Permit •
a -CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
>s COMMUNITY DEVELOPMENT Permit #: ELR2012 -00263
T 1G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/21/2012
Parcel: 2S 113AC00102
Jurisdiction: TIGARD
Site address: 7272 SW DURHAM RD, STE# 100
Project: Indio Spirits Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 25 -27,2;
Project Description: (1) low voltage to change out security system panel and add some sensors for TI
Contractor: ACE SECURITY Owner: PACIFIC REALTY ASSOCIATES
5200 SW GREENWOOD CIRCLE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 750 -9351 PHONE:
FAX: 503 - 692 -4547
FEES •
Description Date Amount
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Specifics: Restricted Energy Permit 11/21/2012 $75.00
12% State Surcharge - Electrical 11/21/2012 $9.00
Type of Use: COM
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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: Y Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
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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 952-001-0090. 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: . it it i't12Yl b6- ,, .1 Permittee Signature: Or" P 1"ru cfpri o
• 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.
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11/21/2012 12:18 PM FROM: Fax Ace Security TO: 5035981960 PAGE: 002 OF 004
Electrical Permit Application RECEI V l• /,Iz (,tvF1(,: I :„l: o
City of Tigard. D y: Il I a I t � - st' Permit NotGL e d pi a,- voa43
i 13125 SW Hall Blvd., Tigard, OR 97223
NOV 2 1 2012 Piao.Review -
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit & , P 3 ' O DI 4D
, ,, „ 1 t Inspection Line; 503.639 -4175 CITY OF TIG , , • 1 Date ReadyBy: rum. ® See Page 2 for
Internet: www.tigicd -or.gov Noti 11 Supplemental information
ALIILDING DIVISI I
-
TYPE OF WORK PLAN REVIEW
®Addition/alteration/replacement di
❑ New construction . . Please et( all that apply (submit; n it; sets of pla w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over throe stories.
❑ Demolition ❑ Other: _ where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds,to,00o amps at 150 volts or Cl Floating buildings.
less to gromd, or exceeds 14,000 0 Commercial
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings:
❑ Multi - family ❑ Master builder 0-Other: ❑ Fire pump. ❑ Irtitallation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
['Emergency system. larger separately derived system.
❑ Addition of new motor bad of ❑ "A ", "E ", "1 -2 ". "1-3 ",
lob no.: lob site address: 7272 durham rd 100112 or more. occupancy.
-,,, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: tigard, or 97224 ❑ tieahh -care facilities. .05uppiy voltage for.more than
❑ Hazardous locations. 600 volts iiominal.
Suite/bldg. /apt. no.: 1 a Project name: ❑ service or feeder 600 amps or more.
/ FEE SCHEDULE
Cross street/directions to job site: n I Qr,.. I- Foe 1 Tots'. I -
New residential single- or molts- family dwelling unit.
Includes attached garage.
Subdivision: l Lot no.: 1.000 sq.'R. or less 168.54 4
Tax Map/parcel no.: Ea •add'f5 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. it) .
Limited energy, multi- family 75.00 2 • Change out security system panel and add some sensors residential (with above sq. ft.)
Services or feeders installat or ,alteration, and/or relocation
200 ramps or. less 100.70, 2
❑ .PROPERTY OWNER I ❑ TENANT 201 amps to 400.amps. 133.56 2
Name: 401 amps to 600 amps. 200.34 2
601 amps to,1 amps 301.04 2
Address: Over 100 amps or volts 552:26 2
Temporary services or feeders installation, alteration, and/or
Ciry /StatxJZlP: relocation
Phone: ( ) Fax: ( ) 200 amps or less. 59.36 i
tot amps to 400 amps 125.08 2
Owner installations This installation is being made on property that I own which is not
• intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
. Owner signature: Date: _ A, Fee for brands circuits with
❑ APPLICANT I 1:1 CONTACT PERSON above service or feeder fee, 7.42 2
each bench catch
Business name: B. Fee for branch circuits without
service or feeder fee, fret
Contact name: branch circuit _ .. 56.18 -
Each addl branch circuit - 7.42 I . 1, 2
Address: Miscellaneous (servke or feeder not included)
City/State/ZIP:
Each manufactured or modular 67.84 2
h dwelling, service and/or feeder
Phone: ( ) Fax::' ( ) Reconnect Only 67.84 . 2
E-mail: - Pump or irrigation 'Circle 67.84 2
Sign or outline Hahne); 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Retort! Inc. DBA Ace Security pallet, a lteratian, or extension. I Page 2 2
-_ Each additional inspection over allowable in any of the above
Address 5200.sw greenwood circle Additional inspection (1hr.corn) 06.25/ In
hr
Investigation (I t
City/State/ZIP: : tualatin, ro 97062 it min) 66.25/.
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 750 -9351 1 Fax:, (503) 692 - 4547 inspections for which no fee is 90 hr
I 3,1 , specifically listed (% In min)
CCB Lie.: 48350 S Electrical Lie.: 3 - 226CLE Suprv. Lie.: 569LEA ELECTRICAL PERMIT FEES
Subtotal:
Suprv. Electrician signature, required: - : 1AA....,%_,A, Plan review (25% of permit foe):
Print name: mark recore 'Date: 11 -21 -12 State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: Yy. Ell)
. This permit appnadon expires it a permit is not obtained within ISO
Print name: mark recore (Date: 11-21-12 days after it has been accepted as complete.
Number of inspections allowed per permit.
t:lauiidin iPnmiul6LC•PormitA9p duo 07/01 /1O 340.461 set{ 1/0S/COa,UWFA
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.11/21/2012 12:18 PM FROM: Fax Ace Security TO: 5035981960 PAGE: 003 OF 004
Electrical Permit Application City of Tigard
. _
Page 2 —Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ..... $75.00
CheckType of Work Involve&
0 Audio and Stereo Systems*
0 Burglar Alarm
0 Garage Door Opener*
0 Heating, Ventilation and Air Conditioning System*
0 Vacuum Systems
O Other.
• COMMERCIAL WORK ONLY:
.Fee. for. each . commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:,
O Audio and-Stereo Systems
D Boiler Controls
O Clock Systems
0 Data Telecommunication Installation
0 Fire Alarm -Installation • •
O HVAC
O Instrumentation
0 Intercom and ;Paging Systems
0 Landscape Irrigation- Control*
O Medical.
0 Nurse Calls
O Outdoor Landscape Lighting*
fl Protective.Signaling
Other hatglox,iniktu
Total number of commercial systems; . 1
*NO licenses are required. .Licenses -are required
for all other installations
lAiluildineemlit.41.0.PermilApp.doe 07/01/10
• 11/21/2012 12:18 PM FROM: Fax Ace Security TO: 5035981960 PAGE: 001 OF 004
•
Ace Security
c o n f i d e n t i a l fax
To: City of Tigard
Fax Number: 5035981960
From: Mark Recore
Fax Number: 503- 692 -4547
Business Phone:
Home Phone:
Pages: 4
Date/77me: 11/21/2012 12:18:16 PM
Subject:
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