Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
II
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00161
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
. Parcel: 2S 112 DA00800
Jurisdiction: Tigard
Site address: 15115 SW SEQUOIA PKWY 110
Project: Integrated Services Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Low voltage for fire alarm.
Contractor: STANLEY SECURITY SOLUTIONS INC Owner: PACIFIC REALTY ASSOCIATES
15495 SW SEQUOIA PKWY #100 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 968 -3353 PHONE: 503 - 624 -6300
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/30/2011 $75.00
12% State Surcharge - Electrical 06/30/2011 $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 sus.. •• .r more the 180
days. ATTEN : •: Oreg• law re. ' _. you to follow the rules adopted by the Oregon Utility Notification Center. hose r - s are se∎ forth in OAR
952 - 001 -00 . through OAR 952 -01 % ou obtain a copy of the rules or direct questions to OUNC by calling 503.232.198 or .800.33 .2344.
■ ' /�� /
Issued By: f 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.
Electrical Permit Applicatio F OR OFFICE USE ONLY .• r
ciurn Cl ' of Tigard Date/
B Received / . / PennitNo.: " , co op
E:t
1 3125 SW Ball Blvd., T 0_7223' " Plan Review I
I Phone: 503.639.4171 Fax: 503.598) I3 O 2 O 11 Date /By: Other Permit:
TIGARD Inspection Line: 503.639.4175 vV �IVV J Date Ready /By: Juris: 0 See Page 2 for
• Internet: www.tigard-or.gov (� TT�/ T GA Notified/Method: Supplemental Information
2 ,. p' k' . ,` a�l:: D f UD - t ;" ;% i "' `. P� -a rra y s, . - a
:TYPE, I PL =AN
. . �; p_zr � .'st ", a ,., $ .: . � � A , � : . , Amt,, , �. . A
El New construction ® Addition /alteration /replacement 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.
a - "� t "� a s r s` : exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
_ . cA r o Y oF�coy ►tuCT�O '`� "0•.- , � - 7 d 10000 p s g .
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling E Commercial /industrial . ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
i � " : d dOB�`gin " NTORIVIATII O N N LOCAT =ION ?° f ❑ Emergency system. larger separately derived system.
., _< ;_ , @+..,,L:t.,kw ,,,, * �1 4 _ I ❑ Addition of new motor load of ❑ "A", "E", "1-2", "1 -3 ",
Job no.: Job site address: 151150 SW SEQUOIA PARKWAY I Six or or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: PORTLAND, OREGON 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal. •
Suite /bldg. /apt. no.: 110 Project name: PACTRUST ❑ Service or feeder 600 amps or more.
U _S� t? v t ? ,' " FEES S
Cross street/direction's to job site: ,...-7; 1---e ' '( Description I Qty I Fee I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
", DESCRIPTION OF WORK " , vg - (with abov sq. ft.) 75.00 2
INSTALL FIVE HORN STORBES INSTALL FIVE STORBE TO EXISTING Limited energy, multi - family 75.00 2
FIRE SYSTEM residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
• 200 amps or less 80.30 2
®PROPERT OWNER � q 4 z. Tlf 1 ANT T 201 amps to 400 amps .
� ^-�.. „L�erarnn.� �.aer.£t.:+ � �:a� k sw 43 .. _ s..r, �., i k, �f � ���� � �, -
106.85 2
401 amps to 600 amps 160.60 2
Name: PACIFIC REALITY ASSOCIATES 601 amps to 1,000 amps 240.60 2
Address: 15350 SW SEQUOIA PARKWAY Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: PORTLAND, OREGON 97224 relocation
Phone: (503)624 -6300 Fax: (503)624 -7755 200 amps or less . 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, l er panel
Owner signature: Date: A. Fee for branch circuits with
„ } _ MAPPICANT {, "' �CONTACT,PERSnN above service or feeder fee, 6.65 2
�� -k r e each branch circuit
Business name: STANLEY SECURITY SOLUTIONS B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: GARY TAUSCHER first branch circuit
Address: 15495 SW SEQUOIA PARKWAY Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: PORTLAND, OREGON 97224 Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: (503) 968 -3355 Fax: : (503) 968 -3398 Reconnect only 66.85 2 _
E -mail: Pump or irrigation circle 53.40 2
" 4 Sign or outline lighting 53.40 2
ds ti;l;:..�CO�aTRACTOR �„ � � n � _", ��'
Signal circuit(s) or limited -
Business name: STANLEY SECURITY SOLUTIONS energy panel, alteration, or •���
extension. Describe: I Page 2 /J 2
Address: 15495 SW SEQUOIA PARKWAY
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 Lie.: 161567 Electrical Lie.: 37 -1054C Suprv. Lie.:
Industrial plant per hour 73.75 '
-4 E * 2ICAL; W141T FYESk J
Suprv. Electrician signature, required: , f'�i Subtotal: 7, s -
Plan review (25% of permit fee): .-----'-^
Print name: STEVE MO OUSE Date: 06/30/2011
(� State surcharge (12% of permit fee): , 00
Authorized signature: 0 ? 6 V TOTAL PERMIT FEE: isei ,�
VV�� This permit application expires if a permit is not obtained within 180
Print name: GARY TAUSCHER Date: 06/30/2011 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC PermitApp. 05/23/06 440- 46t5T(I1 /05 /COM/WEB
•
Electrical Permit Application - City of Tigard
Page 2 . Supplemental Information
LIMITED ENERGY PERMIT FEES:
Ra DEN TA WORK ONL
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ A udio and Stereo Systems*
❑ B urglar Alarm
I I Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
CO44CACIAL WO 7031.7 ,W l rv:
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:' BuildingPermits \ELC- PermitApp.doc 03/23/06