Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IN II
1 : COMMUNITY DEVELOPMENT Permit#: ELR2013-00208
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/21/2013
Parcel: 1 S125DC06500
Jurisdiction: Tigard
Site address: 9670 SW SHADY PL
Project: GILBERT Subdivision: ASH CREEK GATES Lot: B
Project Description: Security system.
Contractor: SONITROL PACIFIC Owner: GILBERT,JOEL S&MARSHA I
8220 N INTERSTATE AVE 9670 SW SHADY PL
PORTLAND,OR 97217 TIGARD, OR 97223
PHONE: 503-223-5822 PHONE:
FAX: 503-973-7773
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/21/2013 $75.00
12%State Surcharge-Electrical 08/21/2013 $9.00
Type of Use: SF
Class of Work: ALT
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 ti ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued 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.
Aug. 20. 2013 3:02PM Sound Security Inc. No. 4043 P. 2
, Electrical Permit Applicatio JV FOR OFFICE USE ONLY
City of Tigard Received
g DateB : _ / "h. Permit No.: �L __ _ g
III • 13125 SW Hall Blvd.,Tigard,OR 97223 0'U G 2 ® 2013
013 Plan Review -
C Phone: 503.718,2439 Fax; 503.598.196 Other Permit:
DaterBy:
'f I CiA.R D Inspection Line: 503.639.4175 Date Ready/By: CY0 See Page 2 for
Internet: www.ligard-orgov VI T/OF Y IGAR® Notifed/Method: p
Supplemental Inform a lion
' 1IPE of WRONG DIVI ;_';pLAN.RE.rIEW.•
❑New construction ®Addiliotn/alteration/replacetnent Please check all that apply(eub,nil2 sets of plans wrteui s checked below):
❑Service or feeder 400 amps or more ❑Building over tree stories.
❑Demolition ❑Other: where ilia available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
loss to ground,or exceeds 14,000 ❑Commercial-use agricultural
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other; ❑Fira pump. ❑Tnslollalion of 150 KVA or
.1013 SITE INFORMATION AND LOCATION
['Emergency anew system. Luger separately derived system.
LOCATION ❑"A",")r",°I-z""13",
Job no.:P130123 Job site address;9670 SW Shady Place 100HP or more. occupancy.
_ ❑Six or more residential units. ❑Recreational%thiclo parks,
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous IocatiomLs. 600 volts nominal.
Suite/bldg./apt.no.: I Project name:Kim Adams Residence ❑Service or feeder 600 amps ormore.
FEE SCHEDULE:
Cross street/directions to job site: Ducripilon I 1. Fes, I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.; 1,000 sq.n,or less 168.54 4
— Ea.add'1500 sq.11,or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
. DESCRIPTION-OF WORK . • _ (with above sq.R.)
Limited energy,multi-family 75.00 2
Installation of intrusion security devices. residential(with above sq.R.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER , 1 ❑ TENANT _ 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: w 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amps 301.04 2
City/Slate/ZIP: Over 1.000 amps or volts 552.26 2
Temporary services or feeders Installation,alteration,and/or
Phone:( ) I 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 itai V A,Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name: each branch circuit
B.Pee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
- branch circuit
Address: Each add'l branch circuit 7.42 2
City/Slate/ZiP: Miscellaneous(service or feeder not Included)
Each manufactured or modular
Phone:( ) p ::( ) dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67-84 2
.. •CONTRACTOR Sign oroutlinolighting 67.84 2
Iusiness name:Sonitrol Pacific Signal circuits)or limited-energy See w
panel.alteration,or extension. l Page 2 75.00 2
Address:8220 N Interstate Avenue Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP;Portland,OR 97217 lnvostigalion(1 hr min) 66.25/hr
Phone:(503)2235822 Fax;(503)973..7773 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.04)/lu
CCB Lie.: 53535 Electrical Lic.: 26370CLE Suprv.Lie.: 3567LEA specifically listed('h hr min)
'- ELECTRICAL PERMIT PEES .
Suprv.Electrician signature,required: Subtotal: 75.00
Print name: Gordon Ducclte Date: 8/20/13 Plan review(25%of peat/fcc):
Slate surcharge(12%of permit fcc): 9.00
Authorized signature: TOTAL PERMIT FEE: 84.00
This permit application expires if a permit Is not obtained xilhin 150
Print name: Ann C Moore Date: 8/20/13 days afro-It has been accepted as complete.
' Number of inspections allowed per permit.
l:lnuildingtl'ermitslELC PermilApp ELR EPLdue Rev 05/21/2511 440.4615T(11/05/COM/117D
Aug. 20. 2013 3:02PM Sound Security Inc. No. 4043 P. 3
Electrical Permit Application--City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
rrrESYDENTIAL WORD ONLY: J OE SCHED(P
Fee for all residential systems combined..,,.,, $75.00 Ducdpilen I Ott Fee I Told I •-
namable electrical energy systems;
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 Iwo 133,56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
® Burglar Alarm Wind generation systems In excess o[25 kill;
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.0 t to MO kva 552.26 2
>100 kva(fie in accordance with 552.26 2
❑ Heating,Ventilation and Air Conditioning OAR 91 8-3090040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ 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 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90,001 hr
specifically listed(15 hr min)
COMMERCIAL WORD•ONLYc • •ELECrn1CAL:?EnM 1p rr,a s .
Fee for each commercial system $75,00 Subtotal:
(SEE OAR 91 8-309-0000) Plan review,if required(25%ofpermit fee): —
Stale surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMrr PEE;
This permit application expires It a permit is not obtained ttithln 180
❑ Audio and Stereo Systems dads alter it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El 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
lauidin 11'ermiiat-CJeratApp_EIR ERE.doe Rev 05/7112013