Permit ` �'°Y OF F TIGARD I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
1 COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00099
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/23/2008
PARCEL: 1S136AD-06505
SITE ADDRESS: 10998 SW 68TH PKWY ZONING: C - G
SUBDIVISION: WAY LEE LOT: 003 JURISDICTION: TIG
PROJECT: FRONTIER BANK
Project Description: Installing video system.
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: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: VIDEO X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WAY W LEE, GENERAL CONTRACTOR, I ALLIED SAFE & VAULT INC
5210 SE 26TH ST 530 NE COUCH ST
PORTLAND, OR 97202 PORTLAND, OR 97232
Phone: Contact #: PRI 503- 231 -9550
FAX 503- 231 -9551
FEES Reg #: ELE 26- 243CLE
LIC 64465
Description Date Amount SUP 3931 LEA
[ELPRMT] ELR Permit 4/23/2008 $75.00
[TAX] 12% State Surch 4/23/2008 $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 direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ,,„..-0.0.1 Permittee
4i
Signature: . S____,:::> ! t '
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'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.
.04-22 06:49 FROM-Allied Securily v
po
lectricalikerntit. Application fki
City SW Hal1 Tigard vdTigard, OR 97223
13125 111.,
' F Phone: 503.639.4171 Fax: 503.598,1960 , (In
Received
p,\ 2 1 2. uu,, Daten3 :
, ,,RM
FOR OFFICE USE ONLY
4
T-149 P001/002 F-779
pcm,i,No.: , .
-
Other Permit:
Inspection Line: 503.639.4175 ' ' G :- , dv/R • lurk 0 See Page 2 for
rioAki) ,...r- k i :, -: •4 i - _. Y.
Internet; www.tigard-or.gov ‘,2. : 1 ` - ,.. 7„:‘,‘91' : :11) : Oboe: SuppiClne n a 1 1116)1r III a t i 0 11
1 .
tiler I g 1 g "Hp r. Mttt: i OS liki dfill iftlitO iti 1 Iti IND Viii INE1 Villa] $11 IWO .■! ' 'til, HI W e tr i p "PIM 0110 li r Pr i ri Fir i fil ti ; g K I i ip
14 Aga!, : Sit . lab,' , : - zrp:,!... 1 . „. g. auf ailLifilfiraicu, cot;; 1M igth rfRiinnwt P ii.pfiTo '14 han ' , I I , • - . .01 villliamoa o . .I, ---.-- . M
i: New construction Rl'Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wiireins checked below):
0 Service or feeder 400 amps Or more n Building Over three stories.
El Demolition q Other: where the available fault current 0 Marinas and boatyards.
milli ligiotiour lammivt.:152:=4..zv,-..-rositiglitsiiiitiaoilfoi exceeds 10.000 amps at ISO volts or 0 Floating buildiags.
less to ground, or ::d5 14,000 a con.,..<1.1....
0 I- and 2-family dwelling InCorrunercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 13 Fire pump. 0 Installation of 75 KVA or
is,70y, : . , , f qtm amiv r .. 0 ,„ 0 ,4, 7 , r , o , i „. 9 .,..,„,. .,....,:„ . . . h i 0 Emergency system- larger separately derived system.
i
,... ,g
, 4 ...,:".. , 4: .. il Af ,.... . 4 . - 1 fliiil I NI& gra. R i : MA ! 0 Addition of new motor load of 0 "A". "E". "1-2". "1-3",
100HP or more. OCCupanCy.
Job no.: 04 09 1 % - /21 Job site address.
'/O '7 , 2 5■)-D 6 id' Pk L, , 1:1Six or MOre re-Sidential units. 0 Recreational vehicle parks.
v../ e.
1
City/State/ZIP.
0 Health-care facilities, 0 Supply voltage for more than
. I I e' C-v C? e.... (-‘ i 3..-ix _ 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 6 Project name: ,_ ,. '7'4
- 1 i W h. r.4.1-... ( ( :. 0 Service or feeder 600 amps or more.
F rO w,..
Clitniraggiffallifake,WOLSWAREMIR
Cross street/directions to job site: er_,...s ,t , cj e, p' i v. ., (./ nosevieuon I Qty. I Cm l Total .
I n f ../ ' New residential single- or multi-family dwelling unit.
P i or, ',.),(-,..rb .\-?)\ 04k fqer b-s)) L ekt eis-1 (*S?' Includes attached garage.
e _ , ,i
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add') 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: w ,..„,.„. ., Limited energy, residential
75.00 2
ii 1 Ort1,1itilAt T ,Wc,T. , ,_ - .tiAfil::;:::‘,1,7L;,',1 . ,,'";',::',i'd, " Ifill ' ik Ithilligri (with above sq, IL) .
Limited energy, tnulti-family
75.00 2
LI eed, ra. < I 2 a . Li e 4 - t, 0 .SS.C.4.e.A.--," residential (with above sq. ft.) _
Services or feeders installationolteration, and/or relocation
200 amps or ICSS 80.30 2
y gngylrr E I 4 . LOOM; :AIR; .1.114f ppplp _Inv '. . .,..::,. Li. e• rilim {1 „„, 1 ■ npip N '. 1.?.1.1Lift.',..,:.1■..,,- 2 0 . iIII/til AIM'. ' ....'iff,alit IiI ',k ', ,1 '. II' illtffilitiMi Idd Et v amps to 400 amps 106.85 2
Name: (AJa y 14) Le_e_ /6e4rr..-0( c.;)-e‘,y- _401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: . _4/11"2 ,,$L Over 1,000 amps or volts 454.65 2
City/State/ZIP: ea r - y e_ q - 7e04_ Temporary services or feeders installation, alteration, and/or
relocation
f k ' l
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
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
4 i!i,y0 .. iirms ill above service or feeder fee,
6,65 2
. each branch circuit
Business name: • - ' . , -(_,... 4- -c.. - . ' • ,P B. Fee for branch circuits
without service or feeder fee,
Contact name:
31r• e Ar - r ; c. - SC.A - .... cll.. 621 --43' ' I. first branch circuit 46.85 2
Address: - L - XI %..s. .e. I- m.v • , Each add branch circuit 6.65 2
- , -- - ,., - Miscellaneous (service or feeder not included)
City/State/ZIP: VIP . _- • (3 g,... ' 3- . .. tAA Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( s . .-4 . - -
Reconnect only 66.85 2 .
E-mail: Pump or irrigation circle 53.40 2
tialtaiiiiglitigliilar,441"-a 2)t§iNgdairalgailliffigangagiffilitieliTONIT Sig o ou tline li .. 53.40 2
Signal circuit(s) or limited.
Business name: A c , ,, <.. ...,, c .,,_ 4 , Va
energy panel, alteration, Or
Address:
extension. Describe: ( Page 2 75'1 0% 2
'7?... N3E. C 0 1/4.k...t,t.. ,
City/State/ZIP: "N Ir.+ L ,i i OK, 2. Eah additional inspection over allowable in anv of the above ,
Pa c inspection
Phone: ( Sr .2 1_ L3 550 Fax: ( S6\ . i - S 557 Investigation per hour (I hr min) 62.50
. r _ .1nduatrial plant per hut _,,, , . _ ,, , 73.75
CCB Lic.:4( v6, Electrical Lica i" , , Suprv. Lic.;,,(
• .
, ii '' iligelnal .. •' A ii
Suprv. Electrician signature, required Av.?. ... ,... e . ,... , Subtotal: ic_
,
/ A' Plan review (25% of permit fee);
Print name: mcv 4 0.< tx., c f , Date: 4 // 2/ / 0 ?
State surcharge (12% of permit fee): Q o
Authorized Signatur / ,.:: i .4 ,
<I)
TOTAL PERMIT FEE: ? Si L. )
' This permit application expires if a permit Is not obtained within 180
Print name:,3' : P , 4p i els Date: y 4 ). ,7 O s
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1.113eading‘PermitaLC-Pr.nnitApp.doe 05/23/06 440.4615TO I/OS/COM/WEB
V
CITY OF TI'r;ARD
BUILDING DIVISION PERMIT #: ELR2008.00099
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2.3/2009
Phone: (503) 639- 4171 .1 r'�pn3I III ,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:01AM PAGE: 36
SITE ADDRESS: 10998 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: WAY LEE LOT #: 003. TYPE OF USE:
PROJECT NAME: FRONTIER BANK
DESCRIPTION: Installing video system.
OWNER: WAY W LEE, GENERAL CONTRACTOR, I, PHONE #:
CONTRACTOR: ALLIED SAFE & VAULT INC PHONE #: 603- 231- 95M
Inspection Request Scheduled For: Date: 6/6/2008 Pour Time:
Code # Inspection Description Co firm -# Contact # Message
199 Electrical final' 070995.01 503475 -8340 N
Corrections /Comments /Instructions:
( 71/
yrt
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gr' (N6e Date: 6.t 'C ' Phone #: (503) 718 - 2.14%