Loading...
Permit „ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 111 8 CO MMUNITY DEVELOPMENT Permit #: ELR2011-00087 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2011 Parcel: 2S112BA05900 Jurisdiction: Tigard Site address: 14058 SW MILTON CT Project: Transcat Subdivision: Lot: 0 Project Description: Data telecommunications system. Contractor: FIRE PROTECTION SERVICES Owner: GOODHEAD, DAVID & JAN M 5573 SW ARCTIC DR 9846 SW PEPPERTREE LN BEAVERTON, OR 97005 TIGARD, OR 97224 PHONE: 503 - 590 -3732 PHONE: FAX: 503 - 628 -6214 FEES Description Date Amount Specifics: Restricted Energy Permit 04/13/2011 $75.00 12% State Surcharge - Electrical 04 /13/2011 $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: Y 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: 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 Center. Those rules are set forth in OAR 952 - 001 -0010 through O • : 952 001 - 0090. You ma ob , ' - .• • • I e I •r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued Bfr�i /'. / _ — L 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. Rpr 12 2011 4:18PM Fire Prote\ \ on Services 503 628 -6214 p.1 Electrical Permit Application \ p Q��� \Q 1 OIt 011 1( t Ni UNI.I City of Tigard Q \ S Q \� �a`d D � �� Permit No. ; ..:—/A — • 13125 SW Hall Blvd., Tigard,OR I Phone: 503.639.4171 Fax: 503. 60 �‘ qMnirlINIIIIIIIM Other Permit. \, \ - a ate Ready/By: Juri r 0 See Page 2 for 1 16.\.H.13 Inspection Line: 503.639.4175 Internet www.tigard-or.gov \ Notifted/Nletbod '- 7 Sapplemeatal Inf rmadoa t - F 10 � ' " ' T� �' 4 ` I a, L i ', �! nn _ - - i . . ,i ! _ -- r :5 -.... arm: � - - , : . �.. � __ 0 New construction ® Addition /alterati ent 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: .: t C f Is�l ....: it t .. DP` 1� .::,,g,'4,',; ° .... exceed the 0, 00 a amps a at t 150 volts or ❑ Floating bolldrn boatyards. - - — ..met ... -- . , . ..... less to or exceeds 14000 nd, xs , ® Commercialiindustrial ❑ Accessory building for all ❑ Commercial-use ings .st;c�ltarel ❑ 1- and 2- family dwelling ry g amps for il l other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ['Fire pump. JJ Installation of 75 KVA or O F POD ©N A 11t1b A7'1.OL( E ""! . g enc y system. larger separately derived system. . ` = .. ;,..., , .� . . , , ,,/ _..., �. . . — -. r, ..:... t . ❑ Addition of new motor load of ❑ "A "E ", °i - Z", "13 ", Job no.: , Job site address: 14058 SW MILTON COURT 100HP or more. occupancy. ❑ Six or mom residential units. ❑ Recreational vehicle parks. City /State/ZIP: Portland Oregon 97224 ❑ Health -care facilities. 0 Supply vohage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: I Project name: Transcat ❑ Service or feeder 600 amps or more Cross street/directions to job site: oere,i rtioa ( Qtr. I Pa i Total L New residential single- or multi - family dwelling unit. Includes attached garage, Subdivision: J Lot no,: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 ni tl PTiQ1 4t ,fi . Limited energy, residential 75.00 2 ,x':1 .,; .._�.. l.,. ... . ,,,,,, _.... i- (with above sq. R ) Limited energy, multi - family LE - ADD PHONE/DATA CABLE RUNS residential (with above sq. ft) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 .:'s = 0213!rTE.,. . . , E - -s'EN .. 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 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 599 amps _ 133.75 2 Date Branch circuits - new, alteration, or extension, per panel Owner signature �#'� A. Fee for branch circuits with s ,, - - lfta_ft: , d 4ostikt i i ris above service or feeder fee, 6.65 2 �" each branch circuit Business name: FIRE PROTECTION SERVICES, INC. B. Fec for branch circuits Contact name: DAVID M. PHIPPS witho service or feeder fee, 46.85 2 first branch circuit Address: 5573 SW ARCTIC DRIVE Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: BEAVERTON, OR 97005 Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: (503) 590 - 3732 Fax: : (503) 628 -6214 Reconnect only _ 66.85 2 E -mail: phipps @fpsnsv.com Pump or irrigation circle 53.40 2 . 40 2 .: _ �- a - -. , . ":W_. ,.,.la.tf t`= ;�Q� 8,.,� � �, -` _ ,. . " Signor outline lighting 53 Business name: FIRE PROTECTION SERVICES, INC. Signal circuit(s) or limited - energy panel, alteration, or Address: 5573 SW ARCTIC DRIVE extension. Describe: 1 Page 2 75-00 2 City/State /ZIP: BEAVERTON, OR 97005 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 590 -3732 I Fax: (503) 628 -6214 Investigation per hour(! hr min) 62.50 ' CCB Lic.: 154333 Electrical Lic.: 3 I LE Suprv. Lic.: 4120LEA Industrial plant per hour 7 3.75 t ,li: x ;;WW It 18 t " Suprv. Electrician signature, required: ' � ,, -' � . =��I,r, i. � `A Subtotal: ? , cry ` � Plan review (25% permit name: DAVID M. PHIP S ,� Date: 4 -12 -2011 ( Pte" fee): 0.00 ero State surcharge (12 %ofpermit fee): q. Authorized signature: ! "` /'� // TOTAL PERMIT FEE: , Print name: DAVID M. PHIPPS Date: 4 -12 -2011 This permit application expires if a permit is not tied within ISO Jape otter it has bepe accepted as compt • Number of inspections allowed per permit. � 0 - , I:1 Bui46nglPeritib lELC•PertnitApp.doc 0921/06 440 461ST(I1 /051COMIWEB Apr 12 2011 4:18PM Fire Protection Services 503 628 -6214 p.2 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for a 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 rtl iuildingWcmitAELC- PermitRpp,dac 03/23/06