Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
` •• ' COMMUNITY DEVELOPMENT Permit #: ELR2011 -00102
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/06/2011
I
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: Lot: 0
Project Description: Low voltage for first alert alarm system.
Contractor: ALLIED FIRE & SECURITY Owner: PACIFIC REALTY ASSOCIATES
530 NE COUCH ST 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97232 PORTLAND, OR 97224
PHONE: 503 - 231 -9550 PHONE: 503 - 624 - 6300
FAX: 503 - 231 -9551
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/06/2011 $75.00
12% State Surcharge - Electrical 05/06/2011 $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 throu 2- 001 -0r • • Yo may obtain a copy of the rules or direct questions to OUNC by calling 503. 32.1987 or 1.800.332.2344.
Issued By: \ A. — / • ", / � . Permittee Signatur 41—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.
05- 06 —'11 12:19 FROM— T -055 P0001/0003 F -640
Electrical Permit Application FOR OFFICE I. (NL,
City of Tigard Received, S i Permit No.: eh � -
13125 S W Hall Blvd., Ti ard, OR 97223 Date /B : Q Q� !�
�~ g �� Plan Review
I • Phone: 503.7182439 Fax: 503.598.1960 ra Date/8 : Other Per � A ge/ S
'f I c:, A I? i) InspCCUon Line: 503.639.4175 • C 0, Date Ready /By: leas: El See Page 2 for ■ Internet: www.tigard- or,gov `/ a ') \'• Notified/Method: Supplemental Information • ^i "L ~ ,.� � ''v'y '� h` ha'9 0, ' ITf vr-n } Ji� , 4 , • tl ' 4 ^sc2`i-; \? .,
h i 1 e ai i
Y ' ' 2t ,•, . , .,,n '., ;
❑ New construction ® Addition/alteration/repi emt s -` Please check all that apply (submit 2 seta of plans w /items checked below):
❑ Demolition ❑Other:
O � Q Service or feeder 400 amps or more 0 Building over three stories.
`�4 where the available fault current ❑ Marinas and boatyards.
4 4 v ` ' yam , j j u w '" r 'r< ; "+a e fi amps at volts or Floating building*,
'4 1 4 ' . . , �.�� M Q + .1r 1 -0 ... �, ,k`F„ 3 � i ;. :;'Mti. '
' ;r: e. . exceeds 10,000 am 150 l ❑ P
. �,,, . P ng
` a
'� less to ground- or exceeds 14,000 ❑ Commercial-me agricultural El 1- and 2 - family dwelling ® Commercial /industrial i Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
hJ n � �y �,,/•+•, atil �-• 77- ❑ Emergency system. larger separately derived system. •
` i i0 0 ,2•°+7 {�,y 6 1,4 t° ,.,, � �S'.a'6k t t s ''' ; ', "' ' ❑Addirionof new motor load of ❑ ., ° ° -3
– Job no.: 110505 -38 1 Job site address: 15055 SW Sequoia Prkwy 100HP or more. occu a
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97224 ❑ Health -cam facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bidg, /apt. no.: 130 I Project name: Yecuris - Alarm Install 0 Service or feeder 600 amps or more.
'
Cross street/directions to job site: , r '. PirW, >., , jr. /.
a Description Qty. I Fee. I Total I
"' .. New residential single- or multi - family dwelling unit.
Includes attached garage,
Subdivision: I Lot no.: 1,000 sq. ft. or less _ 168.54 4
Ea. add°I 500 sq. ft. or portion 33.92 1
Tax map /parcel no,
Limited energy, residential 75.00 2
r 1 �
h (with above s ft.)
+7;zs'` ns „r :, Limited energy. multi- family •
75.00 2
Provide and install first alert alarm system residential (with above sq. ft.) ,
•
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
,•'MrT :. � , ' ° Q •.':, 't .. ,, ; :r •', , • .::m,•' ! ' rt •, i s' 201 amps to 400 amps 133.56 2 •
401 amps to 600 antps 200.34 2 -
Name: Gordon Brown 601 amps to 1,000 amps 301.04 2
Address: 15055 SW Sequoia Parkway Over 1,000 amps or volts 552.26 2
•
City / State/ZIP: Tigard, OR 97224 Temporary services of feeders installation, alteration, and/or
relocation
Phone: (541)510 -2031 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Tiranch circuits – new, alteration, or extension, per panel
Owner signature: ( Date: A. Fee for branch circuits with •
'r' a3,Y `,i.i ! =' y tO ) Y .; ., v t x l Y li T E.4 . 1 r , t e. 4 e above service or feeder fee. 7,42 2 •
each branch CirCtlit
Business name; Allied Fire & Security B. F ee for branch circuits without _
service or feeder fee, first
56.18
Contact name: Lauren • branch circuit
Each add °1 branch circuit 7,42 2
Address: 530 NE Couch ST Miscellaneous (service or feeder not included) _
Each manufactured or modular
City /State/ZIP: Portland, OR 97232 , dwelling, service and/or feeder 67.84 I
Phone: (503) 972 -4136 Fax: : (503) 231 -9551 Reconnect only 67.84 l 2
Pump or irrigation circle 67.84 2
Email LNIrotek@Allied-Security.com Sign or outline lighting 67.84 2 –
� "' a,-,. >4 ` z r ; .i , . �r :, ,. ; a Z.,- e ' , t + '^ ` a a . �, ...‘ A. S c or limited
Business name: Allied Fire & Security panel, alteration, or extension. 1 P age 2 75,00 2
Each additional inspection over allowable in any of the above
• Address: 530 NE Couch St Additional inspection (1 hr min) _ 66.25/ hr
Investigation (i hr min) 66.25/ hr
` City /State/ZIP: Portland, OR 97232
Industrial plant (1 hr min) 78.181 hr
Phone: (503) 972 - 4136 Fax: (503) 231 - 9551 ` Inspections for which no fee is
/e /ill s • cificall listed (1/2 hr min) 90.00/ hr •
CCB Lic.: 64465 Electrical Lic.: ..,2q j ...Suprv, Lic.: 4398LEA + .' ii, .. 1 ; • e tt,2 T;," ±; e w.
Subtotal: 75.0
Suprv. Electrician signature, required; � _ Plan review (25% of permit fee):
•
Print name: Toy Cora Date: 05/06/11 State surcharge (12% of permit fee): 9.00
//1.11d
— TOTAL PERMIT FEE: 84.00
AUthOrized Signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name; Lauren Mrotek Date; 05/06/11 + Number of inspections allowed per permit.
1;\ BuilOiugwecmiti12L .C- PernutApp.dor 07/0V1O 440"46rsT0 uos/COM/Wion
05- 06 -'11 12:19 FROM- T -055 P0002/0003 F -640
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n 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
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
■. Other T,imited FRnergy Panel
Total number of commercial systems! 1
"No licenses are required. Licenses are required
for all other installations
I:1 DuildingWermililELCPennit npp.doe 07/01 /10