Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
2 • COMMUNITY DEVELOPMENT Permit# ELR2012 -00219
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued 09/18/2012
Parcel 25101 DA01700
Jurisdiction Tigard
Site address 7130 SW FIR LP
Project FTDI Chip Subdivision 72ND BUSINESS CENTER Lot 7
Project Description (1) low voltage for burglar alarm, (1) low voltage CCTV and (1) low voltage for access control
Contractor AMERICAN VETERANS SECURITY LLC Owner FTDI LTD
4420 SW 110TH AVE 7235 NW EVERGREEN PKWY STE 620
BEAVERTON, OR 97005 HILLSBORO, OR 97124
PHONE 503 - 808 -9010 PHONE 503 - 547 -0988
FAX 503 - 808 -9018
FEES
Description Date Amount
Specifics* Restricted Energy Permit 09/18/2012 $225 00
12% State Surcharge - Electrical 09/18/2012 $27 00
Type of Use COM
Class of Work ALT
Total Number of Systems 3
Audio & Stereo N Boiler Controls N
CCTV Y Clock Systems N
Data & Telecommunications N Fire Alarm N
HVAC N Instrumentation N
Intercom /Paging N Landscape /Irrigation N
Landscape Lighting N Medical N
Nurse Calls N Protective Signal N
Security Alarm Y Other Y Total $252 00
Other Desc 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 OAR 952 - 00 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 / 1987 / orr 1 800 332 2334
Issued By /�i (/ �(�/ �� Permittee Signature c/� J P/6/l /7
l 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
Sep 17 2012 2:57PM HP LASERJET FAX 5038089018 p•1
Electrical Permit Application r 1.08 01.1'i('1. I .I. ONLY
C
City of T Uatelf3y; 4 I >�1y �{ '
1 114
Pdiln No f _____ .- _ OI ,.,. t
i • 13125 SW fish] f31vd„ Reoe,ved Tigard, OR 97223 S E P 17 2012 Plan Review
a 1'11uno • 803 718 2439 Fax 503,598 1960 f' Datc /13y Other Permit d l(Pd01 a ., 60(
r 1 C. ,' k r> I Line' 503 639.4175 Ct 1 I � I ri i( . ARD Dam Roady /By l,.r c - a - 4(T Pluto 2 fm
Internet, www tigard -orgev l Intl 3 . ��� Noulcd /Method: W Cupplemwiial Information
•'�Y E liPP' V '' , .- - PLAN REVIEW
❑ Ncw construction ® Addition/alteration /replacement Nemo check all then ripply (submit Z eeLq of plans „/items checked be loo 1
❑ 8mvi%e ni todct 40C amps or mmc ❑ Building u\ei (lace sturicr
0 Demolition ❑ Othe" where the available fault arneut ❑ Madras and boaq•aiL .
1CATT OEF cO i/ rucn0N oxceods 10,(X10 amps el 150 volts or ❑ 1 lusting bwldiI,e..
lest IL ground, or exceeds 14,000 ❑ Cmmtro+.,ial -vse o jncuhui,
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amrt fur all nthor tnvtallaunns buildings
❑ Multi- family ❑ Master builder ❑ Other, 0 Hre p.nnp ❑ Instal Iau ia1 Ill 75 KVA or
31;q.$1l ' 1615 'I11N. AND LOCA'["ION, ❑ Addic t io n cif sye n I our raparatols d 1-3 v, 4%111 ❑Addtuonof ❑'A" I' "I.7 1 -,t
,hub no Job site address: 7130 SW FIR LOOP IOOHP mule occupAnc>
❑ Sta dr more iemdenllal um4, 0 Reeieariu lel vuhtcic poi) a
—
City /State /ZIP: TIGARD, OR 97223 ❑ t- loalth•uate Iacihtlw• ❑ Supply Mingo fw' m u,c a nn
❑ Hazardous Iocatirma 000 volt% nominal
State /bldg. /apt, no . Project name: FTD1 ❑ Sarnce Or feeder 600 amps or mote
Cross street/directions to hub site' FEE rDULE
O ncdoe,gn 1 Qb 1 Yee 'I'otal_ _ J
New residential single- or multi-family dwelling unit.
Includes attached garage. _
Subdivision. Lot no.. 1,000 sq ft, or less 16R 54 I
Ea adc'1300 sy 11 or portion 33,92 _ I
v L invited energy, residential 2
>� cil ' '. ORIC (with above sq, t') 75 00 ` - - -
Limited energy multi - family 75 �>< 2
BURG ALARM, CCTV, ACCESS CONTROL roauJcntial (with abnvc to 11,)
Services or feeders Installation, alteration, and /or relocatiun
2011 amps or less _ 100 :O _ 2
'NI ,p k1i , TIMOR, , u , q , TENA%T 201 amp'. t 400 amp 133 56 - 2
401 amps to 600 temps 200 3d 2 I
Name' — -
fi01 amps to 1,000 amps 301 ■4
Address, Over 1,000 amps or volts_ 552,2r
J
City/State/ZIP. ,StatcIGIP, Temporary services ur feeders inctallatlon, atteratlon , andlo
y relocation
Fax: 200 amps or lcss 59 36 - 1
201 nm•os to 400 amps 125 nR 2
Owner installation: This installation Is being made on property that I own which is not 401 amps to 599 amps 166.54 - 2
tntendeci for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
— --
Branch circuits - new alteration or extension, .er ones =
Owner signature. Date' A Pee fir branch circuits wuh
above sery ice feeder Ice,
1Lr 1 f 1St �kttn(�ACI '1Rb 7,47 2
_ each branch circuit
— `
B a vl
usiness naine, 13 Fee lbr branch circuits ',Ibo
— service or feeder fee, Brat 56,18 2
Contact name, branch( circuit
Each Itdd'I branch circuit 7 42 2
Address' Miscellaneous (service or feeder not included) -
hash manufactured nr modular
l y /State/7. dvvellma, service and/or lbeder 67 R4 3
Phone ( ) Fax: ' ( ) _RCOOnncet only _ - - -� _ - -^ 67 tt4 _ ,
I; -mail I'wnp ur irrigation uuclo - 67 84 2
Sign or 0411110 1i5hung 67 54 _ 2
Signal etreun(s) or belted - energy
Busuu s name: AMERICAN VETERANS SECURITY, LLC panel, alteration, or cxtenbion, 3 Page 2 225
Each addittunol Inspection over allowable in any ol'the al t
Add! css 4420 SW 110 AVE, Additional inspection (1 hr min) 66 251 hr
City /State /ZIP BEAVERTON, OR97005 Investigation(I hrmin) _ 66 25/ hr _
— r-.. lndustnal plant (1 hr min) 78,16/ hr
Phone. (503) 8089010 1,3 Fax. (503) 8089018 Inspections for which no IOC is -- --
sitocilically listed (',t hr mail 9000 h r ' —_ -
CC13 Lie . 135086 Electrical Lie.. 3450101,11 Suprv, Lic ' 2277LEA - ,1,'t„EI1 tt1CAtL PERJ'i FEES _
Suprv, Electrician signature, required' 1 /1 114 10 I 1 ' Subtotal ' 225
Plan rovlew (25 %ofpermit fee) — Print name: 101 IN KELLY / 1 / Date 9/17112 State surcharge (12% of permit feu), — _27_
Authorized signature - TOTAL Pt RMfI I'l'l:' 252 00
C h u perm application expires If n purrslt is nut obtained Nrtlun 1811
Pi irtt name' JGSSIC VA i Date 9/17/12
Jay, atter ,t hos been ores prod an complete.
e Number ef inepccnon*alinwcdpmp.nmt
1 tau•Ithna\pernNri?1L- PrrnillApp doo 07,01(10 440.46070 trogtrom tvLra
•
Sep 17 2012 2:57PM HP LASERJET FAX 5038089018 p•2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RES E 'IA .' 14 't ? ' r'_'' ' .
Fee for all residential systems combined $75.00
Check Type of Wotk Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑
Garage Door Opener*
❑ Heating, Ventilation and Air Condttioning System*
0 Vacuum Systems'
• Other:
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
❑ hrc Alarm Installation
❑
HVAC
Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other aURG /CCTV /ACCF-FFSS CONTROL,
Total number of commercial systems. 3
*No licenses are required. Licenses are required
for all other installations
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