Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00218
T,IGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/25/2007
PARCEL: 2 S 115AA -00100
SITE ADDRESS: 16100 SW 108TH AVE ZONING: R -25
SUBDIVISION: DURHAM PARK APARTMENTS LOT: 036 JURISDICTION: TIG
PROJECT: BRIGHTWATERS AT REDHAWK
Project Description: Protective signal /burglar 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: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
DURHAM PARK LTD PTNRSHP PHILLIPS ELECTRONICS
1525 SW PARK AVE SUITE 200 1110 NW FLANDERS
PORTLAND, OR 97205 PORTLAND, OR 97209
Phone: Contact #: FAX 503 227 - 4992
PRI 503- 222 -5083
FEES Reg #: ELE 26- 213CLE
LIC 125364
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 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: 4A A l c i iA4L. Permittee Signature: tr 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'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.
I
Elettrical Permit ApRiVteipc N / E �j� /f : FOR OFFICE USE ONLY ' -
City of Tigard [, DateBy'C e�, /� I) 5 Permit No. L /t 7" Dep./ 1
j/
13125 SW Hall Blvd., Tigard, OR 97223 jUil 1 I 6 2007 Plan Rev' - w l
Phone: 503.639.4171 Fax: 503.598.1960 � t I 1I ' i DDate/By: Other Peen r. •
Inspection Line: 503.639.4175 CITY OF TIGAR -,410.1- " ' Date Ready /By: Juri H See Page 2 for
Internet: www.ci.tigard.or.us EOM rnNG DIVISION Notified/Method: 1 Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ty Addition /alteration/replacement Please check all that apply:
Service over 225 amps, comm'l EHazardous location
❑ Demolition ❑ Other:
EService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling [g Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ['Master builder El Other:
Building over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons 1=1 Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
❑Health -care facility ['Other:
Job no.: Job site address: / � /t ? ,�` ,� Submit 2 sets of plans with any of the above.
City /State /ZIP: - 1--C,9 CL�C. L D,,,, 7 722-4 1 /T" — The above are not applicable to temporary construction service.
��"� / I FEE* SCHEDULE
Suite/bldg - /apt- no.: Project name.F, tttev GCY k�Nt�tk�e(u6 4oC<S I Qty. Fee. Total *,
- Description
Cross street/directions to job site: � _ h � R „,P U New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 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
a ( � ���- /4 GG 'CZ' F dwelling, service and/or feeder 90.90 2
/� � Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER El 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 ❑ 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: ( ) 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
/—� extension. Describe: ' Page 2 75� 2
Business name: pt �1(�' tie ucb.,S
Address: Co /f Each additional inspection over allowable in any of the above
� Per inspection 62.50
City/State /ZIP: )! _ iicA ✓ d t /9v,. t 7. Q 47 Investigation per hour (1 hr min) 62.50
Phone: (3) 22 Fax: (Sr. ) 22 ? -17G7 q2._ Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic -:1 25-26 q- Electrical Lic -:26 2a' - SL Lic.: Subtotal 76-
Suprv. Electrician signature, required: ' ,•D Plan review (25% of permit fee)
Print name: ��` f ` �� Date: ��4�� State surcharge (8% of permit fee) (�
/ rT (
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
— days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri -County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PeimitApp.doc 12/03 440- 4615T(10/02/COM /WEB
A •
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
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260) •
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
I I Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n M edical
n N urse 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 04/03
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2007.00218
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2Ei2007
Phone: (503) 639 -4171 "Viii���
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/16/2007 TIME: 7:01A1M1 PAGE: 56
SITE ADDRESS: 16100 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DURHAM PARK APARTMENTS LOT #: 036 TYPE OF USE:
PROJECT NAME: ORIGHTWATERS AT REDHA\M(
DESCRIPTION: Protective signal /burglar alarm.
OWNER: DURHAM PARK LTD PTNPSHP, PHONE #:
CONTRACTOR: PHILLIPS ELECTRONICS PHONE #: 5p3222 -5083
Inspection Request Scheduled For: Date: 10/16/2007 Pour Time:
Code # Inspection Description onfirm # Contact # Message
13 5 Low voltage 057656 -01 503.222 -5083 N
Corrections /Comments/ Instructions:
("'_
PASS Li PARTIAL APPROVAL CANCEL ❑ NO ACCESS
FAIL — CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: a i' W VC Date: 101 t go Phone #: (503) 718- VA