Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00045
Date Issued: 02/24/2011
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.718. a$ Parcel: 2S113AB00600
0.1 / Jurisdiction: TIGARD
Site address: 16125 SW 72ND AVE
Project: Pactrust Building B Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Fire alarm. 3/2/11, reprinted to correct address from 16150 SW 72nd Ave to 16125 SW 72nd Ave.
Contractor: STANLEY SECURITY SOLUTIONS INC Owner: PACIFIC REALTY ASSOCIATES
7107 NE 148TH CT 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98682 PORTLAND, OR 97224
PHONE: 317- 806 -3749 PHONE: 503 - 624 -6300
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/24/2011 $75.00
12% State Surcharge - Electrical 02/24/2011 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: Y
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issue ub'ect 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 ordance with pproved 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. AT NTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatioi - ter. Those rules are set forth in OAR
952 -001 010 throu•h OAR 952-001-0:•0. ou may obtain a copy of the rules or direct questions to OUNC • -. .1e•,: 32.1987 or 1.800.332.2344.
1 �
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Issu By: �t �� � ���/ i Permittee Signa C
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.
1 111111 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00045
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/24/2011
Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16150 SW 72ND AVE
Project: Pactrust Building B Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Fire alarm.
Contractor: STANLEY SECURITY SOLUTIONS INC Owner: PACIFIC REALTY ASSOCIATES
7107 NE 148TH CT 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98682 PORTLAND, OR 97224
PHONE: 317- 806 -3749 PHONE: 503 - 624 -6300
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/24/2011 $75.00
12% State Surcharge - Electrical 02/24/2011 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: Y
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
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 Cente Those rules are set forth in OAR
952 - 001 -0010 through OA: • ° - 001 -0090. You may or - • • • . rule r direct questions to OUNC by calling 503.232.1' • • 1.80. - .2344.
Issued By: L _ i _ Permittee Signature: _
`w Or —
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.
Electrical Permit Application FOR OFFICE USE ONLY
• City of Tigard Received
(37-7-*"' Permit No.:
's 13 125 SW Hall Blvd., Tigard, OR 97223 \,\‘ DateBy: ?/,} j I t F . - 1 .,.. . )Oil _0304
g Plan Review
t 4. 3 � � Other Permit 90//""" LX,>tj1-3
Phone: 503.639.4171 Fax: 503.598.1960 D ateBy:
TIGARD Inspection Line: 503.639.4175 • - :'s. Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard- or.gov , i •,?.'` -1 , Notified/Method: Supplemental Information
_..T ria . w. ..ssaat�,,w o - . ..-.z
TYPE OF WORK P.;: * ., '� E. ,,
❑ New construction ® Addition/alteration/repl: ment Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEG ® ' CONSTRUCTION a exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
'" '" less to ground, or exceeds 14,000 ❑ Commerc -use agricultural
�� cultural
El 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
❑ Emergency system. larger separately derived system.
�t; JOB SITE INFORMATION AND LOCATION `
• .. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "1 - 3 ",
Job no.: Job site address: 16150 SW UPP ONES FERRY RD 1°°}1P or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: PORTLAND, OREGON 97224
7).- ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: PACTRUST BLDG B ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: nescriptton Qty. Fee. ` Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
INSTALL AFA PANEL, CONNECT TO EXISTING RISERS Limited energy, multi -family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
Z PROPERTY OWNER ° ; -; - ;, ❑ TENANT 201 amps to 400 amps 106.85 2
Name: PACIFIC REALITY ASSOCIATES 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 15350 SW SEQUOIA PARKWAY Over 1,000 amps or volts 454.65 2
City /State /ZIP: PORTLAND, OREGON 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)624 -6300 Fax: (503)624 -7755 200 amps or less 66.85 l
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, r panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT . ; ' ` ❑ CONTACT PERSON '''' '' • '' above service or feeder fee,
b " 6.65 2
each branch circuit
Business name: STANLEY SECURITY SOLUTIONS B. Fee for branch circuits
Contact name: GARY TAUSCHER without service or feeder fee, 46.85 2
first branch circuit
Address: 15495 SW SEQUOIA PARKWAY Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: PORTLAND, OREGON 97224 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 968 - 3355 Fax: : (503) 968 -3398 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACT , r z, , „ }raj ,.., , I Sign or outline lighting 53.40 2
Business name: STANLEY SECURITY SOLUTIONS Signal circuit(s) or limited -
energy panel, alteration, or
Address: 15495 SW SEQUOIA PARKWAY extension. Describe: • I Page 2i 2
• City /State /ZIP: PORTLAND, OREGON 97224 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 968 -3355 Fax: (503) 968 - 3398 Investigation per hour (1 hr min) 62.50
CCB Lic.: 161567 Electrical Lic.: 37 -1054C Suprv. Lie.: Industrial plant per hour 73.75
Suprv. Electrician signature, required: Subtotal: i S %� *tA - --
Print name: STEVE MOREHOUSE Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): `�
Authorized signature: _ TOTAL PERMIT FEE: r � ` ' i
This permit application expires if a permit is not obtained within 180
Print name: STEVE SNYDER Date:
days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05 /23/06 440.4615T(I1 /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:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building 'Permits\ELC- PermitApp.doc 03/23/06