Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
s • COMMUNITY DEVELOPMENT Permit #: ELR2013 -00103
T f CARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 05/09/2013
Parcel: 1 S135BD01100
Jurisdiction: Tigard
Site address: 9780 SW SHADY LN 110
Project: Intrinsic Marketing Subdivision: MEADOW VIEW Lot: 8
Project Description: (1) low voltage for burglar alarm
Contractor: ADT LLC Owner: SHADY LANE COMMERCIAL BUILDING
2815 SW 153RD DR LIMITED PARTNERSHIP
BEAVERTON, OR 97006 7720 SW WESTGATE
PORTLAND, OR 97225
PHONE: 503 - 469 -7219 PHONE:
FAX. 503 - 469 -7128
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/09/2013 $75 00
12% State Surcharge - Electrical 05/09/2013 $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: 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 $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332 2344
�1
Issued By: � �' l�(r � Permittee Signature: V� A I D -' C c4-Tt. OkL
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
05/09/13, 08 : 18AM HP LASERJET FAX p . 0 2
EssItical Permit Application ctivED
City of Tigard Received
Date/py / a1r ?omit No.:6tE 0 i 5- 00/03
---- Hall 13
'i 1312$ SW HaIvd,, Tig OR ard, 97223 - 1t ov
Itlow
, 1 4 I Phone: 503.718.2439 Fax. 503,598.1w 0 9 2013 °thin. permit:
TiGARID '
IntipeCtion Lino. 503.639.4175 6 R , i d y 5- 1 7, Vs. , lifeSee Page 2 for
Internet' www.tigard-or,gov 1 1111 I F TIGARD. Notified/Method 1 I 50 Supplemental Information
Kiii"447510,1041519nrri° ' i ' 'l l '' h 7,41 17 (411;W Ilvin l ` l ' ' '*WitlIqa 2 iniu 1 , mit $ ivo
),..../ o 1 t,141., • ,.h.' .• ..■,,,,L • I: . ' -, , - 4io ■ o • I
0 New construction to Addition/alteration/replacement Please check all that apply (submit 'MN of plans w/iietth checked below).
0 S or r 400 amps or more 0 Budding Over three stories.
0 1)CMOliti00 0 Other: uhcre the available fault eiment 0 Marinas and boatyards.
4" 6" ; FFIf 141 1Pgr'r t's iA" ' ifitirrf . 01 , ' Wit ifi PMETIF exceeds 10,000 amps at 150 volts or 0 1 r buildings
, it 9 4 ■ • 4 4 4 , ■ • 4 ■ VA 1 • 1 • 1, 4 k,- t,, j . . ,. ) A ° t ..; '' ho O 't) '4 A 4,
117.41 7 4OV A '1 r 0: r.., n 'v i. . •: . ■ , • . . kV; to ground, or exceeds 14,000 Cj CommeClal-USe agricultural
0 1- and 2-family dwelling El Commercial/industrial 0 Accessory building amps for all other installMions buildings
0 multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installmion of 75 KVA or
•
mgenampte,Arn, r„ e
. ymrtyar— .,,, tro„,%7 gAimpoi simm 0 ..,..ier system
idrmsaila,1% ..imou, -: 4.44,ricti - nii:kkibilki , .4:imam/Gat s y, Addition anew motor load of 0 huger separately clawed system,
"A,
Job no.: 083-27543 Job site address: 9780 SW SHADY LN 1001-11) or mom. oceuParmY
Six or more mAidontial units 0 RecicatiOnal vehicle parks
Cily/State/ZiP: PORTLAND. OR 97223 Q Heahh-care facilities 0 Supply voltage for more than
— 0 lizrzatdom locutions 600 volts nOtnituil.
Suite/bldg/apt. no.: STE 10 Project name. INTRINSIC MARKETING 0 SlIVICe or feeder 600 amp or inure.
-- . -- ---- gar l . Voini' ' ,. g'117144 . HiNV
Cross street/directions to job site: p 1_221111tho IMO ,. F. 'rola ,,,, •
--'''w"-----------''—"-- — New residential sine; or ntultl-family dwelling unit.
Includes attached garage. .,, _„„,.,„,„,,
- ...
1,000 sq 11. or less 168 54 4
Subdivision. Lot no.. .,- .
'
-- — — Ea add'1500 sq ft or portion 33.92 1 l
Tax map/parcel no.: _............_
Limited energy, residential
75.00 2
'It'll •:(l ., k,0. ±,vith ahos_q_ftl___
. A ); ,k,,;. .i. , ,i.... . 'A .1 . 4 . 1 ' ,1 " '.'" 46 ' '''-'' ' 4 A .. A' 4 , , ■ ■,-• , 4 ' . 4 ■ • , , 4 ,..... .......• ■■••■ ____
Limited energy, min-family
LOW VOLTAGE BURGLAR ALARM residential (with aritivea ft.) 750ft 2
— — - SemIces or feeders installation alteration or relocation ___
200 amps or lets .... 100.70 _ ...... __2
qiiria I , tiV r '67 1: ' , TIV 04 P,. .t ow W,FFTWARI , Flms to 400 amps 133 56 -.. 2
t. ' '. , ,' ,i 4. ',. ' ''n'il ' ,'. '; ' ''Y' too ' .. ' b.. WARM 'jLtiis
401 amps to 600 amps 200 2
ame: 34
N ------ _.,
ooi amps to 1,000 amps NM 301.04 7
___
Address: Over 1.000 amps or volts 552.26 2
_ ---
— - -------- Temporary services or feeders installation, alteration, and/or
(.ity/State/Z1P: ... relociitiou_ _
Phone. ( ) I. x( . > 1
200 i11111/3 or less
— 201 amps to 400 amps 12501t 2
Owner installation: This installation is being made on property that 1 own which is not
401 amps to 5ws. amps 168.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. _______-_----.............-1-.......... 2
Branch circuits -.net rcuits with Ittion or
Owner signature: extension , er ;Inc]
ate A. tbr branch c fe
----,= D: A
— . a . . .
Nat WI, Irlirrr; . ' '1 S'3 " Stir a VNi
A "i! . i t 1, , • ' 'n,'_ L. nA n y '01 . . 4 . . i' $ ' s 1 ,. 1 • ,1114+ 4, a ,„.?N, .1 - above scrvico or feeder e,
each branch circuit 747 2
13ltsiness name: 13 Fee for branch circuit's without
service or feeder fee, first
56.18 2
Contact name: ._. branch circuit
.. _.—_.
— Each addi branch circuit 7 42 2
Address: lt:Iiseellaneuus (service or feeder not included) ----
.---------------------------- - raamanutlictureaor modular
City/State/ZIP: 4
chvoninwervme anator rode' 67.8 2
_
.....---.—_—.--- — ,.- — _ ..---._ ---_____—__—_,--._
Phone:( ) Vox: . ( ) Reconnect only 67 84
„ 2
— „ „ - - Pump or 0058100 circle 67 84 2
Sign Of °Udine light InA 67.84 2
4 1.10 ; ylf tlyqf 4
Avaq a
, .4 •ot, Ji14. ' A 1 m ' : " , ,,, ka.. A.,1: .-.k.' ‘., ,..;1 Ist• . A',4 , . L .. . _-) siva) oiread(s) or imilod
, • 1 75 00
_Eallatiouo e:,_ ....pigt.2 2
Diminess name: ADT LIX:
...___-__________- instadditionis sedan over allowable in nay of the above
_______...
—.—
Address: 2815 SW 153" DR Additional inspection (1 hr min) 6625/ hr
--_________„----_______----------------- Investigation (1 hr rom) 66,25/ hr
------
— ---
_, __ , Industrial piton (I hr min) 78 18/ hr
---- ------ .
Phone: (503) 469 __I___---- Fax: (503) 469 inspections I'm vihiell no leo is 90,00/ hr
—.__ -- ------- s .citleallv fisted f Vi hr min
CCB Lie.: 196560 Electrical Lie.: CLE317 I3tipry ,ic.: 4252LEA ''1' '':' 7111M ') MEIER ."VIIIIKEILI MEMO
_._........... / subtowl: 7.5.00
Suprv. EIcetrieian signature, required: elf I .., . -
Plan review 0.5% of permit fee).
______ .• , — —
Print natne: Ell le WILLARD I . 16 5/9/13 Stow sot charge (12% of Winn fee): 9.00
...
_ — — ' Tol M. PERMIT ME, 84.00
Authorized signature: - This permit suppuration expires if a permit Is not obtained within 181)
. ---- — — days after If Ins been aceentut as complete.
Print name: Date: • Number Or msputions allowed pet permit.
—_--------_—
1A13 FAX.PerintiApp due 07/01/10 444 51(11/05ICOMIwt.R
05/09/13 08:18AH HP LASERJET FAX p.03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMPT FEES:
r , y � � , � I � r ° tai r ^�'-aY•�I i= 1 %'t ". il���l' �Pd ^fir' V7 �
k'' 67�. ������I' �f° �� mh�i .l.ulR�d�i'O,�.ro'D' x. �4�• tyl�tf�rt� %En�t'�'�'tt?ti1����l�tc
Fee for residential systems combined ... $75.00
Check Type of Work Involved:
Audio and Stereo Systems*
C r Burglar Alarm
• Garage Door Opener*
O Heating, Ventilation and Air Conditioning System*
O Vacuum Systems*
E] Other; .....
'4;"4' +lt i° �xJ,v,�u .1 M aul�t'll • M1 } ilf i
Fee for gach commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
0 Audio and Stereo Systems
0 Boiler Controls
0 Clock Systems
E Data Telecommunication Instillation
• Fire Alarm Installation
• HVAC,
• Instrumentation
0 Intercom and Paging Systems
• Landscape Irrigation Control*
0 Medical
Nurse Calls
O Outdoor Landscape Lighting*
O Protective Signaling
0 Other w _..
T otal number of commercial systems:
*No licenses are required. Licenses are requited
for all other installations
11tiuildmsTe miblF[.t'- parmttAppdoc 07/01!10