 88629 A ' ' ie Electrical Li c.: Su Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Ir. ' _ Subtotal: 75.0
Print name: Randy Ehrhard , .Date: 07/25/08 Plan review (25 of permit fee): .�---
AK surcharge (12% of permit fee): 7. O d
Authorized signature: lir` , �� TOTAL PERMIT FEE:, 0
This permit application expires if a permit is not obtained within 180
Print name: Randy ', • and Date: 07/25/08 days after it has been accepted as complete.
. Number of inspections allowed per permit.
I: \Building \ Permits \ELC- PermitApp, doe 05/23/06 440-461 5T( I l /05 /COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008.00226
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/25120011
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .:� 'f_�
INSPECTION WORKSHEET FOR DATE: 8/22/2008 TIME: 7:01AM PAGE: 33
111 06 I
SITE ADDRESS: 11117 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MATERIAL FLOW
DESCRIPTION: Installation of low voltage for fire alarm.
OWNER: ROBINSON, E. LEE & EVELYN L. PHONE #:
CONTRACTOR: NORTHWEST FIRE SUPPRESSION, INC. PHONE #: 503 -644 -7720
Inspection Request Scheduled For: Date: 8/2212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 074501 -01 503- 523 -9540 N
Corrections /Comments /Instructions:
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L FAIL \' ALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: G- NIGE5 L ' Date: i.22• 3 Phone #: (503) 718- t"`q q