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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: Permit S W Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2012 TIGARD Parcel: 2S108AB04500 Jurisdiction: Tigard Site address: 15422 SW CACHE CREEK LN Project: Brentwood Estates, Lot 7 Subdivision: BRENTWOOD ESTATES Lot: 7 Project Description: Audio /stereo, burglar alarm and data /telecommunications. Contractor: QUADRANT SECURITY INC Owner: BRENTWOOD HOMES PO BOX 14833 15170 SW FINIS LANE PORTLAND, OR 97293 TIGARD, OR 97224 PHONE: 503 - 234 -5558 PHONE: 503 - 407 -1101 FAX: 503 - 236 -2322 FEES Description Date Amount Specifics: Restricted Energy Permit 04/03/2012 $75.00 12% State Surcharge - Electrical 04/03/2012 $9.00 . Type of Use: SF Class of Work: NEW Total Number of Systems: Audio & Stereo: N Security Alarm: Y • Garage Door Opener: N HVAC: N Vacuum System: N Other: N • Other Desc: Total $84.00 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 0 952- 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By: Permittee Signature: Q� '/ or71.L / O' ^ 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 603.639.4175 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. Electrical Permit ADplication Ple,0-5e: l'i City of Tigard .� Reeeiacd 13125 hone S50 Hall .4 17..1 i Q r'NL,1- batch : 9...3 Z ,[ ` Detail No.:E . /2 -ems Tigard, OR 97223 m Review Phone: 503.639.4171 Fax 503,598.1960 c i &av ; Other Pe nttit:itfSrAv& DO / ?y 1 1, .., 1 t ■ I,Meador' Line,, 503.�i.g417e Ante her al Slo -Pace 2 Pon interact: www.ti � r Supplrsamut ill[Otbafl T YPE OF WO I`✓ % ,y,,,. � . ::_,.';':.• PLAN .' IEW.- • :''':.: • •:; • New construction ❑ Addition/altertlti ant , - , Please check all that apply (submit 2 Pero of plats maw* thanked below); 0 Sa rt e feeder 400 amps or mere 0 Building DI Demolition Other: g v�aAuec elurtn. • �Q � ! r � ) Q � whorl; she Inviable Thole ammo Q Marinas sod boatyards. • : • CATEGORY OF CONSTRUCTION 0 `\ . meads 10 000 VW a+ ISO VON m D Tteart„8 bald ttg.. tars to pro or 9 11,000 0 Comraeteiat.uto tOrlcalturol e. 1 - and 2-family dwelling ❑Commercial /industrial [t • y ``.b\ . building Saps fir all other installations. buildings, ❑ Multi- family 0 Master builder tTrer: ❑ Fitt rum. 0 ?magi o r 75 KVA or load of ' 1tll;Cfr' r4FO(ATXON AND LOCATION . 0 Y ayatera. largo separately delved system. Mon d "A ", '7 "1 -3°, i�. u r d Job site address: /S / 2 S ) C - - e J G . n of new me CI . e residential Wet Q R Occupancy. o 1 vehicle MAta, 01e1111.ra %Widen. ❑ Supply voltage far more slam 0 Me ,daai lttetlttes& 600 volts nominal. Sulte/bldg. /apt no.: t Project name: _ e- / . oz • ■ Svelte or feeder 6110 amps re mere. Cross street/directions to job site: _ 'a•. a., Total En New residential Slagle- or mad- lbtally dwelling unit. Indada attached at g . Subdivision: Lot no.: 2 L000 sq. or legs 145.15 II TAU map /parcei 110.: Fa. adds 500 vq. R or portion 3 .40 L . DESCRLPTION OF WORK ug t above • residential 75.0(1 _ tide above • . A Limited ter, 75.00 en orgy. y © VD ' s •• t d • et. 1 .,: .+. c residential at - 8. �� Services or feeders installs ' � , , al .. And/or relocation !mi l A(i,i b11 i 200 amps et Ins 8030 © PROPERTY OWNER CI m4Arrr • ' 201 arm.. to 400 amps 1 08,$5 Name: AC i /.r ie.i0 O A r D/ ES 401 amps to 600 am , ' 160.60 6131 antes to 1,000 amps iI 240.50 1E11 Address: z St.i.) _ /i ' /67-3 ,,,2 , Over 1,000: or volts r 454.65 rEll City /State Z P: 776, 9 7 ..a 4/ Tempon*y apices ar feeders lnst1lkefon, alteration, and/or • Phone: (, ) 4 /0 7 //a / Fax: ( ) 200 amps or less 66,85 Owner InSteilletion: This installation is being made on property that I own which is not 201 amps to 400 a 100.30 1.111 intended for sale, lease, rcpt, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 133.75 ; 2 Owner signature: Date: Brand drealfS– t11ew, simnel or extension, piael ❑ APPLICANT A. Fee for branch eireuit9 with ❑ CONTACT PERSON • above service or feeder fee, 6.65 Z Businem name! each branch circuit B. Fix for branch circuit finder IIIIIIIII © +v Contact name: r7havl Service or Parader ta:e Arm branch circuit Address: Each add'l branch circuit In MIA d City/State/Zip: ....` mediums Se1i lee or feeder not indud • 1 Each manufactures or modular II Phone: ( ) Fax: ( ) dwetlin service and /or feeder 90.90 II E retail: -- Reconnect only 66,85 Pump or irrigation circle II 53.413 • • • CONIRACI'OR Sign or outline lighting 53,40 li Busirlca5 trams: f Signal ciroult(t) of limited - 1 r!"1.3 Address: P O . 6,0x 1 83 energy pa D - c r i bet;on. or �• 4.1c,,,,,... 0 , ° 7,�^� 9 3 ` Cott, Describe! 1S 1 Ci,/State/ZTP: & P one: �' 3 lip `( - S F: ; 5'0 Per inspection EMI 62.50 �- N.- - a� � irmgstigation parlour p le mini 62.50 �� I CCD Lie.: Q � + 4 � � Electrical Lic.: _ - ( '389 ' N Supra. Lie.: 'T mammal •ittrlt , -hour NM 73.75 Supra. Electrician signature. requ � p 11111... Prim name: Subtotal: '� � ' i ittE�2M– Date: Plan reVi w (25% of permit fix); Authorized signature: state surcharge (.12% of Permit Re): ° , aG TOTAL PERMIT ME: . .. OV ` Print name: bate: t � a t en taping Wilt peewit Is not s _ , 'dibin WI dos rear ft lies been oeeepted as enmpLyn 7: 18oildmtdPermIMII .C•PermitApp.dne OiIJJNd �M I5T(I tlb!fCt)Mnvna a Number of i eefione tdTowed per pteenh R 0 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: .ism �o 'oPla " 7 f -- - -.. - -- - -- Pee for as residential systems combined ... $75.00 Cheek Type of Work Involved: 14 Audio and Stereo Systems* Burglar Alarm ❑ Gauge Door Opener* ❑ Heating, Ventilation and Air Conditioning System.* ❑ Vacuum Systems* 21 Other; 3�1e ., TV, ... • — Fee for Aasb cornm,ercial 7S.bo system (SEE OAR 918.309 -0000) Check Type of Work involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecomtaunicatioa Installation [] Firc.Aiarm Installation F.VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Sigpaling ❑ Other Total number of commercial systems: — *No licenses are required. Licenses are required for all other installations miiiettnikm fteLe.pcmuApp.aac ammo •