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Permit
illii t CITY OF TIGARD ■ r ELECTRICAL RESTRICTED ENERGY PERMIT `° `` COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00213 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/20/2007 PARCEL: 2S 104AC -14100 SITE ADDRESS: 12934 SW HILLSIDE TERR ZONING: R -4.5 SUBDIVISION: HILLSIDE ESTATES LOT: 006 JURISDICTION: TIG PROJECT: HILLSIDE ESTATES Project Description: Low voltage work in new SF. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: DUY -ANH TRAN ALARM TRACKS LLC 14576 SW FERN ST. 4134 N VANCOUVER AVE #107A TIGARD, OR 97223 PORTLAND, OR 97201 Phone: 503- 380 -5872 Contact #: PRI 503- 490 -5138 FAX 503- 892 -6302 FEES Reg #: ELE 26- 1029CLE LIC 115473 Description Date Amount [ELPRMT] ELR Permit 6/20/2007 $75.00 [TAX] 8% State Surcha 6/20/2007 $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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct •uestions to OUNC at 51 .246.6699 or 1.800.332.2344. Issued By: /1 Permittee Signature: S____k , / ( ' 011 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'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. p. 2 1 - - -_ _•..a a ca A iiCatiOn C of T ► (Ir; 01 C - 1c t: 1 a: t)\l.1 buildings, 13125 S W Hall Blvd., Tigard, Received Date/ 13 /'' 7 Phone: 503. g d O• 4 Date/13 ' . _. Permit No. : 639.4171 Fax: 503. "9 .�,0 . j , r - T I C; f\ F: D Inspection Line: 503.639.4175 Date re Internet: Line: g or.gov JUN 1 9 2007 By: Other Permit: Notified/Method d ` 1 — en e 2 for Informa tion /.ti 0 TYPE OF r od ' ® See P ew con – (�� - Supplemental construction El Addition/. r.:1;111iti/ jl:ia-i '.71.--.7 _ ❑Demolition 't: ' i PLAN REVIEW ❑Other: Please check all that apply (submit 2 ❑ Service or feeder sots of plans w /items checked below): CATEGORY OF CON w here the feeder 40 fault amps urtent more Building over three stories. - and 2 family dwelling CONSTRUCTION °Marinas and boatyards. It g ❑ Commercial/industrial exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ❑ Multi-family Accessory building less to ground, or exceeds 14,000 ❑ Master builder seeps for an other installations. Commercial agricultural JOB SITE INFO ❑Other: ❑Fire pump. I NFORMATION AN D LOCAT ❑Ewer no ❑ Installation of 75 KVA or Job no.: y system. Job site address: ❑Addition of new motor load of larger separately derived system. City/State /ZIP: �A ! ixorm r more. ° c S� • occupancy. (] Six or mo re residential units. Suite/bldg. /apt. no.: ❑ xeattle cats faciliues. ❑ Recreational vehicle parks. Prefect name: ❑Naalth - ca locations. 0 Supply voltage for more than Cross street/directions to job ❑ Service or feeder 600 amps or more. 600 volts nominal. !ob site: FEE SCHEDULE De+cri . lion IMS New residential single- or multi- family dwelling Subdivision: Includes attached garage. Tax map /parcel no.: Lot no.: 1,000 sq, ft. or less - DESCRIPTION OF WORT{ Ea, add'I 500 sq, ft. or portion Limited energy, 33.40 . =� gy , residential 1111 ®© �t,"i A. with above ... ft. Limited energy, 75.00 1 At`' 111 gy, roulti- family residential with above s •. ft. 75.00 �© n ' ' OPERTY OWNER Services or feeders installation alteration, and/or relocation 200 amps to less - Name: ❑TENANT 20 amps or cs tuns 80.30 _© p 106.85 _© Address; •+ to 401 amps to 600 amps — 0.6 601 amps to 1,000 amps ) _© _© Over 1,000 amps or volts - 2440.60 11111 Phone: ( 454.65 —© Temporary services or feeders installation, alteration, and/or relocation Owner installation: This installation is being 200 amps or less intended for sale, lease, rent, to or exchange, according ad to ORS property 449, 670, and h is 401 amps to 40 am s 66.85 _� all pro a that I own which is not amps to 400 amps _ Owner signature: 16930 ®�© Date: _ A. Fe e above for circuits– p _ ❑APPLICANT new, alteration, or extension, r r r and ❑ CONTACT PERSON • Fe e s br service circuits or feeder fee, with Business name: e ice e each branch circuit III 6.65 Contact name: B. Fee for branch circuits without 1111111 1111111 _ i rs t service or feeder fee, bra nch circuit 111E111111111 Address fit bra City/State /ZIP: Each add'J branch circuit In 65 Miscellaneous service or feeder not included _ Phone: ( ) Each manufactured or modular 111 dweJlin • service and/or feeder 90.90 -© E -mail: Reconnect only 11111 66.85 El CONTRACTOR Pump or irrigation circle 1111 53.40 _ 3usiness name: = = a � Sign or outline lighting NM Signal circuit(s) or limited- 53.40 _ A energy panel, alteration, or VC extension. Describe: :ity/State/ZIP: Each additional ins. Page 2 –, Ia hone: (c 1111 ection over allowable in an of the above a i� Per inspection CB Lic.: •>• 62.50 _- Electrical Lic.: _ Investigation per hour (1 hr min) ann 62.50 -- 210 i Q ZQ _. uprv. Lic.: industrial plant per hour St Jprv. Electrician signature, required: int name: 4:11/412.c.) Subtotal: liallififfi • .1 V1 . Date: __ \C(- Plan review (25% of permit fee): ithorized signature'�■ State surcharge (8% of permit fee): inn name: .._ TOTAL PERMIT FEE: e . � illi v =J 4 Y� Date: a days after it has This permit application expires if a • permit ' Perro is not obtained within 180 a ccepted as coo mpleplete CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007- 00213 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2007 Phone: (503) 639 -4171 fie % yp i gh�' � l Inspection Requests (24 Hrs.): (503) 639 -4175 r � INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:00AM PAGE: 15 SITE ADDRESS: 12934 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 006 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: Low voltage work in new SF. OWNER: DLJY -ANH IRAN, PHONE #: 503.3£10 -5872 CONTRACTOR: ALARM TRACKS LLC PHONE #: 503.400 -6138 Inspection Request Scheduled For: Date: 7/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 051724 -01 503. 480 -5138 N I Ck ';:‘ F' ■0 Qo I-- Corrections /Comments/ Instructions: Cr. NO6 iE ), 23 D ; 1 ►� -A SS n PART L APPROOW. ❑ CANCEL n NO ACCESS FAIL ❑ ► , O' N'-" .. s ON I I ADDI-T- IOisAL FEES ASSESSED Inspector: • 4 Date: l #: (503) 718 - __//""