Permit C ' TY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
: COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00395
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/22/2007
PARCEL: 2S 113AB -00300
SITE ADDRESS: 16083 SW UPPER BOONES FERRY RD ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: FANNO CREEK PLACE
Project Description: Building B; install low voltage radio communicator.
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:
INSTRUMENTATION: OTHER: RADIO COMM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OPUS NORTHWEST LLC HSI SECURITY SYSTEMS, INC
1500 SW FIRST AVE. STE 1100 3424 NE 35TH AVE.
PORTLAND, OR 97201 PORTLAND, OR 97212
Phone: 503 -916 -8963 Contact #: PRI 503- 287 -4604
FAX 503- 287 -1345
Reg #: ELE 26 -755C
FEES LIC 42140
Description Date Amount SUP 3778S
[ELPRMT] ELR Permit 10/22/2007 $75.00
[TAX] 8% State Surcha 10/22/2007 $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 • -stions to OUNC at 50 46.6699 or 1.800.332.2344.
Issued : • Permittee Signature: 4A0//
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.
Oct -22 -2007 03:09 PM HSI SECURITY SYSTEM 5032871345 2/8
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Tigard r • I
r 13125 SW F lail Blvd.. Tigard, OR 97223 �' t ' I" - Plns Rcvtew
i ' i Phone: 503.639.4171 Fax: 503 598 1960 is patc/B
Other Permit.
` 1 Inspection Line 503.639.4175 CITY OF TIGA 5;
ate )iris / 0 See Page for
'.•ccattiissoriPAlse Internet www ttgard - orgov BUILDING DIVI "I II ed/l ell o //
il' 6 a Supplemental Information
TYPE OF WORK PLA N REVIEW
® New construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans wfitems checked below)'
❑ 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 I50 volts or ❑ Floating buildings
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling ® Commercini/industiial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire piano ❑ 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 ", 'l -3 ".
Job no.: Job site address: 16083 SW Upper Boones Ferry Rd IDOHPo occupancy I .
m
❑ Six or me resi dential units ❑ Recreational vehicle parks
City/State/ZIP: 97224 ❑ Health -care facilities. ❑ Supply voltage for store than I
❑ Hazardous locations 600 volts nominal I
Suite /bldgiapt. no.: Bldg. B Project name: Fanno Creek ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Durham Rd Description 1 Ory. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes a ttached garage.
Subdivision: Lot no.:
1.000 sq. R. or less 145 15 4
Tax map /parcel nu.: _
DESCRIPTION OF WORK
Ea add'I 500 sq fi. or portion 33 40 I
Install Radio Communicator
Limited energy, residential
75.00
(with above sq. ft )
® PROPERTY OWNER ❑ TENANT
Limited energy, multi- family 75,00 2
Name: Opus NW, LLC residential (with above sq. n )
Address: 1500 SW I' Ave. Services or feeders installation, alteration, and/or relocation
City/State/ZIP: Portland, OR 97205 200 amps or less 80.30 2
Phone: (503)478 -8008 Fax: (503)478 -8038
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 106 85 2
intended for sale, lease. rent- or exchange, according to ORS 447. 449, 670, and 701.
Owner signature: Date: 401 amps to 600 amps 160 60 2 I
EI APPLICANT ❑ CONTACT PERSON
Business name: HSI Security Systems, Inc. 601 amps to 1,000 amps 240 60 2
Contact name: Barney O'Donnell
Over 1 .000 amps or volts 454 65 2
Address: 3424 NE 35 Ave.
City/State/ZIP: Portland, OR 97212 Temporary services or feeders installation. alteration, and /or
relocation
Phone: (503) 287 -4604 Fax: : (503) 287 -1345
200 amps or less 66.85 I
E -mail:
CONTRACTOR
201 amps to 400 amps 100 30 2 1
Business name: HSI Security Systems, Inc.
Address: 3424 NE 35th Ave. 401 amps to 599 amps 133.75 2
City /State /ZIP Portland, OR 97212
Branch circuits — new, alteration, or extension, per panel
Phone (503) 287 - 4604 Fax: (503) 287-1345 A Fee for branch circuits with
t) I above service or feeder fee.
6.65 2
CCB Lie.: 42140 5/41II T Electrical Lie.• 26 -755C / Suprv. Lie.: 3778S 1011 IC each branch circuit
B. Fee for branch circuits
Suprv. Electrician signature. required "' ®���/ without service or feeder fee. 16 85 2
first branch circuit
Print name: Greg Borosund Date: 10 -22 -07
Each add'I branch circuit 6.65 2
Authorized signatu , 5Q • javJ
Nlisccllancous (service or feeder not included)
Print name: Barney O'Donnell Date: 10 -22 -07
I iOuiidmgWenmis EIA - PermuApp doc e5o3006 44n.46ISTI 114)5/rOVMAVEE3 4 C S 1 • Co
I
CITY OF TIGARD
1
BUILDING DIVISION PERMIT #: ELR2007.00396
., 41, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2007
Phone: (503) 639 -4171 t
Inspection Requests (24 Hrs.): (503) 639 -4175 . 1!..
INSPECTION WORKSHEET FOR DATE: 1/!12008 TIME: 7:00AM PAGE: !
SITE ADDRESS: 16083 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: F CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: F ANNO CREEK PLACE
DESCRIPTION: Building B: install low voltage radio communicator.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503 - 916 -8963
CONTRACTOR: HSI SECURITY SYSTEMS, INC PHONE #: 503 -287 -4604
Inspection Request Scheduled For: Date: 1/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 062628 -01 603- 287 -4604 N
Cct g J4.:— --
Corrections /Comments / Instructions:
jgl ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 ( MtJ 8 l,‘ Date: 11 01 Phone #: (503) 71814%,
4
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_ .. _ ._ .. .
CITY OF TIGARD
BUILDING DIVISION
-A' #: ELR2007 00395
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2007
Phone: (503) 639 -4171 'berme � .
Inspection Requests (24 Hrs.): (503) 639 -4175 s el I..
INSPECTION WORKSHEET FOR DATE: 10/29/2007 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 16063 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: FANNO CREE=K PLACE LO ""O TYPE OF USE:
PROJECT NAME: FANNO CREEK PLACE
DESCRIPTION: Building 13; inftall low voltage radio communicator.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503 -9iG -8963
CONTRACTOR: H SI SECURITY SYSTEMS, INC r PHONE #: 503 - }07.4604
Inspection Request Scheduled For: Date: 1 mow Pour Time:
Code # Inspection Description eon! a • Contact # Message
135 Low voltage ( 058530 -01 503.935.1070 Y
Corrections /Comments /Instructions:
D Q (Lo \rio- cO Nb t 1'' . 6'6Q3 6N 8 67 k 6 iO S
❑ PASS PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
El FAIL ❑ " CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (3 • NO8 Date: I 14101 Phone #: (503) 718- 21filie