Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• • COMMUNITY DEVELOPMENT Permit #: ELR2012 00286
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/31/2012
Parcel: 1 S133CA15500
Jurisdiction: Tigard
Site address: 11026 SW MALLOW TER
Project: Castanares Subdivision: VILLAGE AT SUMMER CREEK Lot: 78
Project Description: (1) low voltage for protective signaling
Contractor: SONITROL PACIFIC Owner: CASTANARES, JARED
8220 N INTERSTATE AVE 11026 SW MALLOW TERRACE
PORTLAND, OR 97217 TIGARD, OR 97223
PHONE: 503 - 223 -5822 PHONE: 720- 984 -6497
FAX: 503 - 973 -7773
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/31/2012 $75.00
12% State Surcharge - Electrical 12/31/2012 $9.00
Type of Use: SF
Class of Work: DEM
Total Number of Systems:
Audio & Stereo: N
Security Alarm: Y
Garage Door Opener: N
HVAC: N
Vacuum System: N
Other: N
Other Desc: Total $84.00
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 -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: V�I� -C� j � Permittee Signature: O ' `` f 144.7 A
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.
Dec. 27. 2012 4:25PM Sound�� `II ttil No. 2150 P. 1
EYectncai fen nit Application
0)— `
City of Tigard Received ' DaleP6y: I 3 t ( ' 1 4 f Permit No.: � eU3�
a 13125 SW Hall Blvd., Tigard, OR 97223 1 - L I 202 Plan Review
Phone: 503.718.2439 Fax: 503.598 -1960 Date/By: Other Permit:
t • 1 t ; A h I 1 Inspection Line: 503.639.4175 CITY OF TIGARD Dale Ready/By: r la Src Pape 2 for
Internet: www.tigard- or,gov BIJIi.DINC fNJStp aiOed/Mellwd: (-:' Supplemental Information
TYPE .O1 '::' - PLAN REVIEW :5
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ®Addition/alteratioNfeplacemellt
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demoli tion ❑ Other: where the available fault current ❑ Marinas and boatyards,
r" exceeds 10,000 amps at I50 volts or Floating buildings.
,CATE�OR�t'= t)r;COi�S�`RI1Cr10N p g gs
less to ground. or exceeds 14.000 0 Commrreinl - use agricultural
® 1- and 2 family dwelling El Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' II Emergency system, larger separately derived system,
. JOII - S1TE aIVFi?RkTlO '•AND LOCATION ❑ Addition of new motor load of ❑ "A "fi ", 7 2 ", "1� "
Job no.: pV12050 Job site address: 11026 SW Mallow Terrace
i OOflP 9r 11)9Te. occupancy.
ID Six or more residential units. 0 Recreational vehicle parks.
City/State /ZIP: 97223 El Health-care facilities. ❑ Supply voltage for more than
El Hazardous locations. 600 volts nominal
Suitc/bldg. /apt, no.: Project name: Castanares Residence ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 135 Ave and Scholls Ferry Description a Fee. i Total 1 ^
" "` New residential single- or multi- family dwelling milt.
Includes attached garage.
Subdivision: Lot no.: 1,100 sq. ft. or lcs; 168.54 4
Tax map /parcel no.:
E. add'] 500 sq. ft, or portion 33.92 1
Limited energy, residential 75.00 2
.:. ' .... 7 F ' ,• .'. OF 1VORK (with above sq. R.)
Limited energy, multifamily 75.00 2
Installation of intrusion security devices residential (with above sq. (l.)
- — Services or feeders installation, alteration, and /or relocation
200 snips or less 100,70 2
4 ' `• C PROPERTY OWNER ' I 11- a[] TENANT rr 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200,34 2
Name: Jared Castanares
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 snips or veils 552.26 2
City/State/ZIP: Temporary services or feeders instal alteration, and /or
ty relocation
Phone: (720)984 - 6497 Fax: ( ) 200 amps or less 5936 1
201 amps to 400 amps 125,08 2
Owner installation: This installation is being made on property that 1 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 branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON - above service or feeder fee, 7.42 2
each branch circuit ,
B . Fee far branch circuits Tritlrorrt
Business name: B.
or feeder fee, first
Contact name• brunch circuit 56.18 2
Each add'/ branch circuit 7.42 2
Address: Miscellaneous (service or feeder not Included)
C71 /State /l,.IP: ^µ Each manufactured or modular 67 84 2
Y dwelling, service and/or feeder _ _
Phone: ( ) Fax: : ( )
Reconnect only 67 84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR >••a.. ,....>:; r•:' - ;ri ;< �: -_•
-_, • - -- -, — Signal e or limited -Mergy
Business name: Sonitrol Pacific panel, 8Iterntion, or extension. l Page 2 75.00 2
Each additional inspection over allowable in any of the above
Address: 8220 N Interstate Ave Additional inspection (1 hr min) 66.25/hr
City /State /ZIP: Portland, OR 97217 Investigation (1 hr min) 66.25 /hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 223 -5822 Fax: (503) 973 -7773 Inspections for which no fee is 90,00/ hr
specific listed (5 hrminl
CCB Lie.: 53535 Electrical Lic.: 26370CLE Suprv. Lie.: 3 • LEA 7 I.ECTRYCAT:;,,PER tIT FEES
Suprv. Electrician signature, required: A t' ■ 1 , Subtotal: 75.00
Plan review (25% of permit fee):
Print name: Gordon Ducette Date: 12/27/12 State surcharge (12% of permit fee): 9.00
TOTAL PI3RMtT PEE; 84.00
Authorized signature: /L This permit application expires Ita permit is not obtained within 180
Print name: Ann C Moore Date: 12/27/12 • da,)a after It has been accepted as complete.
• Number of inspections allowed per permit.
r:\ DuildineiPetrnit s\ELC.PermilApn.doc 07/01 /10 .140 -46152(1 l/05ICOSUWED
Dec. 27. 2012 4:25PM Sound Security Inc. No. 2750 P. 2
, Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
.:RESI.DENri W K:Onaz"N
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alain
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
coi+ MERCIA : t O K
Fee for each commercial $75,00
system
(SEE OAR 918 - 309 -0000)
Check Type of Work Involved:
•
❑ Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: \5uaai miu\uC -P nut+pp..eo 07/01110