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Permit ELECTRICAL'RESTRICTED ENERGY PERMIT , CITY OF TIGARD COMMUNITY DEVELOPMENT Permit #: ELR2009 -00340 Date Issued: 11/03/2009 ,Z- IGARDi 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112ACO2800 Jurisdiction: Tigard Site address: 14865! SW 74TH AVE 120 • Subdivision:: METRO PART /ML.P2002 -00007 Lot: 1 . Project: Koregon International Projectbescription: Install burglar alarm system. FEES Owner: Description _ Date Amount FANNO CREEK ACRES LLC 14865 SW 74TH STE 300 Restricted Energy Permit 11/03/2009 $67.84 TIGARD, OR 97223 12% State Surcharge - Electrical 11/03/2009 $8.14 PHONE: Contractor: BROADVIEW SECURITY INC 8080 SW CIRRUS DR BEAVERTON, OR 97008 PHONE: 503.641 -0287 FAX: 503 - 641 -0960 Type of Use: COM Class of Work: ALT • Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data &Telecommunications: N Fire Alarm: N HVAC: N Instnimentation: N Total $75.98 Intercom /Pain N Landscape /Irrigation: N 9 9 Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: Y Other: N 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. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon • Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through *AR 952 -001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. �J� ,cl�L /--iii---77e, By: , 41 Permittee Signature: Q OWNER INSTALLATION ONLY The installation is being made on'property town which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' 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. 7:1-102/2009 03:31 5036410960 BRINKS HOME SECURITY PAGE 01/03 Electrical Permit A lication • r, ^ kECEIVI, n +i,u1 i , , -. r .Pq.'gl 1 ( ' � USL (1N1 1/" ''.inw ll' ,�5" : , 4 ,,1 Q�l�' O Tigard Rccc ived w s e w' ` / / I t .: � i y' r � 0:- t ^ 13125 SW Hall Blvd,. Tigard, OR. 97223 NO •V 0 2 � " B° Permit •• a Pllone: 503,639'4171 Fax: 503.598.1960 Other Permit T (OAR!), lnspcction Line: 503.639.4,175 tc Road /n Internet: www,ti and -or, ov CITY o , 9 .y:.- Inr RI 3ee;Pnpc for g OF TIGAE + t f cd/Mcdigd;.,I Supplemental rnfarmntinn •. � � B ,New construction ❑ Addition /alteration /replacement ❑ d ' Pletsc check ill that apply (submit a acts anions w c I: betnolition Otihcr: ❑ Scrvicc or feeder 400 am or more where the available fault current Marinas and boatyards. rios. CA•TE�* 4 + bI"' I errrlr %1v exceed ,0,000 amps at 150 volts or O p ❑ Floating buildings. dwelling �' C less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 -and 2-family g Commercial/industrial ❑ Accessory building amps for all other installations, buildings. L1 Multi- family ❑ Master builder ❑ Other: 0 Fire pump, ❑ lnstnlinnon of 75 KVA or • Job no.: 91058207 Job site address: 14865 SW 74 Ave .1011 ©`Emgeny c systemrncr separately deri,rod'sysrem, jdR ; S1 E lNt.ij,0 xA'T'it_7iN A 1 LO ❑ Addit of new mo tor 1 ,n 10014P or more. occnpnncy, 0 Silt or more residential units, ❑ Recreational vehicle pnrka. City/State /ZIP: Tigard, Oregon 97224 ❑ HOn1th -care lhcilitics. 0 Supply voltage for more than [LFiazarrlous lnontiona. 600 volts nominal. Suite /bldg. /apt, no.: Unit 120 _ Project name: Koregon international ❑ Scrvicc or feeder 600 amps or more; Cross stxeet /directions t'o site: Bonita Road 7 ' „ 1 ' ' ,' ' ,Va ' : ' Octi. lion , •• f Qty I Ree ! Total " • New'residentinl single- or multi- family dwelling unit. IncIudcs.ntttrchcd garage. Subdivision: Lot no,: 1,000 sq. ft, or Tess 168,54 i '- Tax map /parcel no.: Ea. ndd'l 500 sq. ft. or portion 33,92 ., 1 Limitcd energy, residential . 1t'L�SC)Ii11y' '`10,1 =#,,O tK. - . . (with above sq. R,) 67.84 2 UV Alarm Installation Limited energy, multi - family G7 84 2 residential (with above aq. 10.) Services or feeders installation alteration, and /or relocation 200•nmps or less 100.70 _ • 2 " b.i1i:OPI Aty C`rvGN R "0 TPNAN ' 201 amps to 400 amps 13156 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301,04 2 Address: _ Over 1.000 amps or volts 552.26, 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or . relocation _ Phone: ( ) Fax: ( ) 200, amps or less 59.36 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125,08 2 intended for sale, lease, rent, or exchange according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168:54 2 Owner Signature: Date; Brunch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with t A'ppkr rt;Atr"lr'; ..• • C ONTACT ,EflSO ' ribtivc service or feeder fee, each branch circuit 7.42 2 Business name: Broadview Security D. Fee for hrancl, circuits Contact name: Delta Danielson udthovl service or feeder fcc, 56.1 R 2 first branch circuit Address: 8080.SW Cirrus Drive F,.>ich add'I branch circuit 7,1,2 Miscellaneous (service or feeder not included) City /State /7_3P: Beaverton, Oregon 97008 Each manufactured or modular 07.84 2 dwellin Scrvicc and /or feeder Phone: (503) ;641 -0287 — I Faxc:: (503) 641 -0960 Reconnect only 67.04 2 E-mail: delta.d1nielson@ rroadviewsecurity "corn Pump or irrigation. circle 67.84 2 CONtrg ! ' :, : : ' ,'; , . Sign or outline lighting 67.84 2 Business name: Broadview Security Signal circuit(s) or limited- energy panel, alteration, or Address: 8080 SW Cirrus Drive extension, .Describe: ) Page 2 67.84 2 1,V Alarm install City/State/,ZIP: Beaverton, Oregon 97008 Each ,additional inspection over allowable in an of tlw above Phony (503) 641 -0287 Per inspection 66.25 ( ) Fax: (5 3) 641 -0960 Investigation 'per hour (1 lir min) 66.25 el C13 Lie.: 44421 ./" Electrical Lie.: 34 -16 • L . Suprv. tic.: 3213LEA Industrial plant per hour 70,18 ; 1';:,:...;;; ; ; . ; :1GLECT.Ix1 v!(-.0 '.'' 14Y1j f ` <: FGS ".::: Suprv. Electrician signature, required: � _ Subtotal: 67.84 Print name: Gary Kevin Tucker . Date: 11 -01-09 Plan review (25% of permit fcc); — .- State surcharge (12% of permit fee): 8.14. Authorised signature: TOTAL PERMIT FEE: 75.98 Print name: This permit application ecpiren if n permit is not nhtnined within 100 Date; Mir; after It has been accepted ns complete. ' Number of inspections allowed per permit, t\ Building \Pcrmltnl$LC_rermitApr.dne 10/01/09 44a- 40157(11/05 /COM/WFA