Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00167
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/13/TIGARD
Parcel: 151260100100
Jurisdiction: Tigard
Site address: 9225 SW HALL BLVD F
Project: Ideal Image Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Fire alarm system.
Contractor: T & L COMMUNICATIONS INC Owner: GREENBURG CORNERS LLC
PO BOX 87387 BY MENASHE, R BARRY
VANCOUVER, WA 98687 -7387 621 SW ALDER, SUITE 605
PORTLAND, OR 97205
PHONE: 360- 737 -9725 PHONE:
FAX: 360- 737 -9648
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/13/2011 $75.00
12% State Surcharge - Electrical 07/13/2011 $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: 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 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 obtain a copy •,may . s or direct questions to OUNC by calling 50 . ..1987 or 1.800.332.2 44.
Issued By. .� Perm flee Signature: /,. "l -, / L
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 Application FOR OFFICE USE ONLY
�' Received
Cit o f Ti Date Ian B Re iew ��� Permit No.: a 1
Other Permit:
- " 13125 SW Hall Blvd., Tigard, OR 9 7223 v 67,4490
P hone: 503.639.4171 Fax: 503.598.1960 try\ Date /By: /7 On iii
T I GARD' Inspection Line: 503.639.4175 D- .:1; rly / jnris ® See Page 2 for
Internet: www.tigard-or.gov ' thod. By: y/ -, Information
Supplemental
,. ,. , ,. �..�., �_.;:.::- , a ,.. , .., �,: }, �PL�A R E VI E W ,. .. .
-,, ,...�„ ,. .. T,XPE, OF,WORK ,, .,:,,, "Wr.
❑ New construction E Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
CI
Demolition ❑ Other: ��� where the available e 400
ffault amps
fault CI
and d boatyards
ex ceeds 10,000 amps at 150 volts or ❑ Floating buildings.
`�''�,�, �CAATEG®.RY'�OF " ONSTRCIGTION to ';;;- "• «;.; P g g
` ' ` ' '"'` °` °" " "' ` '" """""' ess to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. El Installation of 75 KVA or
• • : JOB ' SITE',:IN O_RIVIATI N AND � L Emergency of ne w motor load of system. larger separately derived system.
" � � J ..• ;,•r^�w,,Y . ._ ... ...... TIO ��ji't� ;:'�,`'' 0 of ne ❑ ,. ., ,. „
ti ,. ,. .,. k; O OCA N>;
Job no.: Job site address: 9225 SW Hall Boulevard 100 or or more residential Recreational CI or more residential units. ❑Recreational vehicle parks.
City /State /ZIP: Tigard, OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: F Project name: Ideal Images ❑ Service or feeder 600 amps or more.
°'EE ";SCHEDULEM. -r-F: ,. ,iii : :
job site: • c ; *ti°i .y° " I .. �, •r a9 •u. *e ,
Cross street/directions to
] Description � Qty. I Fee. I Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less .`,.if 1 4
SuSubdivision: _ Lot no.: � � I4 �- -- ._ -- - �
— — — — ' Ea. add'1500 sq. ft. or portion 'G• - • ; 1
Tax map /paled arcei no:.
p p _ - residential I
��I)
r Limited
75.00 2
.., H ,. e - ti _ _ - ( with a
,. , ;, ESC G3 = "WO � sq. ft.)
Limited energy, multi - family 75.00 2
Installing a Fire Alarm System residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
a,,. °PROPERTY;:OW*ii.: ,', : ; :.:.•:,:, :ji TENANT ;°' i 201 amps to 400 amps 106.85 2
, ._.., �•�_ o.t�� �. ,. .,.rte ��.; .- - .. p ,., n•��f:
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
Branch circuits – new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
�yi `r .`'= s °. above service or feeder fee
6.65 2
APPLICANT . `❑ CONTAC;I - PE RSO N ,:
>,:. ,..;,;: , , :,. ,,.•,,,, -•�,. ° ,mac.,:,.:.• .. , ,, ,.,,.� .
,,;.;.;�ru; „w ,. sue, - ,,...... ,., - <, - ,.: : • : - �. ;
each branch circuit
Business name: T &L Communications, Inc. B. Fee for branch circuits
Contact name: Ross Bushaw
without t bran service or feeder fee, 46.85 2
first branch circuit
Address: PO Box 87387
Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Vancouver, WA 98687 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( 360 ) 737 -9725 Fax: : ( 360 ) 737 -9648 Reconnect only 66.85 2
E -mail: office @tl- communications.com Pump or irrigation circle 53.40 2
r . "�,,,; ; .a -,„
��• CONTRACTOR l � %�� A”{ z° % ii 1. Sign or outline lighting 53.40 2
Business name: T &L Communications, Inc. Signal panel, e r t o n , or
energy panel, alteration, or
Address: PO Box 87387 extension. Describe: 1 Page 2 2
City /State /ZIP: Vancouver, WA 98687 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 360 ) 737 -9725 Fax: ( 360 ) 737 -9648
Investigation per hour (1 hr min) ,62.50
CCB Lie.: 67787 Electrical Lie.: 37 -428 LE Suprv. Lic.: 684LEA Industrial plant per hour 73.75
:: a•'`'° ., .' ELECTRICAL" PERMIT"FEES '::, .`
Suprv. Electrician signature, required: t Subtotal: '7S",
Print name: Larry Bushaw Date 07/11/2011 Plan review (25% of permit fee): �){ '
/ � State surcharge (8% of permit fee):
Authorized signatur• . ' ( TOTAL PERMIT FEE: -
i shaw 07/ 11/201 1 This permit application expires if a permit is not obtained within 180
La
Print name: Larry Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB