Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00222
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/17/2008
PARCEL: 2S104AD - 04500
SITE ADDRESS: 12617 SW WALNUT ST ZONING: R-4.5
SUBDIVISION: TVF &R FIRE STATION LOT: JURISDICTION: TIG
PROJECT: TUALATIN VALLEY FIRE AND RESCU
Project Description: Installing (1) access control 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:
INSTRUMENTATION: OTHER: ACCESS X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TUALATIN VALLEY FIRE & RESCUE SONITROL PACIFIC
20665 SW BLANTON ST 8220 N. INTERSTATE AVE.
ALOHA, OR 97007 PORTLAND, OR 97217
Phone: 503- 649 -8577 Contact #: PRI 503- 223 -5822
FAX 503- 973 -7773
FEES Reg #: ELE 26- 370CLE
LIC 53535
Description Date Amount SUP 3628LEA
[ELPRMT] ELR Permit 7/17/2008 $75.00
[TAX] 12% State Surch 7/17/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 .699 or 1.800.332.2344.
Issued By: `� ,, P ermit tee Signature: —� / �LZ g c
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.
�..tr><cal Permit Application
FOR OFFICE USE ONLY
Received ^
City of Tigard NED Date/B 7A w J_ Permit No • ` p�
111
- ° 13 125 SW Hall Blvd , Tigard, OR 97223n� r +� Plan Review
Phone: 503 639 4171 Fax 503 598 196 Date/I3y Other Permit TIGARD Inspection Line: 503 639 4175 A a . 0 5 Date Ready /By lures IO See Page 2 for
Internet www tigard - gov 1u` 1 Notified/Method 77,10 Supplemental Information
TYPE OF WORK •! 0SGA `0 PLAN REVIEW
❑ New construction ® Addition /alteration /t DVIS1 Please check all that apply (submit 2 sets of plans w /items checked below).
❑ Demolition ❑ Other: B
u 3 � � U [t�"' ❑ Service or feeder 400 amps or more ❑ Building over three stories
where the available fault current ❑ Mannas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system
JOB SITE INFORMATIO Al LOCATION ❑ Addition of new motor load of ❑ "A" "E" "I -2" "1 -3
Job no : P080203 Job site address: J. W Walnut 100HP or more occupancy.
❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg /apt. no.: Project name: TVF &R - Station 50 ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 145 15 4
Ea. add'I 500 sq ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft) 75.00 2
Limited energy, multi-family
Installation of Access Control 75 00 2
residential (with above sq It )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240 60 2
Address: Over 1,000 amps or volts 454 65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66 85 I
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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for brunch circuits
Contact name without service or feeder fee, 46 85 2
first branch circuit
Address: Each add'l branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90 90 2
dwelling, service and /or feeder
Phone: ( ) Fax. ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Sonitrol Pacific Signal circuit(s) or limited -
energy panel, alteration, or
Address: 8220 North Interstate Avenue extension Describe. I 75 00
Page 2 2
City /State /ZIP Portland, OR 97217 Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: (503) 223 - 5822 Fax 973 - 7773 investigation per hour (I hr min) 62.50
70 l t Industri plant per hour 73 75
CCB Lic.: 53535 Electrical Lic.: 2� 0 LE S uprv. Li c • 3�j - � p p
Suprv. Electrician signature, required a► 6n t ELECTRICAL PERMIT FEES Subtotal 75 00
� ., Date: 1 - - fj � Plan review (25% of permit fee):
Print name:
t � t State surcharge (12% of permit fee): 9
Authorized signature: TOTAL PERMIT FEE: 84
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Building \Permus \ELC- PermiApp doc 05/23/06 440- 4615T(i l /05 /COM/WEB
CITY OF TIGARD , Y ;
BUILDING DIVISION PERMIT #:EL.R2Mil O412.7—
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Al 'o,i1 ,
Inspection Requests (24 Hrs.): (503) 639 -4175 1 .L .
INSPECTION WORKSHEET FOR DATE: VZ -?fit -0 TIME: PAGE:
SITE ADDRESS: 12.,6 1'l $ W W ALN I f $1 y CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: '\ CrCSS CO
OWNER: PHONE #:
CONTRACTOR: $ 01 PHONE #:
Inspection Request Scheduled For: Date: 4 V 11 • Pour Time:
Code # Inspection Description Confirm # Contact # Message
N . �rL�
Q f' ��I�� .
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY u`16* L6 Date: 141% Phone #: (503) 7181.1.1%
CITY OF TIGARD , ...,, .
je:
1 BUILDING DIVISION PERMIT #: ELR2008-00222
13125 SW Hall Blvd., Tigard, OR 97223 , DATE ISSUED: 7/17/2008
Phone: (503) 639 -4171 1 j�l1
Inspection Requests (24 Hrs.): (503) 639 -4175 _�' ..
INSPECTION WORKSHEET FOR DATE: 12/30/2008 TIME: 7 :00AM PAGE: 17
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Insialling (1) access control system.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503 - 649-8177
CONTRACTOR: SONITROL PACIFIC PHONE #: 503 - 223-5822
Inspection Request Scheduled For: Date: 12/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 079248 -01 503519 -4028 N
Corrections /Comments /Instructions:
❑ PASS ❑ PARTIAL APPROVAL XLCANCEL ❑ NO ACCESS
❑ FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:' Iv ( 1-‘ 1- Date: i1 60 4-) Phone #: (503) 718-