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Permit ;i CITY OF T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00168 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2007 PARCEL: 2 S 104AC -14400 SITE ADDRESS: 12990 SW HILLSIDE TERR ZONING: R -4.5 SUBDIVISION: HILLSIDE ESTATES LOT: 009 JURISDICTION: TIG PROJECT: HILLSIDE ESTATES Project Description: All encompassing low voltage. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: LL ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: ECK CONSTRUCTION INC. SIGNATURE SECURITY INC PO BOX 204 2917 WASHINGTON ST SUITE #104 SHERWOOD, OR 97140 VANCOUVER, WA 97682 Phone: 503- 625 -1305 Contact #: PRI 888 - 668 -1010 FAX 360 - 883 -1557 FEES Reg #: ELE 37- 865CLE LIC 138693 Description Date Amount SUP 4217LEA [ELPRMT] ELR Permit 6/6/2007 $75.00 [TAX] 8% State Surcha 6/6/2007 $6.00 REQUIRED ITEMS AND REPORTS Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notifi firm Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Yot nay obtain copies of these rules or erect ques 'ens to • at 503.246.6699 or 1.800.332.2344. Issue By: j _�, � ,i f di , ` Permittee Signature: X A , L _ e btu' OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, ase, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. Y electrical Permit Application • . TOR.01` ii.S'E ONLY City of Tigard Date /By: Y ie (, 4 7 Permit No.: S/ '/, 7-60/ 14 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C �� 17 Phone: 503.639.4171 Fax: 503.598 1960 Date /By: Other Permit: sl [ IGARD Inspection Line: 503.639.4175 Date Ready /By: m 0 See Page 2 for Internet: www.tigard or.gov Notified /Method: 1 `� Supplemental Information TY.P.Es OF .W,ORK x> _ --ne> °PLA REt!IE = ';3' ='' ® 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. 1=1 Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. f'= V:-.;.1:14', 'j4, +.<,�,., aesa' = -r.,.k. .: " � Y ,.. .e .._... „._ ',-N�• �F�' „ exceeds 10,000 amps at 150 volts or ❑ Floating buildings ? CATEGORY OF <_�CONSTRUC'I`ION°_`'' -. ,, r x� �, „ �` -_ .. 5 less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or >••. .� ,.,�.�..f< ,:,;�,.�- ..; , ; ,, „�,_ , rgency system, larger separately derived system. ''-_ • 1OB`K•SITE INFOR ���• _.. OCATIOIV - ? "" ' � „ ” a >, e,.:•; � x -_ — � A:,�:,�_ .., .,. . ..,..��� � -.. - b': . ,.. - :� ❑ Eme 0 Addition of new motor load of Job no.: Job site address: 12990 SW HILLSIDE TERR IOOHP or more. occupancy. ❑ Six 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.: Project name: ECK CONSTRUCTION ❑ Service or feeder 600 amps or more. :” ;` flitao ? a '::: "FEE` ScHEDU_ I E , ' :: ,, `� ` �° Cross street /directions to job site: WALNUT D Qty. I Fee. I Total & I � ” New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 9 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75.00 2 D :mac. ` r `; g i..i ,.' s CM l i', -.,,' ESGRIPTION o-,w RK' °' (with above sq. ft.) Limited energy, multi - family 75.00 2 PHONE / TV / DATA / HOME SECURITY PRE-WIRE AND TRIM OUT residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation Y¢ 200 amps or less 80.30 2 '®. ;PROPS , :W RTY.< OW � r`� �. ` ®TENAN ` 7 N� �� % ' �� � � : 2 1 amps to 4 0 amps 1 ...:� ._..� �_ " � h, ..:,.,. <,,.,, . � <��,ia �� .....>.,.T .,. �, .... .. ° ` = °:i,�,�,:,i,,�:,'. >3�;.,A� 0 p 0 a ps 06.85 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 Owner signature: Date: Branch circuits — new alteration, or extension, per panel A. Fee for branch circuits with ',:r i' AP I = ; °r': ' °r °' i E SON.. 'M;D ..PI CANC ,;: .'�:• P R " _. "�' .. _ ..' a , =w above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and /or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle 53.40 2 is '� ire $ .z;*._, ', :,,z"` "' Sign ou tline lighting 53.40 _�.t ; CQNTRAG "::. 'o;� 7s <; g g g 2 _ .�� : z2� � a:��= nom....._ .. _ Business name: SIGNATURE SECURITY INC. Signal circuit(s) or limited energy panel, alteration, or Address: 2917 WASHINGTON ST. SUITE # 104 extension. Describe;., } Page 2 75 2 • 11 C dokr City/State /ZIP: VANCOUVER / WA / 98660 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (360) 750 - 6000 Fax: (360) 8834557 Investigation per hour (I hr min) 62.50 CCB Lic.: 138693 / Electrical Lie.: 37- 865CLt, Suprv. Lie.: 4217LEA Industrial plant per hour 73.75 /K/g. t 07 / `: rs, ' ELECTRICAI:` =PERMIT FEES°'. ; '; v: , ', Suprv. Electrician signature, required: 7// 7d 0 / �l / fig k Subtotal: 75 Print name: JAMES C. RUSSELL Date: 06 -05 -07 Plan review (25% of permit fee): State surcharge (8% of permit fee). 6 Authorized signature: -- � 1 TOTAL PERMIT FEE 81 Y � " This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. t Number of inspections allowed per permit 1 \Building Tomas \ELC- • p.doc 05 /23/06 440- 4615T(11 /05 /COM/WEB " CITY OF TIGARD , BUILDING DIVISION PERMIT #: ELR2007 -001G8 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 616/2007 Phone: (503) 639 -4171 /,�m4p�iw��� Inspection Requests (24 Hrs.): (503) 639 -4175 �. . ! . INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 3 1 SITE ADDRESS: 12990 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 009 TYPE OF USE: 1 PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: All encompassing low voltage. / OWNER: ECK CONSTRUCTION INC., PHONE #: 503 - 625-1305 CONTRACTOR: SIGNATURE SECURITY INC PHONE #: 886 -668 -1010 Inspection Request Scheduled For: Date: 6/12/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 050071 -01 360 - 750-6000 N Corrections /Comments /Instructions: /' A . • dow aping& ,ninimui ( ici PASS ❑ PARTIAL APPROVAL I I CANCEL n NO ACCESS ❑ FAIL l l CALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: D ate: Phone #: 503 p / (/ (503) 718 -