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Permit 3.4L1 0 Gtadec (t) owj to /( - CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' a COMMUNITY DEVELOPMENT Permit #: ELR2010 -00125 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/20/2010 Parcel: 1S136DC04400 Jurisdiction: Tigard Site address: 11945 SW 70TH AVE Subdivision: DARTMOUTH SQUARE Lot: 30 Project: TVF &R Command Center Project Description: Audio and video. 8/24/10 added (1) audio and video system. • Owner: FEES TUALATIN VALLEY FIRE & RESCUE Description Date Amount 20665 SW BLANTON ST Restricted Energy Permit 07/20/2010 $75.00 ALOHA, OR 97007 12% State Surcharge - Electrical 07/20/2010 $9.00 PHONE: 503 - 649 -8577 Restricted Energy Permit 08/24/2010 $75.00 12% State Surcharge - Electrical 08/24/2010 $9.00 Contractor: SMARTER SYSTEMS LLC 1237 RIO GLEN DR EUGENE, OR 97401 PHONE: 503 - 522 -2970 FAX: Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: Y Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Total $168.00 Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N 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 O • ' 952- 001 -0100. You may obtain a co. • - - or direct questions to OUNC by calling 503.246.6699 or 1.800.3 2.2344. ' I Issued By .. ice_ I s� Permittee Signature: 111 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. 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. v CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT .e COMMUNITY DEVELOPMENT Permit #: ELR2010 -00125 ' ' Date Issued: 07/20/2010 A f Gkikb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S 136 DC04400 Jurisdiction: Tigard Site address: 11945 SW 70TH AVE Subdivision: DARTMOUTH SQUARE Lot: 30 Project: TVF &R Command Center Project Description: Audio and video. FEES Owner: TUALATIN VALLEY FIRE & RESCUE Description Date Amount 20665 SW BLANTON ST Restricted Energy Permit 07/20/2010 $75.00 ALOHA, OR 97007 12% State Surcharge - Electrical 07/20/2010 $9.00 PHONE: 503 - 649 -8577 Contractor: SMARTER SYSTEMS LLC 1237 RIO GLEN DR EUGENE, OR 97401 PHONE: 503 - 522 -2970 FAX: Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: y Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Total $84.00 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: 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 OAR 952- 001 -0100. You ma obtain a -- • • o the ru - or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued B . /� + Permittee Signature: /�- �% 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. 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. Electrical Permit Application uoli.e11 I Ir i.,(isi ,ONl.l - City of Tigard ���I - Permit No.: lc , 11111 13125 SW Hall Blvd., Tigard, OR 97223 V an R eview C Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit: 1 -1 c i RI) Inspection Line: 503.639.4175 c� A , 1 DAte Ready/By: ® See Page 2 for • w Internet: ww.tigard- or.gov 1 :0. . ; 60 L •N13tified/Method: IM Supplemental Information ' TYPE OF WORK - t OF•TIGAR 1 PLAN REVIEW ' C I 1`I Please check all that apply (submit 2 sets of plans w /items checked below): New construction ❑ Addition /alteration/replape 11fu DIV ISI 400 y ( p ): tS U ► V ❑ Service or feeder 400 amps or more ❑ Building 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. Tess 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ", Job site address: 1 . I 10OHP or more. occupancy. Job no.: l ( � �� Jam+ • 7U� ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: • ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 7- j 1� , ❑ Service or feeder 600 amps or more. "�" FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'1 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK • (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 dot C 1) ek LA01 d h uM S C /� residential (with above sq. ft.) at y Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I 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 Branch circuits - new, alteration, or extension, er panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 tY dwelling, service and/or feeder Phone: ( ) Fax:: ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 • CONTRACTOR . _ Signal circuit(s) or limited- energy panel, alteration, or extension. Business name: ,,,�,,, c P age 2 -7 -- 2 /YWt V^ S. Sfrfi'S L G(• Each additional inspection over allowable in any of the above Address: Additional inspection (I hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (/2 hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: -- cfc� Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): -r t CSU ' TOTAL PERMIT FEE: Si j�� Vd Authorized signature: This permit application expires if a permit is not obtain within 180 days after it has been accepted as complete. Print name: Date: * Number of inspections allowed per permit. I: \ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: .COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape•Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling n Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations 1:\ Building \Permits\ELC- PermitApp.doc 07/01/10 err Electrical Permit Application \,� 1 c)lt till 1(1 til ()NI 1 a ` ; '*' R eceived City of Tigard .� M - Permit No.: "� • AI a ?c9° Date/B . ° 13125 SW Hall Blvd., Tigard, 0 ,23, o1� Plan Review .. Phone: 503.639.4171 Fax: 503. 1960 i % (- Date : Other Permit: j Wl o — 0 v i i � , 1 . i) Inspection Line: 503.639.4175 0\-- P A Date Ready/By: Juris• ' RI See Page 2 for Internet: www.tigard - or.gov r - -`.i�kr �q \ Notified/Method: Supplemental Information /'nl 0' . ‘,f.ACp 'TYPE OF -WOj %\ ' `.) PLAN REVIEW �A., \iT. ❑ New construction ❑ Addition/alteratlrepl �' + a cement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 0 Building 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 ❑ CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "l -3 ", Job no.: 3 0 0'7 0 Job site address: 1 i 0, LA 10 7 J 4 40E 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: T / ., 1 -t Q ❑ Health -care facilities. ❑ Supply voltage for more than ty 1 1 ✓ Alt ` L t L� lL ` z J ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: " T `J ❑ Service or feeder 600 amps or more. FEE SCHEDULE. Cross street/directions to job site: z "0 ' O 3 o ✓T(—{ Description 1 Qty. 1 Fee. 1 Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 • DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 Al o i 6 - k.) 1 0 ED residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER - ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: "T„ fa tA Tl n j J 1 ..E\ 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: /State /ZIP: Temporary services or feeders installation, alteration, and /or ty relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: 51,14e1 t-rt s y <'ta'' S L U c — B Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: AvokE� T A(,kj2 branch circuit Each add'I branch circuit 7.42 2 Address: i z ... 2 ) ') ..1 c.> G- t' N 0 Miscellaneous (service or feeder not included) Each manufactured or modular City/State /ZIP: v a-Fti6 ! U 2 1 �� V dw e lling, service and/or feeder 67.84 2 Phone: ( S Z Z Z 91 p Fax: : (5�,) 8 ( 4 4 0 0 8 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: 0 \ ( 1 y g 5✓h 'trie y s rE M S Li, C.. . C U""` Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: � �- panel, alteration, or extension. ` Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr C specifically listed ( ' /: hr min) CCB Lic.: , 8�� q Z sy. Electrical / t J- ✓ 1Z rv L ic.: 3 7 Z L � ,� ELECTRICA PER MIT 'FEES arl �idatL / / .;t Subtotal: '7 UU Suprv. Electrici re, required: Plan review ( 25% of permit fee): Print name: AN i' Q , C T �� Date: 7 40 _10 State surcharge (12% of permit fee): d ; 00 i �� TOTAL PERMIT FEE: VI n U� Authorized signature: r, This permit application expires if a permit is not obtained within 180 D days after it has been accepted as complete. Print name: D R C nip( C C&. Date: t U * Number of inspections allowed per permit. I: \Building\Permits\ELC- PermitApp.doc 07/01 /10 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: • • Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: COMMERCIAL WORK ONLY: . , Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check T ork Involved: Audio and Stereo Systems n B • oiler Controls n C • lock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* n P • rotective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC- PermitApp.doc 07/01/10