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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2012 -00030 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2012 Parcel: 2S112DC00100 Jurisdiction: Tigard Site address: 15605 SW 72ND AVE Project: Consumer Cellular Subdivision:"HERN PACIFIC TIGARD INDUSTRIAL I Lot: 1 -2 Project Description: Security system. Contractor: PHILLIPS ELECTRONICS Owner: PACTRUST 3247 NW 29TH AVE 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97210 PORTLAND, OR 97224 PHONE: 503 - 222 -5083 PHONE: 503 - 624 -6300 FAX: 503 - 227 -4992 FEES Description Date Amount Specifics: Restricted Energy Permit 02/14/2012 $75.00 • 12% State Surcharge - Electrical 02/14/2012 $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: N HVAC: N Instrumentation: N Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: Y 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 of the rules or - t questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued Bytom/ Permittee Signature: 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. 02/10/2012 16:03 5032274992 PAGE 02 Electrical Permit ,Application \�`� \ Fmk c►rri< r. (1st OM ,V City of Tigard r ,� \` \ 0 IN "+ 13125 SW Hatl Blvd, Tigard, 1 � a � ot � e ate/B : a / /-4 40_41,/ Permit No.: - - I.1 ' —cc u inn R ev i o w ' . • Phone: 503 Fax 503.598.1 ° G ` ' D Other nit _ Q ( * E ste/Sy: .dam i } t: i A }t (7 inspection Line: 503,639.4175 01, - a to Ready /By: .it ® See Page 2 far Internet: www.tigard•or.gov �,�` �� Notified/Method: J /i Supplemental Information „,:. ' r rr i • r, a ! N! N�t rt 'W - i s , j . ..'r'. ' 1 1 ,i I' 1 %5 irl '� '. "I S1q r• l lyry r a(T ti ,,.,. p•. qe: ^ -sr 41,"i4',.' I :I'- ..i t :r;:," T �'P 1Ril` ( II!H.t . Pr J, {16' l i,', 1 .i,,. du a .1, •�`' ` f '.�,: �,I.� 1' 'Ii,. iiP Ji . {I',• i inb p .ngrP Nata , j' 1 I� I r, I �t 19 ( 1 ..'li . ' 11 , I 1 ' 'rl , ! lt�it�'I .rr';mf iml ,i., ,{,,it1,l11 1 .,;ttCx, ,1861d(!.. i�' � '! �� , u rl . i t � ( t.rta ,iii �l lAl �r ,r4, k> : j 1,11�c;,lil�l,;.til.I!! rti��1G, 0 New construction Pi Addition/alteration/t.• ent plasm check all that apply (submit ,a sets of plans w /items checked below): © Service or feeder 400 amp or morc ❑ Building over three stories, © Demolition ] Other: where toe available ihuh currant ❑ Marinas and boatyards, Phll:r ';1 ' P iil,e i I -! • rgi iln " `A r. �' II, , r t 1» m 1i irl xmt n 1 rE I�;:i, I nisi rr i 1i 9 i 1 ,• 10 8 ii � ('i t ; exceeds 10,000 amps to 150 volts or © Floating buildings. ] � u y�q�s7a I y h. dilf71aa + + =fr� II JP. 1 leas to ground, or exceeds 14,000 la Commercial -use agricultural 0 1- and 2- family dwelling M Commercial /industrial 0 Accessory building amps fbr nil other instauntions. building, t--i Multi ❑ Master builder © Other; © Fire pump. El Tested:it - Ion of 75 KVA or 1 t y a 1 + ❑ Emergency system. larger separately derived system. '1.^��., g r I I .I ,�>hl![7AA7t �7 y .A 1,t If 'i r'I f �riir<�n r '! "r ir'I% :v • : t. il p, Mad of "A ", "E ", „ 1.2” . •1 -3" i. w-"7l' e t n F 1 s t f 0 , ,' i i ( is . (al 1: :• t Addit of ne w motor ❑ �r ill t ��C ?; 1 � I:1 � t n t n �, i, �J a,,:r.�1r t00HP or mare. occupancy, rob no.: Job site address: i e-��C .--- ��. -S r T - [I Six or mote residential units, ❑ Recreational vehicle parks. ❑ F(ealth care facilities. ❑Supply voltage for more then City/State/ZIP: 1 '' i. J2 __ ❑ 1dazardoue locations. 600 volts nominal. / Service or f 600 amps or more. Suite/bld ./ t, no.: Project name IJ�dShi.G+ ' e l4 c.4 1 yen �L , ri; 1J:• r'1! "ifnl pi ;rlj? l� rJ :';;.1'i ; i , ;I ` 'r l! ii' I 6 . to w' ;, i ' , _. ..„:L 4i &',:11a,,s'.Ja , i;l' , 1. j1} t. , . ,, . 1 : .F • ,.;,1 .. Cross street/directions to job site; netrr ptlsn l •t • Fan Taint - - -- -•.. N - — New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: _1,000 sq. ft. er leas 168.54 4 - -^ Ea, add'1500 9q. R. erportion 33,92 l Tax map /parcel no.: Limited energy, residential 75,00 2 •' r'y''v' ' 1' �' ' l '� ( ^' ui 1 ri, Ai" i +ri'rlrpr li (lord with above s ,'R, r (r l ? (; I I�, ' fl! )f:, , � �' �1 ''l m 4 1 hLnl� Limited energy, =hi-family 75,00 2 i" i i, ' i 1 . t, m1, f A al r 9anlar 1,' , . / = roidonr (with above s�ft� +''- a_ a ,l'''' •r �' N Services or feeders installation, niterationp aud%or relocation 200 amps or ices 100.70 2 - r rr 'tai ' 1 , ' 1' t 1 ' I r r h�f' "` r . r • N r1 1'I I ''l il f ` ifl 201 aniPa to X100 amps 133,56 2 r t 5 , min I t ! r r ri1. ; 1,l lllil (1 , ° { r , ga .r,,i Nfl r ! �,r�i '`.; Ifr',�,, .,, ,,ll , - 2 i idriin °M ilrhl r ? J;,..,,', i "8''# bl�i� 200.34 401 amps to C 00 amps • Name: 601 amps to 1,000 strips 301.04 2 • Over 1 000 amp. .r volts 552,26 2 Address: _, __ .� Temporary services or feeders Installation, alteration, and/or City /State /ZIP: relocation 2 00 amps or It�F 59.36 1 Phone: ( ) l F ax: ( 201 amps to 4 amps 125.08 2 Owner installation: This installation is being made on property that I own which is riot 401 amps to 5 99 amps 168.54 2 - intended for sale, lease, relit, or exchange, according to ORS 447, 449, 670, and 701. Ilrntxch itch - new t►Itcr o cxtcnsiou er panel Date: A, Fns fbr branch circuits wilh Owner signature: above ectviac or feeder fee, 7 42 2 .r ,,,. .Ay,.. �r t r• tbe.. r.' i' ^ I r I-I , pl , •:,3r 1 - 'il 'i 1 q rh I I circuit r� "., , `lid , . „'rrr it I � (l ;. pia �r 1 ' 1 r l ,J, „Ert „nor, xi ;'. �1 ,1!1' ^ T7r� . j1„Ilr:rSJlrytfilr, � i1J}Ill! each branch 1 E r ' I '6' r1 'r ,� ',,:,:r J�;,.,11,Si t ,.,, „ ��.I Is �fj A, Fcc for branch circuits no/thou/ Business name: service or feeder fat, first 56.18 2 branch circui �.. m - - Contact Warne: Each add'I branch c ircuit 7.42 2 Address: Miscellaneous service or feeder not included) • ... — Each manufactured or modular 67.54 2 Cityi5tate/ZIP: - dwelling, service andior th cder 67.84 2 Reconnect only 67.84 — 2 Phone: Fax; : ( ) Pump or • irrigation rattle ( ) ? Sign or outline lighting 67.84 E mail: 1 ���� �� :,r ,n.� ,, r�'!g! „ �:r ' I, n!,;.'. I�. 'nr"'N fi” 1 i signal eitcttit s orlimitrd•cncr¢y r 1 t! P ,;,i1 i i',;..• '1i ^•I Prl;ri %:`.ill';j ai )' Qridal11.iw,n''r i "lrl{iif+:ifJJI;U8i�1� gn O ^']� 2 ;'. P..'oN`.:; :,,I�,,�, }Pl.:i� % ,t,� f _.,,r'a,;.�q. ,711 . r /,.. �WLuldriiit� ! uL't pant, alteration, orcxte i m, _ i P. el �-L —'--- Business name: Master Alarm LLC clba Phillips Electronics Each addttieual lus octlnn river allowable in any "of the above Additional inspection (1 hr rain) / lir Address: 3247 NW 29th Avenue --- — Investigation (T hr aria) 66.251 hr City /State /ZiP: Portland OR 97210 78.18 / T Industrial plant (1 hr min) fir Phone: (503) 222-5083 Fax: ( 503) 227 -4997 ktipeerio for which no fee is 90.00 / lir —„— . ecifrcnll listed ''A ht' min t i " „ 0I , ,, llrM l , � i r�l Electrical • 1 , r ,,,. f r,, l.,.11 crlI i Fiui�R'al', 'f ,, e kdrr; r•f ir' • i ��. : 262I3C LE Suprv. Lie.: � : _.. � :„ lil:i,.r1c1. ';;4c:�itlr;,l r �: Subtotal: 7-5 1 _ Suprv, Electrician signs rc, required: 1i1 I4i Jr' per iD 1 N •� Plan review (25% of permit Fcc): - Print name: ,J 4,, ,• oy Date: 2 �/ l State surcharge (12% of permit fee): /� U ! Print n Authorized : signature; TOTAL PERMIT PEP,: This permit nppueption expire., If n permit is not obtained within 180 Print name: Date: days after It bap been accepted as complete, •,,, , 1 x Numberofinapoetinna allowed per permit. h \ \PLC- ParmitApp,dne 07/01/10 4 WSICOM/WU /74 9 02/10/2012 16:03 5032274992 PAGE 03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: {( •� fi1 t j„'1 "`� ',111;,4 !n}rt 5, ,a iRP , 1 r ' „I �r `llffF�� 1' f i` # FIlf�Ci j `11f l f rli l Jf 0 ���j' [` "P M,n Fee for ali residential systems combined.....,., $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* O Burglar Alart, ❑ Garage Door Opener* ❑ Heating, Ventilation and Air, Conditioning System* ❑ Vacvum Systems* ❑ Other: 1 A , ''1 t' -� i � I i j • ,ar' 1 Ip.. j 1R:�f ��w t aC� ! IN' ,,1'.4 -. .4 )411 h' ".I x'e1 igl u I t 11,k; ir�i ;1 ! II � G +��{�ifiiiy,'(1UAidM i ,At l�i Iii 1! w m�: 1raM ,y+',]t,�Y�l1f6A�1}mi��fir�'�r tmi t � Fee for each commercial $75.00 • system (SEE OAR 918 Check Type of Work Involved: ❑ Audio and Stereo Systems 0 Boiler Controls ❑ Clock Systems E Data Telecommunication Installation ❑ Fire Alarm Installation Fl HVAC O Instrumentation LI Intercom and Paging Systems E Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ utdoor Landscape Lighting* Protective Signaling ❑ Other , .. Total number of commercial systems: — *N licenses are required. Licenses are required for all other installations I; \a,l(Idin5\rernit ELC.rarmunv»,aoe 07/01n0