Permit rt CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
t: COMMUNITY DEVELOPMENT Permit #: ELR201300126
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/11/2013
Parcel: 2S112AC00600
Jurisdiction: Tigard
Site address: 7440 SW BONITA RD
Project: Ricoh Americas Subdivision: GARDEN TRACT ADDITION Lot: PT 24 -21
Project Description: Low voltage for CCVS system
Contractor: STANLEY SECURITY SOLUTIONS INC Owner: BEALES, ALAN K & SUSAN R TRUST
15495 SW SEQUOIA PKWY SUITE 100 BY BEALES, ALAN K & SUSAN R TRS
PORTLAND, OR 97224 2126 MAGELLAN DR
OAKLAND, CA 94611
PHONE: 503 - 968 -3353 PHONE:
FAX: 503 - 968 -3398
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/11/2013 $75.00
12% State Surcharge - Electrical 06/11/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: Y 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: 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 arco ance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspend • • - for more the 180
days. NTION: Oreg • • law r- • es you to follow the rules adopted by the Oregon Utility Notification ' nter. Those rules :re set forth in OAR
952 -0 -0010 through OAR 95 01 -0090. Y • Y. may obtain a copy of the rules or direct questions to OUNC by calling 503.2 1.1987 or 1.800.33 44.
/�
I ue By: _ / Permittee Signature:
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 A licatto4f�CEIV ED FOR OFFICE USE ONLY
• PP
City g of Tigard JUN 1 1 2013 Received
Date /By: /j / Permit No.: ��,�ao�3 - DO� �
-- " 13125 S W Hall Blvd., Tigard, OR 7 3 Plan Review
Phone: 503.718.2439 Fax: 503. i ° F TI Date /By: Other Permit:
TIGARD Inspection Line: 503.639.4175 DU DMI/� DIVISIOPf Date Ready /By: tur� See Page 2 for
Internet: www. tigard- or.gov L "vV Notified/Method: Supplemental Information
TYPE OF WORK 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 OF 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 ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A "E ", "I -2 ", "I -3 ",
Job no.: 5346840 Job site address: 7440 SW Bonita Road I00HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard Oregon 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: RICOH AMERICAS ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: SW 74 Description I orv. I 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'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
INSTALL INTEGRATED CCVS SYSTEM residential (with above sq. ft.)
Renewable Energy _ ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
® APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: STANLEY SECURITY SOLUTIONS each branch circuit
B. Fee for branch circuits without
Contact name: STEVE MOREHOUSE service or feeder fee, first 56.18 2
branch circuit
Address: 15495 SW SEQUOIA PKWY #100 Each add'I branch circuit 7.42 2
City /State /ZIP: PORTLAND OREGON 97224 Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: (503) 968 - 3300 Fax: : (503) 9683398 dwelling, service and/or feeder
Reconnect only 67.84 2
E - mail: steve.snyder@sbdinc.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: SAME Signal circuit(s) or limited -energy I See
75
panel, alteration, or extension. Page 2 f 2
Address: Each additional inspection over allowable in any of the above
Additional inspection (I hr min) 66.25/ hr
City /State /ZIP:
Investigation (I hr min) 66.25/ hr
Phone: ( ) Fax: ( ) Industrial plant (1 hr min) 78.18/ hr
Inspections for which no fee is 90.00 / hr
CCB Lic.: 161567 Electrical Lic.: 37— (05ge..L .Suprv. Lic.: • specifically listed (% hr min)
Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES
Subtotal: 75.00
Print name: STEVE MOR HOUSE Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): 09.00
Authorized signature: • TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: STEVE MOREHOUSE Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
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•
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
rRRESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined ... $75.00 Description I Qtv. I Fee I Total I •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva (fee in accordance with 552.26 2
OAR 918- 309 -0040)
❑ Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
C Vacuum Systems* >100 kva — no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑
Other: Each additional inspection is
charged at an hourly (1 hr min) 66.25/ hr
Inspections for which no fee is 90.00 / hr
specifically listed (h hr min) _ _
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 subtotal:
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):
State surcharge (12% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after It has been accepted as complete.
• Number of inspections allowed per permit.
❑ 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: I
*No licenses are required. Licenses are required
for all other installations
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