Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00217
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/25/2007
PARCEL: 2S 112DC - 00100
SITE ADDRESS: 15605 SW 72ND AVE ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK III LOT: 002 JURISDICTION: TIG
PROJECT: ELYNX
Project Description: Access control.
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: ACCESS CON X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES QUADRANT SECURITY INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 14833
PORTLAND, OR 97224 PORTLAND, OR 97293
Phone: Contact #: PRI 503- 234 -5558
FAX 503- 236 -2322
FEES Reg #: ELE 26- 565CLE
LIC 96806
Description Date Amount
[ELPRMT] ELR Permit 6/25/2007 $75.00
[TAX] 8% State Surcha 6/25/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 o to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 1- 100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: )
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, leas , 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.
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Electrical Permit Au A lit .: `�.1,� rt, it ()Hi( I 1: I l ti t: t ) 1.,
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Received
Ci of Tigard DateB : O n
OA Permit Nom z... 4 . 1 —00 2 47
13125 SW HaII Blvd., Tigard, OR 97223 Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 JUN 221 i _, .44- "'ill # B Date : Other Permit:
Inspection Line: 503.639.4175 : Date ReadyBy: rari See Page 2 for
CITY Internet: www.ci.tigard.or.us CI 14 1 y1 �' 41 Notified/Method: Supplemental Information
� ��f1�� ❑ New construction Ar n la teiation/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling mmercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons El Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
I o f „ C , ) — f\-\ y ❑Health -care facility ❑Other:
Job no.: Job site address: l C� .J vlxJ I ( �l �� Submit 2 sets of plans with any of the above.
City/State/ZIP: 1 C� The above are not applicable to temporary construction service.
Suite/bldgJapt. no.: I Project name: 61.- ( x FEE* SCHEDULE
Description I Qty. I Fen I Total I
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
l /` r \ ` , — CA CrP � dwelling, service and/or feeder 90.90 _ 2
v � V v Services or feeders installation, alteration, and/or relocation
CCD� 200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 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 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
' ❑ APPLICANT I . ' ❑• CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR - energy panel, alteration, or
Business name: V ,� p'a- j - -���� extension. Describe: j Page 2 "25 2
Address: PO L/ � 'mil Each additional inspection over allowable in any of the above
r} Per inspection 62.50
City/ State/ZIP: P�� 0 ) - . q 7 a q 3 Investigation per hour (1 hr min) 62.50
Phone: ( )C'3 ) a 3 L - 55 Fax: ( 5) 3 03c0.--033,Q Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: `1 /w)(n I Electrical Lic.:a� I Suprv. Lic.:335/
Subtotal ---Th O
Suprv. Electrician signature, requited: -- Plan Plan review (25 %ofpermit fee)
Print name: ay) -) TVC-fO -)t°53 l Date: .62 [J>7 State surcharge (8% of permit fee) 4 e 0 . "C)
TOTAL PERMIT FEE \ o CC:).
Authorized signature: ,aei / - This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete
Print name: _ A ,./A A! Date: CQ I`M` 0 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is\ Building \Perniu\ELC- PemtitApp.doc 12/03 440.4615T(10/02/COM/WEB