Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
.; DEVELOPMENT SERVICES PERMIT #: ELR2005 -00036
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/28/2005
SITE ADDRESS: 11445 SW TIEDEMAN AVE PARCEL: 1SI35C6 -00300
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of security system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: 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: X
• INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MERLO STATION PARTNERS SONITROL (AKA SOUND SECURITY)
P 0 BOX 23516 8220 N. INTERSTATE AVE.
TIGARD, OR 97223 PORTLAND, OR 97217
Phone: Phone: 503 223 - 5822
Reg #: LIC 53535
ELE 26- 370CLE
FEES SUP 1812LEA
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 2/28/2005 $75.00
[TAX] 8% State Surchart 2/28/2005 $6.00
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.
Issued by ��" Permittee Signature , ,,e,
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 639 -4175 by 7:00 P.M. for an inspection needed the next 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.
--.— \5 -05
Elegtrit�l Permi A. 1' ED - FOR OFFICE USE ONLY .
City of Tigard G Date/ay,a);, Z3 05_ „pc:K._
Permit No.: r (....., As aeWA
13125 SW Hall Blvd., Tigard, OR 97223 ^ 005 /4t,4 4 Plan Review
Phone: 503.639.4171 Fax: 503.598.1 KB ( 1 , Date/By: Other Permit:
Inspection Line: 503.639.4175 • y. e ms , Date Ready/By: , Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: )6- — Supplemental Information
CITY- of D - - : •._.f,..
IIQG TIGARL ` s i 'r PLAN R EYIE*,
❑ New construction ❑ Addition/alteration /replacement Please check all that apply:
['Service over 225 amps, com'l ['Hazardous location
❑ Demolition 0 Other:
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
- = , C ATEGORY', OF tONSTRUCTION'.:: - ;I' , 1';:' ,1-- .'
- ;j••" - "' .`ii of 1 and 2 family dwellings 4 or more new residential
❑ 1 and 2 family dwelling Ni Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi family 0 Master builder 0 Other:
DOccupant load over 99 persons ['Manufactured structures or
. JO B SITE INFORMATION AND 'LOCATION ;- . ❑Egress/lighting plan RV park •
Job no.: 835 631 Job site address: fj , y H 5 S W T 1 9._d yvvi Rd ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: y 91 -.D3 The above are not applicable to'temporary construction service.
Suite/bldg. /apt. no.: Project name: 'fin/ k( �/ - ' S FEE SCHEDULE:;;;
Y ` \ 1 �1.7Y\ n ` D escription I Qty. I Fee. I Total
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 1
r
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
t Each manufactured or modular
_: . . DESt:;RIPTION-OF WORK: - � . = �: ; :' _ •_ ; ' ",` :- _ _ -
_ dwelling, service and /or feeder 90.90 2
iJ * Cs, 1 �C C h ).� l Q 3 " Services or feeders installation, alteration, and/or relocation
Q 200 amps or less 80.30 ,, • 2
201 amps to 400 amps 106.85 2
❑" PROPERTY'UWNER • _ • . • TENANT :
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
'❑::APPLICANT" ' ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'! branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included) _
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
" : 1 '•: ' .r . •- . 'CONTRACTOR energy panel, alteration, or r � _ C
extension. Describe: % Page 2 l 2
Business name: S(�� ) SC ` _ ,, , . ,1/4
Address: b aao • � �/S�tivK. us,_ Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: u d t O Ck_`1 \ 1 Investigation per hour (1 hr min) 62.50
Phone: ( 50`3 ) a�3_ . ' ) L Fax: (5((5) O - 3 Industrial plant per hour 73.75
��� ' ELECTRICAL PERMIT FEES*
CCB Lic.: . Electrical Lic.: f � _2 T♦0 Suprv. Lic.:4fCL /� -i// Subtotal , --1 S • (g.,
Suprv. Electrician signature, require Plan review (25% of permit fee)
Print name: yl /n � a� Date��a���LL�X���X"�C //( State surcharge (8% of permit fee) ■ (� n
• 1 l TOTAL PERMIT FEE 1 , op
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Pemuts\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard w
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
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:
COMiYIERCIL `YORK' OlYLI':` �, -- . �:
Fee for each commercial system $75.00 •
(SEE OAR 918 - 260 -260)
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*
[1 Protective Signaling
❑ Other
Total number of commercial systems: t
*No licenses are required. Licenses are required
for all other installations
i: \ BuildingTcrtni ts\ELC- PermitApp.doc 04/03
'<CITY OF TIGARD .,
BUILDING DIVISION PERMIT #: ELR2005 -00036
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/28/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 -'. !L
INSPECTION WORKSHEET FOR DATE: 3/14/2005 TIME: 7:11AM PAGE: 48
SITE ADDRESS: 11445 SW TIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PK MORIN ENTERPRISES .
DESCRIPTION: Installation of security system.
OWNER: PHONE #:
CONTRACTOR: SONITROL (AKA SOUND SECURITY) PHONE #: 503- 223 -5822
Inspection Request Scheduled For: Date: 3/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # ssage
199 Electrical final 001565 -01 5032235822 Y
Corrections /Comments /Instructions:
V
(,)
4 PASS4r, ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �;�-u/ Date: 7 ""Q5-- Phone #: (503) 718- 2 L1»/