Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
`" '' COMMUNITY DEVELOPMENT Permit #: ELR2011 -00186
TLGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/03/2011
Parcel: 1 S126CA00100
Jurisdiction: Tigard
Site address: 9225 SW HALL BLVD F
Project: Ideal Image Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Audio system.
Contractor: MUZAK LLC Owner: GREENBURG CORNERS LLC
12449 NE MARX ST BLDG 10 BY MENASHE, R BARRY
PORTLAND, OR 97230 621 SW ALDER, SUITE 605
PORTLAND, OR 97205
PHONE: 803 - 554 -2594 PHONE:
FAX: 503 - 252 -1109
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/03/2011 $75.00
12% State Surcharge - Electrical 08/03/2011 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: Y 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: 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 952 - 001 -0090. You may obtain a copy of the r - • • _ • uestions to OUNC by calling 503.232.1987 or 1.800.332.2344.
`` / ! �`
Issued B Permittee Signature: _ �. w .
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.
3
1125 SW.Hall
Electrical Permit Appli a ti. ;' �i ,
I'OROrP'JCC,USE O1YLY �
City of Tigard • ' `I Reeetved .� __. , - .
rr 1.. DaWB . 1 �1/� Pcrmitiro.. �_
,
t 4 Blvd Tigard, OR 3 A � aa Plan Rev iew ,i %�IS .�
- Phone: 503:718.2439 Fax: 503 A6, i 960� 1S1 Dalc/0 : O1hcr,Pcnnie
�IG,.` °RGg Inspection 503.639.4175" O 11`
'� Internet: www.figard- or.gov N auficd /Melllad
,., rental Infar
9 ate Read Mill H Sec P
age 2.far
si„ . �7., .,,,��,_ _ .
c;, Supp mntEnn
� eye: �
. rt..,, s ". vim.,......::...- ..._ ; ...., < `aP[iA a:e,, -.
�lew constructibn ,:` ,:.` ", ,'. '�...:.: -. •......__...,.. ��� .�.,p,s<;'•''',�,= �'- �`��
,;
' ubmit 2'sels of plans w /items checked below):
❑ Additio teration /replacement Please cbeck.all drat aI
PPY.s
(, p.
❑ Demolition ❑'Other ias nd'b
ED or feeder 400 amps or more ❑ Building over (lace stories.
b- �l j,?�;_ - _ _ where the available fault current ❑ Marn aoaty
zG •I' EGdiaQ'e}C :.' boatyards.
- ... ,,. CUlHS'rA[7�T[OlY� e
xi <r � - exceeds (0,000 a at I Sp volts or
` i1 ' - Ba " , ' 0 b
0 1 -and 2- family dwelling ercial %industrial less to (mound, orexceeds 14,000 ❑ Cammercial- usc- agricultural
❑ Accessory building amps for all
CI Multi- family • ❑ Master builder other installations. l ns ls ing3.
; , f � ,,.: , .,. ,. < , ... Fire pump a ❑ tnslnllation KVA nr
:
0 0 ,
''' . "` 1 `= << <: `; >` J• - . - °IN7?p < i - •, •. T[Ol+j "; <+1vID,'L''OCAT O ❑ Emergency syslcm l ar 6 erse aratel' deriv s t
e
N
�. < . P Y Ys m
:... �. "' ., , .,, - .. - „'. .....- ' ":. "'• "..•, <' ' , "rt''°'= ❑ Addition ofncw motor load
Job no.: Job site address: (1 12'LS S W ,1 � ` 100oIP or snore, occupancy.
�l ❑ Six or more,resitlentinl units. ❑ nee:calianai vehicle parks.
City/State/ZIP: -I-t 1 G_A-(1.,1) O p Gil ��: ❑ Health -care facilities. ❑ Supply, voltage for more than
t� _ ❑ Hazardous locations, 600 'Valli nominal.
t
Suite/bldg. /apt. no.: P roject name: - ❑ Service or fceder,6o0 amps of more,
Cross ,��s l _u �.� � .,, „'� €r1: .. < ,
street/directions to-job t' All `le dim - ?`; >.,• .1' iii ? :-`•'`; FEts Stub it 1
- �, = ; ;tt: °�; . -
acacriptioa 1 Qir•.1 .� . -. x-,tw." Tamt '._e l ,< . .
NIeiv residential single= or multi-family dwelling -unit.
Includes attached.garage.
Subdivision: Lot.no.: 1,000 sq. R, or.less 168154 4. a
• Tax map /parcel no.: La.add' 1500sq. -f. (*portion 33.92'. l
', i �'.'; =,.: „;1., Yk "t <;� a',.:. •,�� Limited energy, residential
•
.R ".,�;.:,::.. ;:•,•�: 75,00 2
• a.., ..a•, ,:..., ;w ; °iia�;w�T <P<<'�?`' ;'s = 64,1.. ,
D O ((�� Limited'energy, multi - family
U•..4.e0 t residential'(with above sq. f.) 75,00 2
Services or feeders installation; alteration; and /or relocation
>':i'gt '<� PR() TY'OW ' °,_ _r`; ". ,;:,' a t,. '200. amps or lss 100:70 - 2
,.,- :x. EER: LvfFR +a=„x'.e`°
. _.... _�. ... ,<,..� ............:'t•.„ ,.. .,._ <�'',. ; 1PFNi�N'C:kt:YYV:E;<.a -;Fi ?Ol tunps to400amPs 133:56
2
Name:. ' 401 amps'to 6017 amps 200:34 2
601 amps to 1-,000 amps 301.04 2
Address:
Over 1,000 amps or volts 552.26 I .2 •
City/ State/ZIP: Temporary services or feeders installation, alteration, and /or •
relocation •
Phone: ( ) I Fax :•( ) 200 amps or less 59.36 1
Owner Installation: This-installation is being made on- property that 1 own which is not 201 amps to 400, ariip's 125 y ,
intended for sale, lease, rent, or, exchange, according to "ORS 447, 449, 670, and 701. 4ol.nmps-to 599 amps 163.51 2'
Owner signature: "Hriincit circuits - new, alteration, or extension, per panel
Date: A. :Fcc f h
°a'rr,:;�: °�_�' f];'-;AP.PG '`�5:; �i"s &' .,:�. or ranch circ6it3 with f ee,
.. �,, s�..r,_..,� :. _ _.._ .:��, , _.r;; s:; �. ";CO ' ..� L� - ,�_�;,���� �'_ ;abo e ..
�,..__.a� ..._ � w M � Gk`„ _RSON <:.,••.z._.e v servte corftic
` �" each blanch ci iauit der 7A2 2
Business name:
B. Fee for brunch circuits without
Contact name: service or feeder fee,, first
bmnch-circuit Sb.l$ 2
Address: Each add'I branch circuit 7;42
Misvellaneous..(service or feeder not included) '
•
City / State / ZIP; Each,mndufacniicd,ormodular
dwelling, service and/or feeder 67. 2
Phone: ( ) 1 Fax : -: ( ) Rcconnect,only 67:84 2 ,
E -mail: Pumper irrigation circle 67.84 2'
*'... ,..h'*' ..' * a «> « ' Sign or outline lighting 67
S.: .. r,.,. .QLVTRAC:I'OiR`; " Yi ° ry:4',41 .:, :. < - g 84 2
� ,,:a:hx. � - „ '�� "d`
Signal circuit(s) or.Iiited-ee
Business name: -- A r/ �� panel, alteration, or extension. Page 2" 2
Address: `t Q t � - t Eacb additional inspection over allowable In nny.of the abovc
t Z `C , to £ r /, A, r
Additional inspcction(l:hrruin) 66:25 /hr
City/ State/ZIP: J ( ^ ^� Investigatiati (I hr min) ;6625 / hr
�� UJ U industrial plant hr.Min) 66.25
Phone: (263 ) SSL —U ' t4. ` Fax
50 Ls-z„..._ Dcj Inspections for which neacc ib
CCB Lie.: l4 Z ` ,o specifically listed (% hr min) 90.00 / hr
1 Electrical Lie,: 2(D k'S 3831 LEA- .;,v.
bU � up ty. Lie.: SL� - ... ` .. K : EL' ECFRICA,': PE} Zi4f1' mFLESac:=:;:,',,;1°•
Suprv. Electrician signature, required: �— Subtotal: - 1 S ,.....a.
Plan review (25% of permit fee):
Print:name:
Kj N( ., r Date: 4 ( State surcharge (12% of permit fee): 9
Authorized signature: ( I TOTAL ,PERMIT FEE: 13 4. rs
This permit application expires If a permit is not obtained Within 180
Print name: Date: days after It has been accepted as complete ; ,
. Number of inspections allowed porpcmdt.
t: lauildingtFnnuiislELc .Pe,,dsApp.doe 07/01/10
440.1615T(I 1 iosicOnMVEn
Electrical Permit:Application - City of Tigard
Page 2 - Supplemental Information
L,IMIrEt) ]ENERGY PERIYIIT FEES:
Fee for all residential systems combined ... $75.00 •
CheckType of Work Involved;
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum: Systems*
❑ Other:
GOTvLMERGIAI ON s= ;s: °W '' ` 1
Fee for each Commercial $75.00
system
(SEE OAR 918- 309 -0000)
Checkk Type of Work Involved:,
R4/ 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
1:ID uilding \Pmnils1ELC- Pcnni1App.doc 01/01/10