Permit . fi 7 / '? - 0 - ig ae.ii-p-e. a-v •
CITY OF TIGARD ELECTRI L RESTRICTED ENERGY PERMIT
11 1 a COMMUNITY DEVELOPMENT Permit #: ELR2009 -00291
T l GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/11/2009
Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 90
Subdivision: Lot: 0
Project: Islands Tanning and Nails
Project Description: Low voltage for T -Max timers. 9/17/09, adding low voltage for audio /stereo wiring.
Owner: FEES
13500 PACIFIC CORP Description Date Amount
BY CAPOZZOLI ADVISORY FOR, PENSIONS Restricted Energy Permit 09/11/2009 $75.00
INC, 21500 HAGGERTY ROAD, SUITE 100 12% State Surcharge - Electrical 09/11/2009 $9.00
PHONE: Restricted Energy Permit 09/17/2009 $75.00
12% State Surcharge - Electrical 09/17/2009 $9.00
(manual)
Contractor:
ADVANCED TECH SOLUTIONS, INC.
P.O. BOX 179
HUBBARD, OR 97032
PHONE: 503 - 981 -1118
FAX: 800 - 709 -8705
•
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: Y Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $168.00
Intercom/Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: y
Other Desc:
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. ATTENT . n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -00 through OAR 9 -0 00. You may obtain a copy of the rules or direct questions to OUNC by calling 503.24 6 or 1.800032.2344.
Issued y: ( AA J Permittee Signatur . d
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 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.
. .
09 -16 -09;05:50PM;Advanced Tech Solut ; ions 5035981960 .
# 2/ 3
• . - • • - -
Electrical. Perinit.AritillAKErVED , f•'()It ■ H'Fit "F. l:itii
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'...'•eitY'Ot ligord • ItitiiiiiiViiii. '' - ....P4 , -0023 L
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. N IN --4 1 1.3 . 15.SINT 11011 titivti-lrigtud aprzt 7 2009 1_, ,
Plop, tic
' . ig" Minna: St7..4.030:4171. Fax: .503.593.1960 Dctid.14 (mkt
...., .
. T : G A f ''' r) 1"Plai°1111TID. 5E13 OF TIGARD I'kda Aract — rgly; RIAU:. [ !
• - • -... l ,ki-e Pap2 tor
ItqCfnel: 4 :,._ i -: ivalifirtINIet ---__ hat .
... •
•s•applealaitial latonnanna
.- ... Ai i , . , ,-. - _....._ •
enarilWit filliftlifl . l i17 .g 1 2 " 2 - ` 51 -$1 - 1:0WV:Cd‘ 11 -! 1 ' 11 11'.. fi 0-1,'
, D r.tow construction 1,21 Add itinu/altoratiOnireplacmen t Flew cbteft all thitiAtty ottunsit2 sets snitimsmotpocnoorit tichno
cv
laEii im AT ii!Oui:lkilkilnitfAirrisino 0 Binitlkat onl Iht=e
0 0,:..gzolilion 0.:(!ill:f: whov Me - inailable itivu karma CI tuitriNk4 mitt liabiliat.k. •
Ei57,7@ i i raffiffM011: ,`114i1Pi;y1,CVNA'fi'fliPtillill!ifilrg.,, qtr rstodl10,00tIonyv 3,3o.v El Rost ingevittlintrg,
erluis‘ a ■-, . - .....' eftilltil.:i.ntsta1 lank 1 i1A1 I I i - 1 6 ‘fi -..31146 ro,y,u, ground rir
, or ak ,, w i. tit,a1110 0 Conant/OR I-ase nit 1
0 1 - anti 2nniiyd
•weilire 531 Cm
omerciat/IndUsttial U.AccessokybUilrlint stam tni MI ullie2 lima ib tnowings..
0 Alittlit 0 Mamer. builder • Other. El 14trixdup. CI hunitraim a 75 ICYA .11" 1
IMI! '' ItiVi RI ''.....; .7 ' S.71 ■ 51" I ' M I l e:; uhrittEetN. ocamica. a linigircey Arsten Itarksvpkwavy stki Mit p m.1
,!...., _...., , , .0s .I! .',.•,--,.- ". . " . .:,..,1 1 ;,. l a , +,:. -, .: .„..., ._...,,,r 1 ,,,i,.,„- ".. •,,,, 1.1% ' : '''' -- y.' , 417..,...---* 0 . new wow land et 0 - A",.'ie:. -1.2
t•
luaus,. ilim sceepssey..
J: Pm: i lob site tithlutz: 13500 SW Paelftellwy
......,„,_ El six et BUM tolaenasi toldip, Cl auleaittnninhitle parks.
CitY.Malcalls: Portland •llgard), OR 9722.3 ; El iteittat.two mcilities. CI Sgsny yrioNs, formic ihtti
'
1:31-kumnstias ir,Liatickg:. Ovum" ulna:hut
t----- ..
StliteibldgApt. no.: Proje.o name,: Istands Tanning and Nail:: 116rgvirt.yt.tzuut.ttitstatr ; et ttiotc. .
1-1,1 mmtLitAIIII5 1 , 04 4 1. 'a - = .1 TzT4M7TTAITiqvt41
— .• . ...: _nic.,,,..,;#.1.,f.".!‘tr.;:•,:21,2,,!,:7.40,1,10,a1,..., 7'?..-
C'xixis streglidirections tupttsiii;:.
. _ .--•!=kAJIttlii. ..., ..... . : I, , - wt.; •
1 ----- • ....._ ..___ .. . .
---- Now roildiwiiol isCnit dIMIndly d willing mgt.
IntIndasaltichid garage.
- - -- --
•
Subdivision:
L1 no.: 1,0(10 q. s rt. at Ins 14515 ----
t...dal 500 sq. R. or portion ';3 40
' ... • • 1 ,
ix map/parent no
„ . LimiteU cuerhly, residential
4:31 .'' :I.:I " 4 : 4:e - T -- 1 . 'i i'" N • 0 7:3.00
• .1..itnItad eitetgk, inalti-fainity
idaidentiat'w1ih alanc.-; ..8.) Ill)
tAiw Vtitutgn whing fort Timers 7
. ..... . . • 1
......_
973 .6 7 6 a 00 9— po A 9 / 8 c.rd.ett 4 -arteit• Ors butitilid atter:Mon, and/or Macadam
,_ 200 rips richlx 80 311
: fir .1P;■/ ■ 'i i' •; 1 illn" Itrit' ROM - - i lltriffIrT'v 7,-- 4 Y
tA I. ', '''. ''-'•:' l'.I lh,i4.., I • ,. 1 ':' ..a...li i I '„.: ■,..,"......._ x li al 2,!I9..!.8! , -1)) amFei 0 1 itillPs _ 4 2-
Mune: lainud8 Taming and Nails, Inc. .
. 401 inapt! to l)tykuips 100$ 2
- ti131 amp, to 1 ,tX1ft arrok 3,40.00 , 2
•
. . ...
Add16181, 358 Warnerikillne:Rd '
Over 1,000 iimpsor volts ; 154.0
... . . _ .
City/Stale/MP: Oregon City, OH 97045 'remporaly senlees or &tilers iaatathaian,alteralia0, all(War
t'hoing (503)6564207 — I Fax: (503)692 -8277 300 amp. or les li0.115 1
- — - —
Ovinerinstallittkut: This installation is being math: on proper . tly f I +hi t L 7ri 201 La 400 malm
). 4.1 own Vi t. S 11 Itli/Li0 2
...._
i intended for sale. lease, ram or exchange, atx:ording tn .016 447, 44.9„ b70, and 701. , ;01 snips In ks.a.nym L. '- NMI 2
, branch err;11[1 Ati/rido . or extaadon, • .., ;
' Owner signtaure:
.. . • Date: • A. Otte foIr Nandi iiitoW ii•ith
. 0.6.5
,P1 22 L09, fagir laniffaia ,. ,, , i I SiprIM il !'" 'Izmir ,, iipil above service-or 13/tater:lee,
.''' +,--,- — "-, - t . .. ' : ' 'in I . c■A,rn. .1{. ' .r. - - , 1
,. each hn.m.eltrtmlit
N
Ruskin% 'OWE): Croviive Coed:end:ors and Design., LLC '.
[
Corium name: Jushint Tittle li.lare ter luandiatebila - .....'"
wilhoitt aurvIca el' feeder ran.
ii NI hum* 4reitit 41'1.83
.. . '
• " •''''. ........
Addren . 15157 Llnion School 14d • titich ;Win tinnatt.dircult. 6,0 ,.... 2
• • -•----- 97071 • ,. W_Iicetb.,_ j,L,ttall1 Atty.. Its• feeder nal I lured)
;
City/State/7P: vvooab4rn,.ga. iikell znpnitlItettated
. .,...
00:90
dung .sarviee and/or ketfar 1
Phone: (503'y 904 I Ftix: : ( ).
Rocontieici only iSikitS 2
.. .„„._ __, ....
F..snail: biliingercdft,ntall.corn jitmitur hriguttorl ritele___... 5140 - - - ',
.„„._ ..
1 `1 - g71107„' i ' I. 11, . h)T 111 .4;INPIRMID;k20{Cit raigig , Si gu or raaliat 1 41 1 Cahlg ; 63 A , 2
Business tinrup: Ai:Narked: Tech Subdions, Ine. . ) - §igiutl circult(s) . ()Hite' lett- I '! I
; energy panefanteriation. . §?e
.. ,
• : .ostrosion. Detierthe: „4--- iti - 2
Addras: PO Ibm 1,79
• .. ' T,-Max Times
_
-
City/51.11eal It Hubbard,. 611..91032 Each additional,tomtiion'oer.nRosvable hi itisy u( (h nbow ,.
'
• - her lasptelinn t'.1.51i I
Chm: u (563)9M 81-1 F. (PO) 709:4705
.. tnytigratee.perbiatix(1 la- mini
MB Lie,: 176316 llietArit:111 Lit: ( 1 "S tarry. 1.1c:: 407 .. ' - iiutustriai ....pni.... .:14110 —
----" ■ - 11 .1! i if ti noi 74rirr"T'irly
Snprv. filectrician signature, required: - • ,,,iite: ----. Subotal: ' 1 v
p6,....miew (23% of puma fee):
Piiill ;lame: Alex Martusturi
Date: 90/2009 . _
• ... - -- Stave sarkitatga o( iii fee): 1 ! teX gE ....,
,...
. .
Authorized sigoontre. ..e .. ..., ,,i ..... .....:., of ""7, • ,
TOTAL PERMIT Ph F.; ts
Print name:. Alo gartushev • ,
09
17 --- A" ' 9 i 9 / 2 ° _I lid, pkragt imp" Iliaqua.expLret Urn penal tlk,ant ttaintacolvtthin 180/
itt4s after Rhos haat ampton.ra cumntete. Li
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• &WAN yl V Y }Weatnt.74)
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09-16-09;05; 50PM;Advanced Tech Solutions 5035981960 # 3/ 3
Electrical: Permit, Application City .of Tigard
Page 2 - giappleinettat Iiifarination
.LIMITE D ENERGY PERMIT FEES:
Fee kir 4iiatis combined $75.00
Check Type otWorlcintiolv.ed: •
0 Audio and Stereo Symms* •
O Burglar 4iam-
•
Garage Door Opener*
•
0 .Hating, Writiktiorrand Air C'onditioning Sistern*
0 'Vacuum Sys
1,3 Other.
vc for pad .commercial, 75,00
systetn
(SEE OAR-9.18,309-0000) •
Check pc of Involved:
Auclic.1 arid Stere6 Systems • Pe4
0 Boiler Controls • 5 .
O clock s dr4AL. a Aci\
Data Telecoirannnication insLnin
Ej tire. :Alarm tri.stlitation
0
0 Instrumontation
•
0 Tatettorn and Paging Stems •
O Labdsape Co
•
0 Medical
D N'xg4e.. (alms
D Outdoor Landscape Lighting*
•
0 Protective Signaling Atre44 4on
Other T-1Virec Tirnork Wirin < .
Total. nurther of commercial systems: 1
*No lkenseA: are requited.. Licenses are required
for Il oilier installations
■:to,IS1.14e mb9‘,P1.4:- refliM+111 .fi1.1.3•43f)
, • . , • ••• •• ,TOTIVIrEnti: • • ... • • • •
2
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
;'1 a COMMUNITY DEVELOPMENT Permit*: ELR2009 -00291
Date Issued: 09/11/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2S102CC00500
• Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 90
Subdivision: Lot: 0
Project: Islands Tanning and Nails
Project Description: Low voltage for T - Max timers
FEES
Owner: Description Date Amount
13500 PACIFIC CORP
BY CAPOZZOLI ADVISORY FOR, PENSIONS Restricted Energy Permit 09/11/2009 $75.00
INC, 21500 HAGGERTY ROAD, SUITE 100 12% State Surcharge - Electrical 09/11/2009 $9.00
PHONE:
Contractor:
ADVANCED TECH SOLUTIONS, INC.
P.O. BOX 179
HUBBARD, OR 97032
PHONE: 503 - 981 -1118
FAX: 800- 709 -8705
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 Total $84.00
Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: y
Other Desc:
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 R 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. ` /
Issued By: Permittee Signature: ex/ ��Gie��O'v
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNERS SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4176 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.
` i . 09- 10- 09;12:20PM;Advanced Tech Solutions 5035981960 ; # 2/ 3
Electrical Permit Application ECE D . 1'OR ,,,..u. t i; ()NIA
City of Tigard 11 tt¢ceivcd /gym . " E n
g Date/11 : Z C 9 ` - Permit No.: .000 �r�0 6,,9
13125 SW hall Blvd. Tigard, OR 97223
a b 6� E P 1 I 2009 Plan Review _-
Phone: 503.639.4171 [tax: 503.598.17 Date/13 : (AherPertait ._ - - ro
't' 11'. A 1t I ) Inspection Line: 501639.1175 Date Ready/By: NM ®See Pagc 2 for
Internet: www,tigard•or.gov CITY OF IGARD Notified/method, Supplemental Information
:r "„,!',, :t - ::.. .'r .�7;1 { '
• -,..r, �_•� _ �� ar ts, �..._...,.It - -ItL 1 - _ l
1 i� l r I rli�� i 3.' ,i, 'I i u
.rt r r.L„_e.,:c. . , 1 1 _ u,r,!:es.,aL�.,:.:.lu!,1 �IJ,i- ',',',, , rl 14 wl :,,J } h,l - WiI N i it ,ct_ill �} 1 r vl
. ! ,1 a�1 1 ;:_ h r' � „ r`.:.,f�,�:..' flit !.. .Glhi! �� � It , =• , � - T;'''- `'I�'; 'lE�► -�1f = _''�
❑ Ncw constructio ® A it /. l t • / eplace eat chck
ae e all that apply (submit z Seta of plans w/¢ checked cots cheed below):
LI Service or feeder 410 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: wlu:rn the available bah current Q marinas and boatyards.
'7,71a I f0 Ip li i';! iI 2 ql il'r;� ty "y v u 14: pe m f lu t r lcn' � tl � ss •s_tn n•r a r¢ y
'1 y . ✓; � � �, �� 9 ,^ YID r '� �' r' Iy"� r:;5i exceeds 10.11110 8n1 81 150 vials or n N 7 1: ra 7 .;AM7, , lillit v a amps a Floating buildings.
i,,.r I c,,.,r - ; r :�t „n .;.lar<I �1.�rtL 1,11., :� I iildn r,u rlllrlfilidl.,}97.IA�'. , u`' ,,,1 �llk,. +,,L�wtYtl. leas to ground, nr exaerbs 14,000 ❑ Commerevl -a6e agricuhurel
❑ 1- and 2- family dwelling ® Commercial /industrial • Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder • Other. D FIrc pump. ❑ Installation of 75 KVA or
et7t . 1 . ° l,, 4 }' P ,1 c I �9 F El �'1' 1 / 11 P 4 y . ` t ' . }r _ ,e f+rlil r� i ! I ' , . I, D p rgeney system. larger separately derived system,
t�l, :'.1'''2 r�'c1 ' 1 I . I } ' � `r 'g t 6. ` t. +X l _ 15 °s tar ( k li f t
g lY muh,r o f 1
, , .-. :���al;,n:r;.r,.•?u:,rr_*<:.u, : � �. ,.. a ' ;tl l;�:,,. ,S �Additioaof new load ❑ ,. A .. „ „ i ..
Job no.: Job site address: 13500 SW Pacific Hwy 1011Hr or more, occupancy.
❑ Six or more residential units. ❑ Recmatinnni vehicle parks.
City /State(!.I P: Portland (Tigard), OR 97223 ❑ Health -care faeliitie:. 0 Supply voltage for MOT! than
❑ Hazardous hxatioru, 600 voila nominal.
Suite/bldg./apt. no.: g I Project name: Islands Tamping and Nails ❑ Service or feeder 600 amps or more.
CfORS stfee-V IireetioDS to job site: I : 9 .1. 1 I 1i;;I li 1nt r n r "li '
.� �1'll i t , i, m
I ,N ii l 1 u i,; a. i...r_ • � 1 t .11'1! . [ i i d 4 :. �,1
Description Qtr. Fee. Total •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 s6 ft, or less '145,15 4
-
Tax map/perm! no Ca. add'I 500 sq. R. or portion 33A0
t - ". 1-�i,1,� { 1 3 tr, F rn 7rs-t4 Ir4 yy r l!!� ,I ! Limited energy. residential 11
�1t ! lo." ----- -11 dq„c *li t l� 1 \'V { �,--' '''1']14 }} ''11. &171 �� ` l' irn:rit4:i:62 ( ..ull.u`S' +r • 141 � "'" tit ' ' 1} I (With above fun. 0.) 75.00
i.0. w L ■
Low Voltage wiring for T -Max Timers I Limited energy, multi- family residential (with above sq. rt. ill
Services or feeders installetto , alteratio , and/or relocation
200 amps or less 80.30
rwr 1 ,e� uu I 1P I,r Ill tit t l�,�>,�r u� c,7� s ill ^ v t , .. .. lei �.I= e�
d$i+1 J ` 1 tl [= 1�r,'� A j tJ, t 1' t (, L1 ,a'..17y�!,`11�1 201 � .g1. iv 'll a ' to 400am
ItA. I. ;.:,.L:.L 1U..,.�.,1t u.lv.:,t:'7lla,s.>fl;..:.1 }'� -'ii'J .6'll "1�.',1!i3u�i:l,l.• ,... ��}.. .., II'ln,�J. 1. .,- .�lwlrrli }I1liLLlLW. - ice' 106.85
Name: Islands Tanning and Nails, Inc. 401 amps to 600 amps 160.60 2
i 601 amps to 1,000 amps 240.60 2
Address: 358 Warner Milne Rd Over 1,000 amps or volts 454.65 2
City /State/Z1P: Oregon City, OR 97045 I Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)656 -8267 I Fax: (503)6928277 200 amps or leas II 66.85
Owner installation: This installation is being made on propci ty that 1 own which is not 201 amps to 400 amps 100.30 II
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: I D14e:
Branch circuits- new,alteredo orextenslo, , r. anel
A. Fee for brunch circuits with
t l t r. , a„ n;n,r
1 �ij Mlil 11! 1 ! t '"1+ '•+'•Ss'a,,.e tlmtr r ^ I�t t4 t l It ,'� r. r nclac t uu { r
,t :1c: c '�.i f .,� ,,.;- A t..d,:l ,74, n..:,s ti . N.1 tams.:. tl an. c..�:, . ' I ; ,r1' Y't+sl) at i ';.. ` r } ' !! L + it 40 above service or feeder f
l-,j ., U 1 1 •,,,,1*�2,n, r>aPd l.. 1 1 t, fee,
2
Business name: Creative Contractors and Design, iiLC
B. Fee for branch circuits
Contact name: Joshua Tittle 2
without service or feeder f
first branch circuit
Address: 15357 Union School Rd I Each add'] branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/Slate /ZIP: Woodburn, OR 97071 I Each manufactured or modular 9090 z
dwelling, service and/or feeder
Phone: (503) 9f14-3220 Fax: : ( ) I Reconnect only 66,85 2
E - mail: biliingeed@gnlaihcom I Pump or irrigation circle - 53.40 2
; ' 1 RE t �' r r, ' [ `O R � ` .. . YT Sign o o utline li tut 3
s .. Itu3,.i va i t. �v9;,: tii�4. �, „t„`i n1 Ira uu 1 ' u9 tY a .J .: „ : 1 , it Sig g 5.. 4 0 2
Signal circuit(s) or limited -
Business name: Advanced Tech Solutions, inc. energy panel, alteration, or
Address: PO Box 179 extension. Describe: 1 Page 2 $75 2
T•Max Timers
City /State/ZIP: Hubbard, OR 97032 I Each additional inspection over allowable In any of the above
O Per inspection = 62.50
Irl
Phone: (503) 981 - 1118 ill Fax: (800) 71 705
I I >R Investigation per hour (I min) 62.50
C :C1 1.ic.: 1763'16 0 EIectricall Lic.: 176 • - ! ! , uprv. Lie.: 487 - industrial plant per hour 73.75
' c 1 _ / 1 tItg ittI, ug
_ 4 .
. ` , i;;i,: ' ,
� ,u • : fa . :fd
Suprv. Electrician signature, required: Subtotal: +5;. N� :3
l: $75
Print name: Alex Martushev Datc: 9/9/2009
Plan review (25% of permit fee):
Stale surcharge (12% of permit fee): $9
Authorized signature; f T
_� �. 1i / �•. I I'0'1ALPL•RMrrPP.P.: $84
ate: 9/9/2009 This permit application expires if a permit is not obtained within 180
Print name: Alex Martushev �D
days after it has been arrested as complete.
• Number of Inspections allowed per permit.
t :WOuiWingWormiWELC-rbrmilApp,duc 05123106 44u•401S1(11/a'+/rX)M/Wya
09- 10- 09;12:20PM;Advanced Tech Solutions 5035981960 ; # 3/ 3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined .. I $75.00
Check Type of Work Involved:
❑
Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener* i
❑ Heating, Ventilation and Air Conditioning S
El Vacuum Systems*
❑ Other:
.rV WW1
i
Fee for each commercial I $75.00
system
(SF.F. OAR. 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
•
❑ Clock Systems
❑ Data Telecommunication Installation
❑
Fire Alarm Installation
❑ I
❑ Instrumentation
❑ Intercom and Paging Systems •
•
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other T -Max Timers Wring
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
. i:\Duaain mii U C P rmiulpp.da 03/13/06