Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2012 -00024
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2012
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9771 SW WASHINGTON SQUARE RD D08
Project: CCS Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: CCTV system.
Contractor: CHECKPOINT SYSTEMS INC. Owner: PPR WASHINGTON SQUARE LLC
8180 UPLAND CIRCLE BY THOMSON PROPERTY TAX SERVICES
CHANHASSEN, MN 55317 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 971 - 212 -3779 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/07/2012 $75.00
12% State Surcharge - Electrical 02/07/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: Y 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 OAR • 2- 001 -0090. You may obtain a co y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �^ 4110 Permittee Signature: _ �•rLi�u
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 7 the - nextavailable - 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.
02/03/2012 14:21 5032561527 PORTLAND TAX COMPANY PAGE 01/02
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Electrical Permit Apjlicatu , , L' . r,
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rTgrala TT City of 'Tigard
gaa 1 Date/13y• t 5 , . k & Permit No ---, .41 1 . _ Lua1 , 1,
'`-':',;''''',: i't 13 125 SW Hall Blvd. Tigard, OR 9722K EB - 3 201? • -
I Plan kr.niitn7
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Other Pe.nnd
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e: (9.718,2439 f;a•x: 503.598 .1960
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CITY OF TI - pntemy.
„,.,, , ,, . • 503 ( 4 r5 Date Radynly: lurk: te Sec ag 2 or
i;iilak.:Wwqi inpo..n ../e, „ , , ,,,„, . ,,
i.04-•:iiwit'4 Internet: www tigard-or,gov Notifimirmeliod. -- a.726), I Stippiernentni frtibrinntion
_Bun rilk10 nv, , ....
. • rtilit Or WORK • ,- • ' , .
' ' • 184.•,AkitEiVitt* • • . •'' -- • •
Please cheek nfl that apply &submit 2 sets of plans whims checked belmy):
r_T.) New' construction El Addition/alteration/replacement
I Service or feeder 400 amps or more 0 Nodding )VI illtee aiOlaca
[L] Demotition 0 ()the: where the iMIllahle Valli' current 0 1.N4arinas and boalynals
• exmeris 10,000 aav at ISO volts ot 0 bloating buildings
:. - • • . , . . , .: . t8iitMORY OF 'CONSTIIIICTION , . .
...... • . l to gr ,,,,i, ,,,. , xace d s 14,000 0 Commercial-use. agricultural
[3 1- mid 2-rilmilv du-offing, FA Commerciiillimiustrial [ AC.CetifiOry 61111Cling anala fOr all other installations. buildings
F] 1\ilulli-family n Master builder [J Other 0, Fire pomp Li Inidallation of 75 KVA or
— . -7.-----7-----.--------7-----"'" 0 Rinerg, system. larger separately derived 3 ystem
il0V.• qrtit INVOikklIATION AND LOCATION' • 0 Addition of 11M notor load c‘f
. . ... . . , .. „ .
I enTIP or mote nccUpancv.
.lob no. 700541406 I kill sne address: 9771 Washington Square Rat 0 six°, 111MC MSItiettlii AI Mli15;. 0 RECITtallnial Vehiclo pail.d
...„ ... . ..
( ;it yiS111.leiZIP 0 4kinith-citie facilities. 0 ripply voltage Iran
ge fin more an
• Tigard
- 1 Li Hazardous locations. 600 volia 110/11inai,
-
SlliteibkigiaDt. no I . - , ! 0 Service or feeder 600 11111pn III more.
1 PrOjed Mille. CCS
-------- ------------ • :4 WiTEDULE , ..- .
. . , . .. ..... ___ /..„
Csmss sired/directions lo trib se' W
itashingon t Square NW of Sears Upper lev 4:4 _ ot,:engglin 11. - __.9J l', . .
- ...q 7 :' ' " - - - iTt z - : T
___ __ .
" - New residential single- rtr multi-family dwelling unit
Includes attached garage.
... . .
ism sq. fi. or less 168.54 4
SilbdiViSiCitl i TIO..
,. _ -
. Ea. addi 500 sq, It or ration 33.92 1
_ f i\ map/parcel no —
Limited energy, residential 1
---
' - • 5 00 2
• 0) 4,11 li . (with above sig..)
._...._
... ..
. .
. .
- Limited energy, multi-family
.7 .1 00
'installotion, of CCTV System rmidentiat (with above sq. fl-) •
__ .... ___ __ ........._ _ ._
titit' irvieris or feeders installation, alteration, IllatitOt relocation_
200 amps in less 100.70 2
0 oataitittv •diiiiotli .-. ' - I • El TFNANT - 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: _
__ _ 601 amps to 1,000 amps 301.04 2
. . .__.
Address. Over 1.000 amps or VON 55226 2
..._.
TerfilliOrfAlrY FIM'VICM; f Or feeders installation, idterMti011, g314E/02
CitViSt!de:/7.1FL relocation
I Plionc! ( ) 1 l'ax. ( ) 200 amps or less 50.36 1
20 1 amps lo 400 amps 125.08 2
Owner inst Airflow! Tins installation is being mode on properly that I own which is not .______ _ _____ .
101 amps to 599 amps 168.54 2
isitenddl for sale, lease, rent, or e)lchange, according to 0128 447., 449,, 070, did 701.
Branch eirenrits - new., alteration, or extension, perpomel
OWnet SiE,9111tUrC .1 A. Fec r,,, branch circuits with --___ .... ___ .
===. - ......==zi=====.7.7..2.=::::.z.-' =-- --- .
1:.'01' , . . , , I . „ ... . 0. to PEUSON A7014: simice or feeder fee,
7 42
.. _...
- „ - - ..,. ...„ ...,• - • each branch circuit
11101 n MIK: 14 Foe (in circuits Wilma(
. service or feeder fee, first
56.
Contact name. branat eircuil 18
_ 2
Each addr1 braneh eireuit 7 42 2
Address Piliseellaneons (Service or feeder not inebaded)
. -
Each manufactured iic modular
City/Stale/41P 67.84 2
dwelling, service' and/or Rieder
. ._._. _ _ ....._
Phone: ( ) [ Fax : ( ) Reconnect only
_ _ _ . 67.84 2
______ . Pump Or irrigation circle 67_84 2
I
E-tnai: ______________
sign or outline lighting 67.84 2
.. - . . . ... , ttormAcroR . . . .. ._. .... . _..... _
. • Signal cotenigs) in limiled-energy 1
75
Business mime' Checkpoint Systems !Mc panel, alteration, or MiCM1011. Pago 2
Jar!! additional inspection over allowable In any of the above
Address' 8110 Upland Circle Additional inspection 11 hr min) 66.251 hr
.. ......._ . ...... ....„ _ _ .„.„._. .... .... ..... ....._.... . ... ____ . ....... . . __________________ __ ...... - -- ---------- --------•••-------•••- •••••• - - ------------ • - - • - - ---
Investigittion 11 hr min) 66.25( hr
City/State/ZIP: Chanhasson, Mn : 55317 -
. —
• i, industrial plans 0 hr min) 78.18! hr
Phone: ( 97 II 217-1779 1 Fax ( 9 !„ !--'6; - / imam-nous for which no fee is
900
P - ...., e, / .W hr
, • ., sreifici.silLlisted (1.. hr min) ______„____, _,_ '
CCU Lie.. 187898 1 Electrical lie 1 CLI1229 Suprv. I.ic.: ,15fit.i, ...•14.31/CTIUVAL, - ikERIVOItAltS . — ' '.
- IO3'ii3 .
Snpry Flo t:yricion sigm ura, requir e d i
: x t , A - --!1!-/ '
ev „,, 27 , < , ,,
- Subtotal: 75
' • .`" ;''' Chin review (25% of permit fee):
.. ..„. ..... .
• --- _
Pr ha ntRilt William M rIsss r)ate 03 Fel) 2012 slate SUrcharge (12% of permit fee). 9
. . ...... ....._ ___________ ........_ ....._ _ .
TOTAL PERMIT FEE g4 --
koth . .. ...______________
This permit application expirea if a permit in IIM obtained within 180
... _ ..... _ .. .,.. _ .. , . . .. __. __
days after ii has been accepted as complete,
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