Permit 4 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
s ' • COMMUNITY DEVELOPMENT Permit #: ELR2012 -00244
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/30/2012
Parcel: 2S113AB00600
Jurisdiction: Tigard
Site address: 16160 SW UPPER BOONES FERRY RD
Project: DOW AgroSciences Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30
Project Description: (1 low voltage to upgrade access control system
Contractor: PROTEC INC Owner: PACIFIC REALTY ASSOCIATES LP
720 NE FLANDERS ST ATTN: N PIVEN
PORTLAND, OR 97232 -2763 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 235 -4000 PHONE:
FAX: 503 - 235 -0363
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 10/30/2012 $75.00
12% State Surcharge - Electrical 10/30/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N 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: N Other: Y Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 -001 -0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: APPL,(_24 - nod
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT-29-2012 15:11 EENE,.
Electrical Permit Applicatio 1•01,.01-1.1( 1..1-;1
City of Tigard OCT,29 2012 R- c • .i. U' ., _
Date/B : -36 i - Permit No.: azg40/).., 00 .1 A
•.._._..• 13125 SW Hall Blvd.. Tigard, OR 97223 nr n Anon Plan Review
Phone: 503.718.2439 Fax: 503.598.101Y ur i IVIrWM3 Date/f3 : Other Pernik:
I , ,... , 1 , „ Inspection Line: 503.639,4175
BUILDING DIVISION Daio llody/By, ... y : 0 s.. Pat 2 far
Internet www.tigard•or,gov Notificd/Methodi 1 re Supplemental I nforniation
.r j.i . ;1.i.. 4 .1 - .. 1 ..Nt r in.:•; Y :41,N 1 ,•, 11Pri i 'i . : ‘ ' . . ' il.t: . • ' : - ;0 1 ■110i 3 .01 14 14 . 0 1 4 . 00.$*'n-•:: ' 1g1 : :•Yii . J'' . : 4 i : ;• ... ':
0 New construction El Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or mote 0 Building over throe stories.
0 Demolition El °then where the available fault mute 10 Marinas anil boatyards,
:'' ...''..:.•i'V:301*(AtitiO*IiVO,Mil#,Cdititiiforc:Iai.-...,.::i: ....ds i 0 und, ,000 amps exceeds at IS1000 O vollu or 0 Floating buildings.
less to gro or 0 COntenercial-use agriculturut
0 1- and 2-family dwelling El Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder ClOther: 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived SyAluit).
..i 0 Addition of new motor load of El "A", "E^, "1-2".
Job no.: 634 Job site address! 16160 SW Upper Boones Ferry Rd 100HP or more. occupancy.
13 Six or more residential units, 0 Itommuinnal vehicle parks.
City/Statc/ZIP: Portland, OR 97224 0 I lealth-care facilities. 0 Supply voltage for more than
O Hazardous locations. 600 volts nominal.
Suitc/bIdgJapt no.: Project name: DOW AgroSciences 13 Service or feeder 600 amps or more.
2,itt:i17•.•:4•':q,fll'i.Vil:EtSt11101:Itt-ii41 i.4 .: i::::iY .q •. :,
Cross street/directions to job site: between SW 72' and SW Durham Rd 13nri0 1 Om I re. I Tow I •
New residential single- or multi-family dwelling unit.
.,- Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less . , .. 168.54 4
Ea. addl 500 sq. tt. or portion 33.92 I
Tax map/parcel no.: Limited energy. residential • 75.00
...:i AV* :t9&1!:§V10.1..*OtktiftW410.400itniK.14;;t.,.V.,14P.01.■.f (with above 541. (l.)
Limited energy, Multi-family
Upgrade access control system residential (with above so. ft.) _
. .....
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
1
. itt..01140iI;Tuviktlitp.. .: 201 amps to 400 amps 133.56 2
• .'. I' i' .7! i i6I ..'' • i .... Iq. :.■.;., t !!,:r:: ..:., ‘...,..!!." ;0
Name: 401 amps to 600 amps 2(10.34 2 '
... 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 77
Temporary services or feeders installation, alteration, and/or
C it)/ relocation
Phone: ( ) Fax: ( ) 200 amps or less 59,36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
4
intcndcdTor sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. •1 amps to 599 amps 168.54 2
Branch circuits- new. alteration, or extension .er panel
Owner signature: Date: A. Fcc for branch circuits with
.'d•;.q....$:11:1.;.:'::121t40...4100,4tVlia:P:.:40-igElitigal3k0a, ....151fti::1N above service or feeder fee,
each brunch circuit 7.42 1
Business name: Protec Inc B. Foe for branch circuits without
Service or feeder fee, first
2
Contact name: Heather Hill branch Cir 56.18 euil
Each addl branch circuit 7.42 2
Address: 720 NE Flanders St Miscellaneous (service or feeder not Included)
Each manufactured or modular
City/State/ZIP: Portland. OR 972.32 67.84 2
dwelling, service arui/or feeder
Phonc: (503) 1354000 I Fax: : (503) 235 Reconnect only 67.84 _. 2
Pump or irrigation circle 67.84 2
E-mail: hentherh@proteesecurity.com
,. , . ..
Sign or outline lighting 67,84 ,
:.
',...:::::',:!:'•'. 'V :1. . =‘, ' I g i ...k140..: -: . : 41 : ::0.010Sinall°01VIRICi.R.P,In144..g 7 43;!1;i:il.'! . 1'ff •1 :.; :'. si o i rou it0 or ii ro k o o_ onorgy
I
BusilleSS name: Protec Inc. _ panel, alteration, or extension. _ Page 2 2
Each additional ins ■ ection over allowable in an of the abov
Address: 720 NE Flanders St Additional inspection (1 hr rain) 66.25/ hr
. -
City/State/ZIP: Portland, OR 97232 _ Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/hr
Phone: (503) 235 I Fax: (503) 235-0363 inspections for which no fee is —
specifically listed 06 hr min) 90.00/ hr
CCB Lic.: 55414 i Electrical Lie,: 34215CLE I S prv. Lic.: 102:4 ..... _ L __F_______ ,_ __ .. r.CA,E
.----- .,-
Suprv. Electrician signature, require Subtotal: 75.00 d
_ — . _ Plan review (25% of permit fee);
Print name: Jack Chilson . Date: As) 2 State surcharge (12% of pcnnit fee): 9.00
Authorized signature: - A ... TOTAL PERMIT FEE: 84.00 .._
A III ... roil This permit application expires if a permit is not obtained within In
Print name: Heather Hill Date: 10/26/12 dors after it has been accepted as complete.
—. • Number of inspections ellowed per permit.
_
lABvialiaaTermas‘RIX-PerraizApp.dise 07/0i/10 440-441STO I/05/COMAVED
OCT -29 -2012 15 12 PROTEC INC P. 02/06
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for ma 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:
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
O Clock Systems
n D ata Telecommunication Installation
❑ F ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ L andscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
® Other Access rnn arol System
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
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