Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2020-00063
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2020
TIGARD g Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 290
Project: Fairway Mortgage Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire alarm.
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/04/2020 $75.00
12%State Surcharge-Electrical 05/04/2020 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 1
i
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 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./'
Issued By: �— fir,-�dr—� . Permittee Signature: l /
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 licatio ECEIVED FOR OFFICE USE ONI.I'
City of Tigard p Received � r Zv � Permit a:FL/'Pc.~( -iOO 3
13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 2020 Date/By:
Plan Review
g Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit a:
Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date.'By: Janis: 65 Sec Page 2 for
TIGARD Internet: www.tigard-or.gov BUILDING DIVISION Nonfied/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):
0 Service or feeder 400 amps or more 0 Building over three stories.
D Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exre'ds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: I0OH Job site address:6650 SW Redwood Lane. ❑ 0H m of new motor load of " ,"P or more. ❑`A" F""1-2"«i-3"
City/State/ZIP:Tigard,OR 97224 ❑Sic or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vebick parks.
Suite/bldg./apt.#:290 Project name:Fairway Mortgage 0 Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description 1 Qty. I Each 1 Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.f.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Fire Alarm Notification Devices (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER ® TENANT Renewable Energy 0 See Page 2
Services or feeders instailation,aiteration,and/or relocation
Name:Fairway Mortgage 200 amps or less 100.70 2
Address:6650 SW Redwood Lane Suite 290 201 amps to400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:___ Date: 401 amps to 599 amps 168.54 2
® APPLICANT El CONTACT PERSON
Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Point Monitor Corp. above service or feeder foe, 7.42 2
each branch circuit
Contact name: Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 servicecirfu fee,first
branch circuit56.18 2
t
City/State/ZIP:Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)627-0100 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:bwilliams@pointmonitor.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Point Monitor Corp. Sign or outline lighting 67.84 2
Address:5863 Lakeview Blvd.Suite 100 Signall,alteration,i(s)or limited-energyxl . ® See Page 2 1 2
panel, or extension.
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable In any of the above _
Additional inspection(I hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:bwiiliams@pointmonitor.eom Inspections for which no fee is
CCB Lie.: 135901 Electrical Lie.: 34508CLE Suprv.Lic.: 4460LEA specifically listed(/br min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: - Subtotal: '75 ,
Crp
Print name: Ben Breit Date: 4/27/2020 0 Plan Review Required(25%of permit fee):
.�j State surcharge(12%of permit fee): 9 t D
Authorized signature: —� T`` TOTAL PERMIT FEE: e?e, crc)
This permit application expires if a permit Is not obtained within 180
Print name: Ben Breit Date: 4/27/2020 days after it has been accepted as complete.
- • Number of inspections allowed per permit.
1:Buildine\Permib ELC_PemutApp_ELR_ERE.doc Rev 06.,1"2015 44046151(114)5/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
DFee for all residential systems combined: $75.00 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
Li' I Burglar Alarm Wind generation systems in excess of 25 kva:
g 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
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
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):
r Number of inspections allowed per penult.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
I.Bailding'Penaia ELC_PermitApp ELR ERE.doc Rev 06 17 20 I5