Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00029
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2011
Parcel: 1 S135BB00500
Jurisdiction: Tigard
Site address: 10355 SW CASCADE AVE
Project: Fisherman's Marine & Outdoor Subdivision: Lot: 0
Project Description: Security and CCTV systems.
Contractor: GUARDIAN SYSTEMS Owner: RAM /CASCADE CENTER LLC
13500 SW PACIFIC HWY BY ELLIOTT ASSOCIATES INC
STE 245 901 NE GLISAN ST
PORTLAND, OR 97223 PORTLAND, OR 97232
PHONE: 503 - 639 -3723 PHONE:
FAX: 503 - 624 -8258
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/07/2011 $150.00
12% State Surcharge - Electrical 02/07/2011 $18.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: N Boiler Controls: N
CCTV: Y Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: Y Other: N Total $168.00
Other Desc: Required Items and Reports (Conditions)
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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
lIP
Issued By: Permee Signature /
j' itt
/
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 the next available inspection date.
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.
Sent By: GSNW; 5036248258; Feb-4-11 4:22PM; Page 1/3
Electrical Permit
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..... .
Application
RECEI v i,,,, Received tfirl l( i I '',1 ON 1.'0
•
City of Tigard , :: Date/By: 0 • Ju FCnilit NO.:
l ig ---- '!ii: 13125 SW Hall Blvd., OR 97223 4 _ _ Plan eview Other . Wir
': i Phone: 503.7182439 Tigard, 503.598.1960 FEB 4 201! :1 Date/ Permit
j . , ,, „„ ,-; Inspection I.,ine: 503.639.4175 ate Rcady/13y: ii,As, 7. Svc higc z Far
'
' ' :' Internet: www.tigard-or.gov CITY OF TIGA'Ab N D otified/1M ethod , 5..U6 Supolementai tof■!rination
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,":i7AIMMilILI :pis,'iiirfirri'PWV ri , ! , 4. ;„ii,l; i r,j tato ,, k•;: , ,i IF : 1:': ::;• i ::•, • ;:ipoto ..'l 7#'7971. ,;, ,, ,n , ytp: , :iiiiiiiit :ill'
! ■ IM ' EltuilitioitutliAel'; ui,./1 ic, r[11,Ato ,, e i,it,,.''' ; ;'-, (4.! g •• • 444 . I .. , , r I*, • U u t , ou l l '41Uliuk • : , • I,:iftl . •
Please check nil Mai apply (submit 1 seta of plam wiitems checked below)
0 New 00EISITUCIIOn 0 Addition/alteration/replacement .,: n Service i feeder 400 amps or more 0 Building over tau stories.
0 Demolition 0 Other: , where the availuhle fault current IZI Marinas and boatyards.
• '.iVii : liAl; I.: RIP nlzrlrrk2mniwair4 B::: l ';', ::,::w;',I NI excc.d.10,CHX1 mops al. 150 v011& Of 0 'Floating building&
• : ' • ' •Ilf • ,'31.I' " , I .•:'' • ••,,' ecie t 0 ' ' t h LIll ' ' V . ft :,' ' !! . • , ' ' : :"" "1 7•%; • I I' 1..510 ground. or exceeds 14,000 in
0 Cemerciol-uae alp icultural
El I- and 24amily dwelling 7: Conuncreial/indastrint El Aceass00 bui ,;■■ lding goirp tiff all other installations. buildings.
0 MUlli-l*mily D Master builder 0 Other: ;:;,: 1:1Fire pump. 0 Installation of 75 KVA or
• , r .....•..,,a., ,•,.; • i.... ..,..„..;•.., rim mewoo, , Nowa im le Stri915111,1YrianalWilllieralimilletiMere= ...•; , >iNilli.:LII:d:'ill! •: 1 : 1/4 ' 1 7g," c Y 5Y9Itcul• huger separately derived system
a 1. 141 i!iici:' LtiAllaMli .11ilikilidgaltil'Agiti6101,QiiiiliAWIMN.+#0.,;.!! r D Addition anew motor load of ID "A", "E", "1-2",
Job no : Job site address : kb 0 6 & % a S LA) 616e0,12_ 1St • 100HF or more
0 six ur mum rosidentint unitx. occupancy.
Recrmilionfll vehicle parks.
- •" "" -
City/State/ZIP: 1110jy CA 4144 , 0)4 fat 0 Supply voltage for more than
0 Hazardous locutions. 600 volts nominal.
-.. ,.,.
Suitc/bIdg./upt. no.: Project name: cit An .. 447.ng, 0 service et feeder 600 snips Of inOfe.
_..,.- r7 41, MINfifilli ,i!!!1!';',',., 1' .!!',.
Cross street/directions to job Site: ,,, Dworman -
:::
„.
New residential singIe- or multi-family dwelling unit.
includes attached garage.
Subdivision: no.: ( poo sq. 11. or leas II 168.54 11111 4
tg" t
- ... Ea. addi 500 sq, ft. Or portion 33.92 1
Tax map/parcel no.; Lim
,.-
ited energy. residential Mil 75.00 2
' 0 I : .4 !...: i l•!• : • • • ' ;.•0111111=7111711 1 .1 1 203CIFII2.31Elnit4 . !11: ' above '
Limited energy, multi-family III 75.00 2
eCcau41-. 4 0 ayr‘ .QA: S .::::.. residential (with above sq. tt.)
) : : - Services fir feeders installation, alteration, and/or relocatinn
*'::
200 amps or less r--- 100.70 2
.: ' i .4i:N•1 • l ,rail • -• ; j . •1:;.' . 1.1t !•!:. Hili 1111§111814K qlt I.i'• 0.1.;i:' filiitilitr di 201 amps to 4(X) snaps 133.56 2
4 ■ '.du 1i Mat I ' u ill ' : a; :".. '7. ' .:,.. • lallfell0f, . • , 1 441A , -r . 0 .? , '274. ,.; , .., - .• . .. , -
H: 401 amps to 600 amps 200.34 2
Name; . i
.... ......._4. 601 amps to 1,000 amps
-.- . 301.04 2
Address: . i'. Over 1,000 mnpa or volts 552.26 2
City/State/ZIP: - Temporary services or feeders installadon, alteration, and/or
relocation
Phone: ( : ) [ ( ) •
, :: 200 amps or less - 59.36 , 1
201 amiss to 400 amps 125.08 2
Owner installation: This instialilion is being made on property that i 4* which is nut 0 ..,
1 amps to 599 amps 168 ,54 2
intended for salc, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 4
i:
Branch cirealla- new, alteration, or extension, r panel .
Owner signature: Date; :3, A. Fee for branch circuits with
lee .,,, ,•mmiornumffemr i 1 , ;EEL *iv ;,,,.. , ,,•■•,-..!:.a. , , 'r' !1: , , :''""'•''''''I'rq.12 NI bove service or feeder ,
ter 41110.13llilAgg'4V'''''''''','" r E
'''''' ''' 1111' Ay a h • • ' 742 2
Business name: A. Fee for branch circuits wideour
service or feeder fee. fiffit 56,1 ft 2
Contact naine! branch circuit ...
-,.. ---ti.+7 Each add'lbranch circuit 7.42 2
. .... - --
Address: : :::1: Miseellineous Iservice or feeder not ineluded)
.-.,..... . H' ...
City /State/ ZIP: i'i, ----' Each dwellin manufactured or mod , service and/or &oular 6714 2
--.- -----4. der
1.:: Reconnect only 67.84 2
Phone: ( : ) Fax! .. ( ) ....,,
.. Pump or irrigation circle 67.84 2
E-mail: .. ,.
i.4,. . Sign Of oudinc lighting 67.84 2
III,JiAll..,,. 1 i ' ■ ij '''''
...P.ac.::.0. sig..' Ci•19 or limited-y=1W _--
-74 .--
flusinessniuZ C
panel, alteration, or extens ‘ P age age 2 150 2 -
• Each additional inspection over allowable in any of the above
.... .
Address: ft
__ -4v,.i: _ ..._ E Additional inspectirm (1 hr min) 66.25/ hr
City/State/ZIP
.,
7 ,. n . IP: RjeAtarCP_ . . c",. ___ .3 ..- Investigation (1 hr mm) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hi
...
..,,'" .....,
Ilio r_ 4 Fax () tiaLtS? Inapectirms for which no fee is -
90.00/ hr
speeiliCallasted 4 hr rr,t, i7!
COB I .ic.:53,0g3 Electrical Lie.: 3 tet... Suprv. 14: - 1,t) CI LER FrONAVAIt ,;'!' -:(4,,,l;; ,';:.,',1111r;:1::
• , .
Suprv. Electrician signature, required: . Subtotal: k ,o.o•
„- .. Plan review (25% of permit fix): CI' . 6 '• L' ' 1
•
ir !VI
Print name; ‘04,4Ane Pv Wk 132, Date: c i i ::-.,.,:4- t 1 State surcharge (12% of permit Gze):
i. 101AL PERIvfiT FEE' i , 1 $010
I Authorized signature: • .1: --- rhi. permit application expires' if a permit is sot obtained nithin Ian
, ,
),
Print name days after it has been accepted as complete
ate: .
: D 0,
• Number or invectioin allowed per pennit
. . 1 1:
1AiluildingNierzair4LC-Pci lull App ate 0 7/01/10 ' 4404615To ims/commas
. r.i.
Sent By: GSNW; 5036248258; Feb -4 -11 4:23PM; Page 2/3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
1 001 :10 . 1 4MOWV,4500NtYiNLIOgljElliEltilinl III
Fee for 1l residential systems combined $75.00?
Check Type of Work Involved:
❑ Audio and Stereo Systems*
B urglar Alarm
❑ C�nragc Door Opener*
❑ Heating, Ven tllat.iori and Air Conditioning System*
❑ Vacuum Systems*
❑ Other;
Fee for each commercial $75.00
system
(SEN. OAR 918 -309- 0000)
Check Type of Work Involved;
❑ Audio and Stcrco Systems
❑ &iilcr Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ mike Alarm Installation
▪ FWAC
El Instrumentation
❑ Intercom and Paging Systems
Li Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
12n'rotective Signaling
❑V " Other Cw.- ;~ S
Tr; number cif commercial s C.
No licenses are required. Licenses are required
for all other installations
I . vion,n g \Pe,,; lk..t.( -P.' App noC 417/111nn