Permit � 4 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00300
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/22/2008
PARCEL: 1 S136DC -04400
SITE ADDRESS: 11945 SW 70TH AVE ZONING: C -G
SUBDIVISION: DARTMOUTH SQUARE LOT: 030 JURISDICTION: TIG
PROJECT: DARTMOUTH SQUARE
Project Description: Low voltage for 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:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
DARTMOUTH SQUARE, LLC CAPITOL ELECTRIC CO INC
7165 SW FIR LOOP #100 11401 NE MARX ST
TIGARD, OR 97223 PORTLAND, OR 97220 -1041
Phone: Contact #: PRI 503- 255 -9488
FAX 503- 257 -7121
FEES Reg #: ELE 26 -496C
LIC 48748
Description Date Amount SUP 3132S
[ELPRMT] ELR Permit 101221200E $75.00
[TAX] 12% State Surch 10/22/200E $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: X; — - ittee Signature: gi p/ r,„
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.
21/2008 16:21 5032551966 CAPITOL ELECTRIC PAGE 01
•• 'cal Permit Apvlieation ,
S) S) Pi)R orrIcE litip: ( VS' l.y Received
b \j Datc ( / la - 64 W" itnn.: �'e�.l%/�-Otl) W
City o #'�ti and � Q r
1111
M 13125
hone ; 503.639.4171 Fax: 5 350 Ball Blvd., Tigard, 03. 598:1960
9722 A r1 O P11111 P11111 Review J � �
P + t% . Other Permit:
Phone03. y DatcJBy:
T I c R T> tnSpection Line: 503.639.4175 • I ZI Date Ready/Fly: 7uris: El Sc stmt 2 Air
Internet www.tlgard- or.gov ,e1Cj �
- . , . -.. • O w 1( g1 � , TlOtlflfd /Mf(hod: _ �. Su1'Mleroenml lnfnmmtlnn •
TYPE OP WORK 0 4, 1 ,+ ♦ PLAN RSVIHW
L Ncw construction U Addition /alteration/replacement VW''' Please check all that apply (submit 2 sets of plans w1tems checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUC'T'ION where the available fault current ❑ Marinas and boatyards
LJ 1. and 2•Ibmily dwelling (_ Commercial<ndustrial Li Accessory building exceeds 10.000 amps at 150 volts or Floating buildings
❑ Multi - family ❑ Master Builder ❑ Other 1955 to ground, or exceeds 14,000 Cammerclel -use agricultural
JOE SITE INFORMATION AND LOCATION amps Fer all other Installations. ❑ buildings
Job no.; 270775 Job site address; 11945 SW 70th Ave- ❑ Fire Pump 0 Installation of 75 KVA or
❑ Emergency ayetem larger Separately derived system.
City/Stale/ZIP: Tigard, OR 97223 El Addition of new motor load of ❑ "A', 'E', '1.2^, ^t
100HP or more. ❑ occupancy
Suite/bldg./apt no.: ./ IPmjcet name: Dartmouth Square ❑ Six or mare residential units ❑ ReereaOonsl vehicle parka.
❑ HCelfh care Facilities ❑ Supply voltage for morc than
Cross Street/Directions to job.site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
Subdivision: Lotno.: - PEE SCHEDULE
Description 1 Qty, I Fen. I Tntal I e•
Tax map /parcel no.: New residential - single or multi- fnmily dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
Install fire Alarm Circuit 1000 sq, R. or less $ 145.15 ` 4
E'1. Add 500 sq. ft or portion $ 33.40 I
L .PROPERTY OWNER 1 LI TENANT Limited energy residential
31 ft (with above sq. R.) 3 75.00 2
Name:
ex Limited energy, multi - family
Address: v residential (with above sq. R) 5 75.00 2
dVW / w ixn/rrl VIZ Service or feeders Installation, alteration, and/or relocation
200 amps or less 5 60.30 2
City/5tatc/ZlP:
f � 7 201 amps to 400 amps S 106,85 2
Phonc: Fax: / 148'
may-. 401 amps t0 600 amps
$ 160.60 2
601 amps to 1000 amps 5 240.60 2
Owner Installatlon: This installation is being made on p that i own which is not Over 1000 amps or volts 3 45 2
intended for Ralc, lease, rent nr exchange, according to ORS 447. 449, 670. and 701 Temporary services or feeders installation, alteration, and /or
Owner signature: Date: relocation
200 amps or less 5 66.85 1
LF APPLICANT 1 u CONTACT PERSON 201 amps to 400 amps 5 100.30 2
RusinCSS Name 401 amps to 600 amps S 133.75 2
Branch circuits • • new, alteration, or extension, per panel
Contact name: A, Fee for branch circuits with
service or feeder fee, each
Address: branch circuit S 6.65 2
9. Fee Co r branch circuits
CilyfStalCJ /IP; without service or feeder fee,
first branch circuit 5 46.85 2
Phone: Fax;
Each additional brunch circuit; 5 6.65 2
Miscellaneous (service or feeder not included)
E-mail: Each manufactured or modular
CONTRACTOR. dwelling, service and or feeder 5 90.90 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only 5 66.85 2
Pump or irrisation circle 5 53.40 2
Contact name: Sign or outline I 1ting S 53.40 2
Signal circuit(s) or limited-
Address: 11401 NE MARX ST. energy panel, alterations. or
extension, Describe: I Page 2 75.00 2
City/State/ZiP: PORTLAND, OR 97220.1041 Fire Alarm Circuit
Each additional inspection over allowable In any of the above
Phonc: 503. 255.9488 Fax; 503.257.7121 Per inspection 3 62.50
investigation per hour (1 hr min) 1 62.50
CCB Lic.: 48748 IElcctrical Lic.: 26.496C uprv. 65-5 Industrial plant per hour s 73.75
Suprv. Electrician signature, required; ELECTRICAL PERMIT FEES"
Subtotal 3 75.00
Print Names RICHARD MARTIN tc: x 10/21/ Plan review (25% of permit fee)
/�(�� Su surcharge ( 12% of n fee
signature:
permit ) S 9.OD
Authorised
TOTAL PERMIT FEE 9 84.00
Print Name: RICHARD MARTIN Date: 10/21/08 Thbpermlt applteannn aprra if o per/1300i eel MWAISN I WIlhln 180
days after It hna been accepted at complete.
• Number of inspections per permit allowed,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008- 00300
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: - 10/22000B
Phone: (503) 639 -4171 � u�d4p I�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/28/2008 TIME: 7:O1AM PAGE: 18
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Low voltage for fire alarm.
OWNER: PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 255 -FM88
Inspection Request Scheduled For: Date: 10/28/2008 Pour Time:
Code # Inspection Description C-onfiirm' # Contact # Message
135 Low voltage 077256 -01 , 971- 506 -2982 N
� N) Corrections/Comments/Instructions:
9 7A , 601)-0 - ijori - c/csot riM.
F,13.(Ac
V
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G's' NOG L Date: 1 2 Oi Phone #: (503) 718 - Ziff0