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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00343 "'''' Date Issued: 11/17/2009 T t G AR 0 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102DA00200 Jurisdiction: Tigard Site address: 8720 SW BURNHAM ST Subdivision: Lot: 0 Project: City of Tigard Project Description: Add card reader to back door of IT Department. FEES Owner: TIGARD, CITY OF Description Date Amount 13125 SW HALL BLVD Restricted Energy Permit 11/17/2009 $67.84 TIGARD, OR 97223 12% State Surcharge - Electrical 11/17/2009 $8.14 PHONE: 503 - 639 -4171 Contractor: ARONSON SECURITY GROUP 8089 SW CIRRUS DR BEAVERTON, OR 97008 PHONE: 503 - 639 -9988 FAX: 503- 684 -4357 Type of Use: COM Class of Work: ALT Total Number of Systems: Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Total $75.98 Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Required Items and Reports (Conditions) Nurse Calls: N Protective Signal: N Security Alarm: N Other: Y Other Desc: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. At 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 the 180 days. ATT • •': • _, • law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 •10 through OAR 95 001 -• • I. ou may obtain a copy of the rules or direct questions to OUNC by calling 5' •.6699 or 1.800.332.2344. Issbed By: 6 Permittee Signature: — `= ' thrle . • 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' Date: LICENSE NO. CaII 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. • 11/i16/2009 13:42 5036844357 SELECTRON PAGE 03/03 Electrical Permit A iicatio , n [�CESVE ° ,,- Y , _ rig / -- -' i II „ ,. ,' r -r , . . j FOR f'1Ci - . U t �' .4 � � , h i, v a �a,,atia�rr, . r•z , . � 44 City of Tigard Received • M 7G p g Date/By: / I « 0 9 p Permit No.; i i i , - • �,3 3 13125 5W 14x11 Blvd,. Tigard, OR 97223 { 1oV 6 20 1 9 Plan Review J Phone: 503.630.4171 Fax: 503.598.1960 1 Other Permit. Date/Bv; r.�' G p Date Ready/By; •T 1 GYA' ^12'n ° Inspection Line: 503 .639,4175 Juri 10 See Page 2 for •y ..,.p,� Internet: www.tigard-orgov CITY OF TIGARD Notified/Method; (Qr, Supplemental information TYPE OF W _ PLAN REVIEW Please check cell that apply (submit2 sets of whims checked below): ❑ New Construction Addition /alteration /replacement ❑ Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition Other: whole the available Mutt conent ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground, or exceeds 14.000 ❑ Commercial -use as- Heehural ❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family Master builder ❑ Other: El Fire pump, ❑ tnstnlantion of 75 KVA or JOB SITE INFORMATION AND LOCATION ©Emergency system. larger separately droved system ❑ Addition of new motor load of Job no.: : ^� r Job s i dd '1 � t 1vA 100HPormore occupancy. 4 site address: ,M^+r r - r ► - ❑ Six or more residential units. ❑ Recreational vehicle parks. Ctt /Sta /ZI y d '22 8 7 -° Sc . � . / � � 0 Health -care tAcilities. 0 Supply voltage for more than ❑ Hazardous loeatians, 600 voles nominal. Suitc /bldg. /apt. no.: Project name:,, 7 0 Service or feeder 600 amps or more, a • FEE 'SCHEDULE Cross street/directions to job site: Description I QtY. 1 Fee_ Tent 1 New residential single- or multi- thmily dwelling unit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. R. or less 145.15 4 Ea. add'/ 500 sq. II. or portion 33.40 1 Tax reap /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. R) 75.00 2 &I y Limited energy, multi - family • _ , !,,_ ,. P ♦ �, • res (with above sq. fl. 75.00 2 � Services or feeders installation and/or relocatio 200 amps or less 80.30 _ 2 © PROPER .',Y'OWNER E TENANT 201 amps to 400 amps - '1015.85 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 T 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 .11111 133.75 2 Owner signature: Date: Branch circuits — new alteration, or extension, per panel A. Fee for branch circuits with - [1 APPLICANT I 0 CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder tee, first branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State/21P Miscellaneous i service or feeder not included) Each manufactured or modular 90.90 T 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: ARONSON SECURITY GROUP Signal circuit(s) or limited- / .f p Address: 8089 SW CIRRUS DR extension, Dcscribetion, or t tP � aI�,� Page 2 .i-" ' 2 City /State /ZIP: BEAVERTON, OR 97008 1 Each additional inspection over allowable in any of the above Phone! (503) 639 -9988 Per inspection 62.50 c: ( ) Fax: (503) 684 -4657 Investigation per hour (1 hr min) 62.50 CCB Lie.: 185024 Electrical Lic.: 26497CLE Suprv. Lic.: 974LEA Industrial plant per hour 73.75 Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES Subtota - l: 00 Print name: JIM LEPPER Date: 11 !q I Plan review o mit fee): Authorized Signature: C State surcharge (12% of permit fee): .9.410* 8./t TOTAL PERMIT FEE; Print name; Date. This permit application eapirea If a permit not obtained within , Q q V days after It hat been accepted as complete. h lauildinePerm ¢a1ELC- Perml,App.dm 05 @3/06 Number of inspections allowed per M irk 4 4615T(1 1 i05/CO