Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
s = COMMUNITY DEVELOPMENT Permit #: ELR2013 -00095
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/30/2013
Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 7245 SW DURHAM RD, STE# 180
Project: David DeLuca Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 37
Project Description: (1) low voltage for Data/Telecommunications
Contractor: QUADRANT SECURITY INC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 14833 ATTN: N PIVEN
PORTLAND, OR 97293 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 234 -5558 PHONE:
FAX: 503 - 236 -2322
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/30/2013 $75.00
12% State Surcharge - Electrical 04/30/2013 $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: y 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: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 -001-0090. You may obtain a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/
Issued By: U/ tX I L D+ t e -(�4�1 Permittee Signature: Dili iAPPU C 1`t" ( f akL
( OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY .
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Per Anplic$i JED
1, ____ City of Turd °,� r Received Ao (3 s' p«, tmg.:C ao13 ax�4'
13125 SW Tian Blvd., Tigtcrd. OR 97223 P 9-1 `� �3
le e Phone: 503.639.4171 Fax: 503.598.1960 ' BLitt Review Other Permit
1nspeation Line: 503.639.4175 ruo 7 u
I c .., et1 sup D m gr: 41/ lit Set plea npe 2 tar _ intern= www or.gov ' ' l i p scdpaerhod , Sappkm l )tArtt+>,IPatlan
TYPE OF wet r 1. '.. " l ' PLAN.' NE W '
gew construction ❑ Addition/alteration/replacement Please check all tlylt npply (submit 2 sets of plrntl Alms checked below):
E l scrvi« m•'$p,ier 400 mope re mom O Baildlnp o.wr nova ntori,at•
❑ Demolition ❑Other
where the available 'bolt current CT NA. abd boatyards.
_ ' CATEGORY OF CONSTRUCTION exceeds 10,000 crape t� 150 vales or ❑ Inuring buildings.
❑ 1 - tend ? family dwelling ammercial /indueata1 lento MUM, ar e>ftceda 14.800 ❑ cvtmuop61x1.1Hn agrrculterst
g j-C ❑ Accessory building amps Tor all enter installations. bulldmga•
❑ M`ulti family ❑ Master builder Q Other: _ ❑ Fire pump, [f rnnallatiOn of 75 KVA or
JOB SITE INFORMATION AND LOCATION El Soicrgerrcy .ante. larpp soperetoly dc rived sygr el,
❑ Addition anew motor load of CT "A ". "F', "1-2", "1 -
Job n0,: Job site >iddress:'�' �5 - �� GGG{{..6�1LL��' III �� Six lr more residential units. cr °r ❑ Recreational vehicle parks,
7- ❑ M1
CitylStCity/State/ZIP: D Neahhoura facilities, s, ❑ Simply voltnpo f o r that/
L `�/ ' - i ` � a }Wytttdewc locatior 600 volts nominal.
Sutte/bidgJapt n o.: j Project name: n„c fie{ �;.. ❑ service or feeder 600 amps or moo.
SCHEDULE FEE
Cross strisetldirections to job site: Aenripttm 2a•1 xrs 1bm
1
New rtsidentittl or tadti -family dwelling utiie.
Inetttdes attacked garage.
5Ubdivision: I Lot no.: 1,000 aq. or less - 145.15 ,
•R 4
Ea. add'I 500 sq. h. or portion 33.40 1
Tax map/parcel no.:
Limited wttsrgy. residential 75.00 2
DESCRIPTION OF WORK (with above eq. d.)
� 1 i AC �1' ?' L Limited energy, multi- family 75.00 2
4 (34. 1 l � ` . (with (with thovn , ft.)
1 ! 6 '1 "- I Services or feeders lieetillation, alteration, and/or relocation
,�. 200 amps to Tess 80.30 2
❑ PR • e Mg , OWNER (»] TENANT 201 amps to 400 snips 106.115
Name: 401 amps to 600 amps 160.60 2
601 amps to 1.000 amps _ 240 60 2
Address: Ovor 1,000 amps or volts - 454.65 2
_
City/Stata/� TP: Temporary services or feeders Inttallat ion, elteratlon, and/or
relecatipn _
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Chwner atdllation; This installation is being made on property that l own which is not - 201 amps to 400 amps 100,30 2
tn
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670. and 701, 401 amss to 599 amps t 133,75 2
Brantb eir cuib - new, alieritien, or extension. , , core/
Ovtmet signature: Date:
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or tbeder fae,
6.65 Z
each branch circuit
Business name: e 0r branch circuit
Contact Hama; — � without service or feeder fee, 46.Ri 2
first branch circuit
Address: Ent add'I branch circuit 6.65 2
Mi tneoua ear+ ee or feeder ant included
City/Stated7_TP: menuibciured or modular r r—
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax :: ( ) _ Reconnect only 66,05 » 2
E'.aiail; Pump or irrigation circle 53.40 2
• • CONTRACTOR • • Sigtt or outline lighting 53.40 2
f ' Signal circuit(s) or limited -
Business name; Gh. c�4 t^c .� + _S 57`P - _ energy panel, altca•ution, or
Address: P.0. 13d�/ 14s3---4 extension. Describe' 1 P1150 z 2
0 _ _7 9
e[ the
ciE P a r � �,,� e ach additional - Ins over allowable in any above
Per inspection 62.50
Phone: �O 3 )? _ Fax; (5)3) 3(7 . � 3 D Tn tagation per hour (I ha min) 62.50
Cos Lic.: q 6 go E lectrical Lic.: a(, - 5"1 C,14Suprv, Lic,: +09 9 LE A Industrial plant per tour 73.75
ELEcTRIC4L • PERMn no.
5uprv. Electrician Signature, required: Subtotal:
Print name: �'Ecf. '�+ rZLE t n Date: - rlan review (25% of permit fee};
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMfF FEE: o`T -
Print nettle: f rj�; Mk perm appiinction expirsa H■ permit is nor abMned within ass
ll iota atter is bra ben accepted as oomph:in
"-` — a Ntugber of insprrotippe allowed per permit.
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