Permit t CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 -00040
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/19/2013
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 101
Project: Illo Chiropractic Subdivision: VARNS ACRES Lot: 3
Project Description: Low voltage for fire alarm
Contractor: AMERICAN SECURITY ALARMS, INC. Owner: HILLTOP BUSINESS CENTER LLC
5411 SE MCLOUGHLIN BLVD HUNZIKER LLC
PORTLAND, OR 97202 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 231 -0303 PHONE:
FAX: 503 - 230 -1044
• FEES
Description - Date Amount
Specifics: Restricted Energy Permit 02/19/2013 $75.00
12% State Surcharge - Electrical 02/19/2013 $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: Y
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: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
•
This permit ' '- - - • subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d• • = in accordance • approve. • ans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da . ATTENTION: Oregon -w =quires • • , to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9.2- 001 -0010 through OAR 952 -0.1 -0090. ou ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 .23344. .
Issued By: • / / Permittee Signature: a e /C � ✓ v
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.
•
Electrical Permit Application -, - l ( ' 1' // FOR OFFICE USE ONLY
City Tigard �� Received
�, �iJ , it of Ti and , ,/, DateB : ���� � / Permit No.: !lJ V
et 13125 SW Hall Blvd., Tigard, OR 97223 FEB 1 Z013 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 a ``" Date Ready/By: Juris. ® See Page 2 for
TIGARD �p• •' r • :v
i
Internet: www.tigard �;,� a �y F Notified/Method: Supple
mental Information
iPE!pFoWORK I F'tN)' tt I PLAN ; REVIEW
❑ New construction Addition /alteration /replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
' CATEGORY 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 E'ommercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
0 Emergency system. larger separately derived system.
I r ar d d s st em
.. : :IOW. SITE INFOIiMA:VON:' AND. rLOCAil?ION:; .; r''' 0 Addition of new motor load of ❑ "A" `E" "I -2" "I -3"
Job no.: Job site address: 7 `f 0 ,. 474 i"1 Z-1mac"Ia 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: _CO / re / v / ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: /LL0 C g/20 / "' /Jfrf /C.._ 0 Service or feeder 600 amps or more.
Cross street/directions to job site: FEE 'SCHEDULE- I .
J Description I Qty. Fee. I Total 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. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: teal
75 00 2
Limited energy, residential
.. :.. 'ti,. ��
: : i�IyES�G' tR. j�� I��T ' vOF��WORIC - `�,� ;.: ; . , '`.;r, : ' : ?a; �:r'_';� (with abovesq.ft.)
! ,a v Limited energy, multi - family
i /l,' t/ �.VF3 -1 /! 1 ; /1 , of5cer; a' :4'/ // 1 0- 2 /4fried44 -i /'e residential (with above sq ft.) 75,00 2
/ ' feeders or fee ers installation, alteration, and /or relocation
f (1 / ,. , } t'�?f/1'°te !%` 0 1'f 5' ►'t 0 144 L ✓I o, '.f 200 amps or less 100.70 2
,C]`'PROMERTY OW■Eit „ ' i " �11', TENANT: ;:.±.'...::'.' 201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /Z1 P:
Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: 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 branch circuits with
,�/
- PP;L
A(i:AN�? 1 ; + ' . I, ;. LKJi' CON ['i C ?<;FER§ON�u 'I` ~ = above service or feeder fee, 7.42 2
each branch circuit
Business name: / 41 e✓ / (.CL -7 5::.,,_,., / : .� B. Fee for branch circuits without
J service or feeder fee, first
Contact name: ✓1 / G v /If cG f L. / branch circuit 56.18 2
Each add'I branch circuit 7.42 2
Address: 7/ // St / (,..-01.1 6 /••t1./A1 '_", /. Miscellaneous (service or feeder not included)
I 7 t. , Each manufactured or modular
City /State /ZIP: / I - ; ') Z • i r ,. ,�� .,l ,,� � y �j7 �' _ dwelling, service and/or feeder
67.84 2
Phone: (cif ) .7:)) • JC.) 4.1 / 6 V 5 Fax:: ( 505) 2.--3c• / Oq f/ Reconnect only 67.84 2
"-) Pump r, Pump or irrigation circle 67.84 2
E _�G1 r- r^L. 41. s, �4 4 t s , ene, (a
,...: .
Sign outline lighting 67.84 2
. , .CONTRAC +TOR - ,' .:.: Signal - - � - � - - ignal circuits) or Itmrted- energy /
Business name: l, r / panel, alteration, or extension. / Page 2 75 2
f �%'l �� )� 7" ' "" `- t;f + r r `� f Each additional inspection over allowable in any of the above
Address: ,5;(4- s C•( Es.. i.'1.- 4 &v Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP:
Investigation (I hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ('A3 ) + _ S E .. 0) `' 0' 1, Fax: ( ) Inspections for which no fee is
r , ; r specifically listed ('/3 hr min) 90.00 / hr
CCB Lie.: •s ;; l (d Electrical Lie.: ,2 iO _ 2-g3 Suprv. Lie.: / 2 ///.45,4 • ..ELECTRI PERMIT FEES
Suprv. Electrician signature, required: G C.-e. / . .:3- %5:-.. Subtotal: 7S
� ' - / O
t / i, . i . F L u Plan review (25% of permit fee):
�i ( ,
Print name: t� 7 a /� State surcharge (12% o of permit fee):
. _ Date: Q /
Authorized signature: / + �, ,' k ('\.,,• TOTAL PERMIT FEE: g d6•D(�
'
f' ( ' f L� This permit application expires if a permit is not obtained within 180
Print name: J ) i Cl is (--_�. ' days after it has been accepted as complete.
r Date: / 3 - / y Number of inspections allowed per permit.
1.\ Bu lid ing \Permits\ELC -Permi tApp.doc 07/01/10 440- 4615T(I1 /05 /CO,bt/WEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7340 SW HUNZIKER RD 101, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
02/25/2013
ELR2013-00040
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7340 SW HUNZIKER RD 101, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
135 Low voltage
02/21/2013 00:00
ELR2013-00040
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7340 SW HUNZIKER RD 101, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
02/25/2013
ELR2013-00040
PASS - No C of O
Violation Summary:
Inspector Contractor