Permit IN q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit e: ELR2012 -00081
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2012
Parcel: 25111 CA07900
Jurisdiction: Tigard
Site address: 15280 SW 100TH AVE
Project: Hix Subdivision:STATES NO.2 A REPLAT OF "GULF SII Lot: 23
Project Description: Low voltage for security system
Contractor: SONITROL PACIFIC Owner: HIX LANDING LLC
8220 N INTERSTATE AVE 11438 SW WOODLEE HEIGHTS CT
PORTLAND, OR 97217 PORTLAND, OR 97219
PHONE: 503 - 223 -5822 PHONE:
FAX: 503 - 973 -7773
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04 /27/2012 $75.00
12% State Surcharge - Electrical 04/27 /2012 $9.00
Type of Use: SF
Class of Work: ALT
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. ATTE : Orego law =•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 through OAR 952 -• -00'1. ' / may obtain a copy of the rules or direct questions to OUNC by callin• • . 32.1987 or 1 .8' 800.332.2344.
Issued
y: k_L i/ L� ��_ Permittee Signatur � _ - �' ' " (� - �
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.
Apr. 26. 2012 11:49AM Sogt u EIVED No. 1324 P. 1
Electrical Permit Appl hc)li OFFICE IJSF ONLY
City of Tigard APR 2 6 Z 01 Z ec Rec eiv e3 , Permit No.re/.. ene)4V �jQaB
/.�.
4 13125 SW Hall Blvd.. Tigard, OR 9722 Plan Review
I 7 Phone: 503.718.2439 Pax: 503.59 ' Pate/By: Other Permit: •
Inspection Line; 503.639.4175 OF TI GARD Dale Ready/By; /uric 1 61 Sec Page 1 for
Tl(;A1lll Internet: www.ligard or.gov BUILDING DIVISION Notified/Method; Supplemental Information
•
❑ New construction ® Addicion/elteration /replacement
Please check olI that apply (submit 2 sets of plans wlirems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition El Other: where _ boatyards.
the Marinas and
._-• r . t -,"-_ , ,, •�=Jp1 -- w __ x: :r- exceeds available faul t current Mari 150toltsOr 0 -_ . r.� ��x_= �' :_; - ��'.- - rip �a �..,,� -� F
. _ ,.t7 _ . . 0- J' .ti ii : 7 .� ;., -.. t . ..4:. . = , kQI�J � � Se YQiyA . ' '.__.__ lilarf�3
- �.- .�- _,.. -..._. ?,}.t_iti; = ..:.. , . -....4:7,. , �..._......:.. ,:,_.., - ..._.. — less to ground, or exceeds 14,000 ❑Commercial -use agricultural
® I- and 2- family dwelling ❑ Colnmercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ O ther: ►Installation separately derived system.
Fi re pump.
- ., ❑ Emergency system, larger
4 .;:lc.; •_ - l ;Y I 7 --:... Z „ " "E", "1.2 ", "1 -3
-� �`:.,�:: : _ 1'�� I F,Q AT'lt)IV 'C.O;,L T. QTY_ _ r load of
r _ . - . � r J QR °, S N 81 1X. UVl1!.. . �. ;:: r�s ^;:'• # _ 0 ❑ • 100HP or more. occupancy.
Job no -: P120053 Job site address: 15280 SW 100th 0 Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97224 ❑ Health-care facilities. 0 Supply voltage for more than
❑ Hazanlous locations, 600 volts nominal.
I or m
• Jason & Hicks Res CI ore-
Suite/bid ./a t. no.: Project n ame: y �,,,� _ -.
-
:_
g P :6 :—.....�— : =- ;x_�; i` ;i.,tg ::.r -
,:•tiiMa?rr:::, •,,- c-L,.: ....rn... '>;.: .i'
Cross street/directions to job site: Descrt lion • t'. Pen Torrl •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision:
Lot no.: 1,000 sq. ft. or less 160.54 4
_ t,t
Tax map /parcel no.: _ Limited energy, residential 75.00 2
'.^:,:.{ ,sii,lrl.. ... `_�. 1:�.' =r �:i7'.F �;+'9:i' II:iT�� V��7 ro 1 �• � � : 4 L • w2 , ' ;. 1 ;U,� , T �
p r
� c-*. �; �!, •,;•.• � � : , : ..... �•t - .,....._ ....; 3 ^ . (.. Limited energy, mid-family II 75.00 -
Installation of Intrusion security devices. Includes a base pallet, keypad, 6 residential (wiihabove ,. IL) El
Services or feeders Installolion alteration, and/or reloca(ion
audio sensors, 7 door sensors and 1 windo sensor. 200 amps or less 100.70 I 2
., _ i ..,-:- *: - - ,- •- -;x - - f - - - - :r„• =' F _ a mps l amps 133.56 2
p_rltal�la)- _.
�'ir o13r[V r . 1. .• = 200.34 2
.. ....... :
- 1 KI1:.. .;�....., = : -- 600 amps
, - - . � .. 401 amps [
Name: 601 amps to 1,000 amps 301.04 _ 2
Address: Over 1,000 amps or volts 552.26 2
- Temporary services or feeders installation, alteration, and/or
City /State /ZIP: • relocation
200 amps or less 59.36 1
Phone: ( ) I Pax: ( ) 201 omps to 400 amps 125.08 2
Owner Installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or ex _ lenslon, per panel
Date: A. Fee far branch circuits with
Owner signature: above service or feeder fee,
t
... _ ..� :._,: • 2 is 7.42 2
r . r .�-..�..._ .. _.7k2 :.: ` -
_..: t: . �7r. t•tchbranchcirc�
• - ' �_ r•: j °fy.w i, �: .; ' .:�� '" It
. .. ia .�. t ' rr
- B. Fee for branch circuits without
Business name: service or feeder fee, first 56.18 2
branch circuit
Contact Each add'' branch circuit 7.42 2
Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
dwetlin :, service and/or feeder
Reconnect only
Phone: Pump or irrigation circle
Sign or outline lighting
• a Signal circuit(s)orlimiled -cnergy 1 00
. or emension-
Business name: Sonitrol Pacific Each additional Ins tcrlon over allowable In an . of rite above
Additional inspeclion (1 hr min) 66.25/hr
t N Interstate Ave
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Portland, OR
i 1 tit
CCB Lie.: 53535 Electrical Lie -: 26370CLE Suprv. Lie.: 3567LEA d-XIZP,ggf4 'I
- Subtotal: 11
Suprv. Electrician signature, required. � Plan review (25% of penni[ fee):
Stale surcharge (12% of permit fee): ' ► ►
Print name: Gordon DuCes • Date: 04/26/12
TOTAL PERMIT FEE: 84.(X)
Authorized signelui`: 4 /�� • , , %ill.j. This permit application expires If a permit is not obtained within t89 4'
'
d L days aver tt has been accepled an complete. v e
Print name: Leslie Eric on I Date: 04/26/12 • Number of inspections allowed per permit.
t; tauildinePtrm ilaLC- PemulApp.dOC 07/01110 440.1615T(11/0S /COWwCn
A p r . 2 6 . 2 0 1 2 1 1 : 4 9 A M Son i t ro l No. 1324 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
NI�;:r= :::
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
Other; Intrusion Security
--�.., -�,:: .;._.. ._.. �.• -- -ter- _, • T-i- ,..� -r _
1 ,,.(`QMME•� �• ' w� `�LC'�����rC� _'_ i= i•i'�i.•k.�E•;x... .. .. -. --
i Fee for each commercial $75.00
system
(SEE OAR. 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: 1Duil0inglPcm1Ii61EGC- Penn4App.dx 07 /01 /10