Permit YE"
"' N CITY OF ®R ® ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00030
TIGA 13125 SW Hall Blvd Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/2/2007
= PARCEL: 2S 102AB - 04000
SITE ADDRESS: 12386 SW MAIN ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: CAFE ALLEGRO Security and 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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
WARREN REESER ADT SECURITY SERVICES, INC
12386 SW MAIN ST 2815 SW 153RD DR
TIGARD, OR 97223 BEAVERTON, OR 97006
Phone: 503- 750 -9026 Contact #: PRI 503- 469 -7100
FAX 503- 469 -711
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount
[ELPRMT] ELR Permit 2/2/2007 $150.00
[TAX] 8% State Surcha 2/2/2007 $12.00 REQUIRED ITEMS AND REPORTS
Total $162.00
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 quest' ns to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Ct�c.�i� -lc-rti Permittee Signature: ayy�_� (a
OWNER INSTALLATION ONLY I
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.
42/..f..)7 09:04a Stephanie Pate 503 -469 p.1
�„Ae T,Y ` "'.,'+tFt ^�s " r i _ , .. rr r e: t,,�'t. di
:.lcctrica[ Perm it p y .RB I OR OFFIC E U , r ; 1 i x '
afim
lwr C ' liceceve∎ �y� �M
City of 1 Tigard lhrlo'li • � PCtTJI N --/_._/ / _ �,t7 •
13125 SW 1-1n11 Blvd,. 1 •i ,ard, OR 91223 I'L,u Review
Phone: 503.6.1.4171 ) Fax: 503.591;,196 ) t Other' Pcrul t:
I) ' . 2007 + ' �4r"_�' I i 1 lhttctr +y- _._.,....,.-
lospo;tion I-ine 503. 639.4175 ' ..- _� b �. Dal: Iterdy,Uy guru i ®S fa;,:c 2 for
lntcmvt: v,'wv..ci.lit?1rtl.r ; Notified/Method: J i 1 upplen,catal Information
>
.,,. '' '� C - Plea,c check all that apply;
❑ N1:14'COnSltUCtlUn b Ad t; +� /rcplac
❑ DCI11011 U1}n 0 Qt}1C ;; ❑Sery ITC eve 225 atl'rl)s, corm', ❑ Hazardous It .fit 06
. ❑Service ov.x 320 Imps - rating ❑ Buildng ova 10.000 ix. lt., • GATECORY OF CONSfR17(71 , • .. of1- and 2- family dwellings 4or more nowresidual:11
(2 1- and 2- I;nnily dwellini' ® Commercial/industrial ❑ Accessory building Dsy .xnnva 600 salts nominal units in oneaIruCtufc.
❑ lsuilding ova Uutx stories Gi•o:t.iers, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Olhts; ❑ 41 :utuf :'tcture
_- ._. -_ -.. .._... DOceup :utt load over 99 persons d structures OT
. JOB SITE INFORMATION AND LOCATION ' ❑l na>'l.ii;lrtinn plan RV park
-� 01-1:7:11111-care facility ❑Other:
`l no. :2pe.s / -1 sat site itidress :/Z 3dr' Sz / ./2 / q / ;,, ) s T
Submit 2 sets of plans with :toy of the alwv c.
CityiSt;dc/T1 P: 77 4 - n2 ,) D,e 9 7L z� The above are not applicable to temporary consttvcliitn service.
FEE* SCHEDULE • •
Suite/bldg./apt no.: I Projectname:G'yf e`e' ,e0 nr,onmon I Qtr. No I Toirl
Cro,s su'xL'dircctions to job site: Nev. re6uOent)a1 single• or multi - family dwelling unit.
-' - includes attached garage.
' I ,(1011 Ss', rt. or letiv 145.15 r 4
Sul 1 Lot no.: lit. udd'1 5dU sq. 11. trrpurti.n ._ _ 35.40 1
Cimino energy, residential 75.00 2
Tax snap. /parecl no.; .0 2
_--__ Limited energy, nun•residu1li :il 75.011
` ^ I)J C1t1PTit)N` OF WORK ' > Each m
Each tu or modular
Je lli
vcn mr vice andiee feeder 40.00 1 2 :
_.__ . .. , � , - - � rvi of feeders installation, allcrulion, and /or relocation
200 arrnpv or lcxs - TT rio.30 2
201 :imps to 400 amps 106.ri5 2
0 pitO rEUT'Y OWNER •p TENANT ' ...r _.
-- 401 amps to 600 amps amps _ 160.60 2
F - N.lmc: - 601 ;;tips to 1,000 amps 240.60 2
Address; - - Over 1,000 am or volts 454.65 2 I
• 12e'COi,no:t only 66.85 2
City /Stater/AP': Temporary services or feeders instal/ado', alteration, and /or
relocation
Pholle! fret: t. .'..._
200 amps or ktis _66.85 1
Owner installation: This installation is being made on property that 1 own vt'hich is not 201 amps to 400 :ulips 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 4-49. 670, and 701. 401 autps to 600 :imps _ 133.75 - 2
Owner signature:. -__ Date: - .. - Branch circuits - new•, alteration. or extension, per panel
❑ , pr1,lcANr .... . ' , ' CONTACT PCitSON A. Fee for branch cin;uils with ,
f!llT service or fc xkY fee, c.'ich
Business name: brunch circuit 6.65 2
f � � �/ B. Fee for hunch citt:uits
Contact name: (Ag�,e �/ 2 ���SE/ i tvithrmt ;exvice or feeler fee.
46.85 `
_ "" li,st branch circuit
Address' �� - Each add'I btutch circuit -.
6.65 _ 2
City /State/ZIP. Miscellaneous (service or feeder not included)
Pump or irrigation circle � 53.40 2
•hums: (57)3 ) 75V ' '70 z / Par:: ( )
!� Sign or uullint lighlinlc 51.49
E-mail: .w Sii'n.i1 c.rcuit(S) or limited-
CONTRACTOR 1'UR . - atta'gy Panel, alteration, or
Do
.,r.� „.. __.... -_- cxteztsion. LX cribe: 2. P; t,r_,C? / 2
13usine.' Milne: ADT Security Services __
Address: 2815 SW 153' Dr. w ^T ICAO additional' Inspection over allowable in any o (lie 41.101V
Per inspeciion 62,50
City /State /ZIP: Beaverton OR 97006 1 1 vt,:tin';iti:tn per hour tl kr hnin) 62.50
Phone: (503) 469 -7100 Fox: (503) 469 - 7114 industrial plant peT hour 73.75
• ELECTRICAL PERMIT PEES"
CCB L;c.: 59944 Electrical Lie.: 26- 209C1_li ; Snprv. Lie.: IL A389 � Subtotal 0S�'
Suprv. Electrician signature, required: �� �� - - 1'l;uertv;cw {2S °.•i Ice) �_ -
l� _.- _.......� //z/..) ��e /Z Print name: • /e2.--/ti /� L)atcz Slate stntrl4'irl;r; 04$, or permit fcc) %�- C�
It r /1Z (/ •7 . -.... __ I TU'1'AL l'ERM1'r' VEIL 0; 1
itUlllUl'1ZC'(j SlbltatllfC:A � /44,4a.../ - 'Phis permit appli„tion :xpirtA if a permit is not ubtainurl within 180
-
clays after Ii has been accepted am complete
1 Print name'. /t / I/ ie/A y r Due: • Fee methodology set by'Iri- County i tuiiitiny l n d u,lly Service Board
�. • .. Z.../......c7"---4 - • • N'u,itber Of inspcctie•n; per permtt alluwcd.
i lfluit dig,s \Yvmitrt8l.t: 11 17•C1 430.461ST(: Jt:.'CUU'WClt