Permit p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00059
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2011
Parcel: 2S102CB01802
Jurisdiction: Tigard
Site address: 13407 SW PACIFIC HWY
Project: AutoZone Subdivision: Lot: 0
Project Description: Security system.
Contractor: 3 GUYS ELECTRIC LLC Owner: BAR -AM, LLC
2062 NW 15TH CT BY GODFATHER'S PIZZA
GRESHAM, OR 97030 1416 THIRD AVE
SEATTLE WA, 98
PHONE: 503 - 729 -1522 PHONE:
FAX: 503 - 661 -7378
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/11/2011 $75.00
12% State Surcharge - Electrical 03/11/2011 $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: 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 $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 Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtai - • • of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .. = tl Permittee Signature: —
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.
Mar 11 11 10: 1Ga mult. county urtti attorney (5031 988-3377 p . 2
Electrical Permit Application 14)p, orru r. 1 sr u1N1 \
City of Tigard lieceived iiirm ,,,,, i _ . N .
1 ' Dote/B 3 : ii Maid 0..
iii 44 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C
Phone; 503.718.2439 Fax: 503.598.1960 Date/11 ! Other Permi(: g i.... ,, , • -00161
kL)
Inapet;tivit Liue: 503,639.4175 , , ' _ Dale lleudy/By: lurk: ti1 sec Page 2 for
Tit.7;A
Internet: www.tigard-or . - . C:ili t ! •
gov C t Y '.• -. Notified/Malted, — Erel7 Supplemental Information
. i..
TY0;,9F)V :1 ':::';'".... " ''...' . '' ..; •:: ... . , .:' . .. 1 '::' .: :::;: .: :‘"'11.N:%ki00;,;.:.:4" . :.::.:Mi.1.:::.:::;':'..
lE New construction 0 Addition/alteration/replacement Please check at that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 (Wilding ever i Mat storita.
0 Demolition 0 Other;
where the available fault current 0 Mannm and boatyards.
csecuilx i gone 2111114 it ISO volts w I:1 Floating boatlings.
':.:. .. ..\:.‘.“....,' :..l. ..., ' . ...";cAMORY•Or .C.ONSIRI.ICTION:::.3::.!:;.;.;: -::..:' 2 .....' ••':...".•.': • :.
less to ground. or exceeds 14,000 0 Commereial wieuItural
El 1 - and 2-fiunily dwelling E) Commercial/industrial 0 Accessory building amps for all other installations. buildioas.
121 Multi-family 0 Master builder 0 Other; 0 Fire pump. 0 Installation of 75 KVA or
loger separately de, 4,1 spawn.
7 ' '',..',:.::: ..: ,.• .' ' JOB' srrE.••*06 • ' ': tf.si'"'•' • . • ..::'...:':•• : 0 Pm Addition of now motor load f
In "A", "F." "l-2,"l-3",
100HP or more. occupancy.
Job no.; Job site address! 341 . SW Pacific Hwy
six or more residential units. 0 RaartatiOnal Wattle parks.
City/State/ZIP: Tigard, OR 011eolth-cskre 111.ititioe. 0 Supply Yehaite ror more thao
------__. 0 Halart.talls location. 600 volts nominal,
Suite/bldg./apt. no.: Project name: Autozone 1:1Service or feeder 600 amps or mart.
"" ••••••"...• .., o• . . ::::......7.:•::: . 0,•„/••••••:•••.
Cross street/directions to job site:
isusrlauou ....
" TO
...
New residential single- or multi-family dwelling unit.
Includes attached garage.
.__.
Subdivision: Lot no.: 1,000 sq. It. or less 168 54 • 4 ,
Ea. addl 500 sq. ft. or portion 33.92
— 1
Tax map/parcel no.:
Limited energy, residential
75.00 2
....-: . • .. ' .,::' '. • '.' : ' • .. „ DE§CR1PTIbil:Ittk..W.O.K •' ',: ' ;',.":',!,...:). :, .......": :.,...; . :.!::::-:;::.4.,... (Nyith abo sq. ti
Limited energy.. multi family
75.00 2
Install one (I) anti pedestal, residential (with above sq. it)
. - — Services or feeders installation, alteration, and/or relocation
200 amps or less 1 00.70 2
''?..?..".. 11 1 1 °PERTIr 9V.SE1 ' . '. ...:' ".. .,.'...'.... ;',.;...''''q Is .;!TEINAiS ''''' ''' ' '' ' ' . 201 amps to 400 amps 13356 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address:
Over i ,000 amps or volts 552.26 2
Temporary services or feeders installation lteration, and/or
Cily/Slatc/ZIP:
,..... relocation
. . -
Phone; ( ) Fax: ( ) 200 amps or leSS
59,36 ;
201 amps to aoo amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 anti to 599 amps . 168.54 2 -
Branch circuits - new, alteration, or extension, per Impel
nwner signature! .
... Date: A. Fee for branch circuits with
-77- . • • .,.' • 1. .. " '.. ,' '. " ------- above service ur fcedor 42 fee
• ..:,....• ........ „•••:.,••• ••El • •••• f•'.. ; ....:...a •PERSQN• ':., .• .• ,.., , 7. 2
- • • " --- , ! ........;;;L each branch circuit
Business name: 3 Guys Electric, LLC B. Fee for branch circuits without _
. — service or feeder lee, film
56.18 2
Contact name: Wade Hadley branch circuit
Each add'l br,mel...._3_
Address: 2062 NW 15th Court
- ---
Miscellaneous (service Or feede not included)
Each manufactured or modular
City/State/ZiP: Gresham, OR 97030 67,84 2
dwelling, service and/or feeder
Phone: (503) 729-1522 Fax: : (503) 661 Reconnect only 67.84 2
— . • .— Pump ut it s iga(ion circle 67.84 2
L-mail: Wade.igUys@gmaikeota
Sign or out ine lighting 67,84 7
**** 7 ' r • :' '''. . •77 signal Circuit) or .
limiled 1 75.00
Business name: 3 Guys Electric, LLC panel, alteration. or extension. _ Pago 7 2
_ Each additional inspection over allowable in any of the abov
Address: 2062 NW 15th Court Additional inspection (1 ht min) 66.25/ hr
—
- - ,
Investigation (1 hr min) 66.25/ hr
City/State/LIP: Gresham, OR 97030
- Industrial plant () hr min) 78.18/ hr
Phone: (503) 729 Fax: (503) 661 Inspections for which is 9 ........ ' '
u ull/ nr
speciireally listed (I4 hr min) .
Cal Lie.: 177242 Electrical Lie .: CIF,120 Suprv. Lic.: 5161EA • •:•:•••,:•",..'::••:',TELECMICAL •OE'RafITAtrEE.V.:*1'..F:`Y'le,
Subtotal:
Suprv. Electrician signature, required: 11 tj oti l .A. H,,,,,„1,1,.. .
Plan review (25% of ()m 75.00 fee):
Print name: Vinton Wade Hadley Dale: 3 _____ State surcharge (12% ofpermit fee): 9 00
- ,____.
TOTAL PERMIT FEE: 84.00
Authorized signature: 4
1 .---,----,-----
This permit application expires if a permit is not obtained within 180
days after it has been 11Cettplci as complain
Print name: Jane Hada Daft= 3/11/11 • Numbel ur map:miens allowed per permit.
1:usuiiihropermunKtc-PermiiAppeo0 (memo 440-1615Tir HOKUM/WEB
Mar 11 11 10:16a mult. count attorney (5031688 -3377 p
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORD ONLX.
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ I Iearing, Ventilation and Air Conditioning System*
fl Vacuum Systcms*
❑ Other;
COMMERCIAL WORK ONLX c i
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
E Boiler Controls
❑ Clucic Systems
❑ Data Telecoimnunication Installation
❑ 1 Alarm Installation
❑ HVAC
❑ Insuvmentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
• Other Anti -"heft Ped. Is71sta11
Total nun-iber of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
PV wdin .;_1'vimilApp.d 07 /01/10