Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00298
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/24/2007
PARCEL: 1 S 135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 208 ZONING: C - G
SUBDIVISION: TIGARD PLAZA LOT: 002 JURISDICTION: TIG
PROJECT: DOLLAR TREE
Project Description: Install audio intercom system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TIGARD PLAZA LLC SAFE TECHNOLOGY GROUP INC
8320 NE HWY 99 6400 NE HWY 99
VANCOUVER, WA 98665 SUITE G #375
VANCOUVER, WA 98665
Phone: 360 -566 -8102 Contact #: PRI 360 - 699 -2130
FAX 360 - 719 -1527
FEES Reg #: ELE 79CLE
LIC 173731
Description Date Amount SUP 4272LEA
[ELPRMT] ELR Permit 7/24/2007 $75.00
[TAX] 8% State Surcha 7/24/2007 $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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By 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'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.
Elejrical Permit Application FOR OFFICE USE ONLY
° Received nd
IN City of Tigar Date/By �'1 /� �� SL PermitNo.: CI Y�40A.9 — mZ ,-
n 13125 SW Hall Blvd., Tigard, OR 97223 P lan Review (�( K[ V
C - Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit.
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: kris: 0 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: 7 1 & Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction IRE Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling J1 Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A", "E ", "I -2", "I -3",
/, Q��, I00HP or more. occupancy.
Job no.: Job site address:
I 9 I S I C "r a � ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: ' / CI Health -care facilities ❑ Supply voltage for more than
r 5 �'r(A 0 g a 3 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: .9 206 Project name: as I I ar -rrce ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: y , /( /3 va f 1 0, 6, ` p FEE SCHEDULE I Q Y. I I
J � � Description Fee. Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. 11.)
^, Limited energy, multi - family 75.00 2
AU N ;o J l Lair- S y 3 1-e444 residential (with above sq. ft.)
7 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
Vf APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
rr
n �7 each branch circuit 6.65 2
Business name: SG17'G T ,„oio5 if 6j' (4/0 d' i C. B. Fee for branch circuits
// eel without service or feeder fee,
Contact name:
�GSQN ,I r ee first branch circuit 46.85 2
Address: (M00 N i 9q s ue ; 4 . t t 3 Each add'I branch circuit 6.65 2
y G Miscellaneous (service or feeder not included)
City /State/ZIP: Von to i 4 W W4 9 e. t. S Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (3teo) i,»9- / ,i 1 3 p Fax: : ( 31'0 ) ?lg.. /5o)7 Reconnect only 66.85 2
E -mail: 341L5 G 4aft,..1eckh0Iol .14i1- Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
/ / Signal circuit(s) or limited -
Business name:
6/,../t. T c cL. /►O (o y y 6to , a e, ,o c • energy panel, alteration, or
1
Address:
V yf b g MI 4'' .� 4 . 375 extension. Describe: Page 2 ?5 00 2
City / State/ZIP: (44, to lit/ i_f4 41c, c, LOS Each additional inspection over allowable in any of the above
G Per inspection 62.50
Phone: (31,0 ) b,61 - . 206 Fax: (3&b ) '?04 _ /S? -7 Investigation per hour (I hr min) 62.50
CCB Lie.: i 7 3 -) 3 1 Electrical Lie.: 6` F -21 Suprv. Lie.: (J 72 1.,,c,..4 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician siglta r �, "filled: /f f /0 /0 �l /e Subtotal: ,0(�
Print name: s... 5 S j Date: 7 _) i - 6� Plan review (25% of permit fee):
D n lN'� State surcharge (8% of permit fee): / bo
Authorized signature: TOTAL PERMIT FEE: 6 ( oh
This permit application expires if a permit Is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pemiits\ELC- PermitApp.doc 05/23/06 440- 4615T(l1 /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007
Phone: (503) 639 -4171 41 a ' , I�I
Inspection Requests (24 Hrs.): (503) 639 -4175 P_
INSPECTION WORKSHEET FOR DATE: 7/26/2007 TIME: 7:03AM PAGE: 19
SITE ADDRESS: 11945 SW PACIFIC HWY 208 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: Install audio intercom system.
OWNER: TIGARD PLAZA LLC. PHONE #: 360 -56 6-8102
CONTRACTOR: SAFE TECHNOLOGY GROUP INC PHONE #: 360-699-2130
Inspection Request Scheduled For: Date: 7/26/2007 Pour Time:
Code # Inspection Description • ' - Contact # Message
199 Electrical final 052818 -01 '60.521 -8137 N
Corrections /Comments /Instructions:
Pli - ASS
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY N azut Date: 1 J26f 01 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007
Phone: (503) 639- 4171d l
Inspection Requests (24 Hrs.): (503) 639 -4175 . �!lJ'
INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:02AM PAGE: 61
SITE ADDRESS: 11945 SW PACIFIC HWY 208 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: Install audio intercom system.
OWNER: TIGARD PLAZA LLC, PHONE #: 360 - 566.8102
CONTRACTOR: SAFE TECHNOLOGY GROUP INC PHONE #: 360. 699 -2130
Inspection Request Scheduled For: Date: 7/25/2007 Pour Time:
Code # Inspection Description Co ' # Contact # Message
135 Low voltage 052682 -01 360 -521 -8137 Y
Corrections /Comments /Instructions:
ici I bE s &ii a, 10 s
C E i L I N c c ' .s .
N'0 cf.,TV • bqA f PUN* .I5 y 0-
❑ PASS X PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' \�
1 t8 Date: 1 •26' 6 1 Phone #: (503) 718- *MA)