Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' _ COMMUNITY DEVELOPMENT Permit#: ELR2020-00105
T f f;A R n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/15/2020
Parcel: 2S101DA00101
Jurisdiction: Tigard
Site address: 13190 SW 68TH PKWY 200
Project: Aspen Capital Subdivision: VARNS ACRES Lot: 9
Project Description: Fire alarm system.
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: PACIFIC NW PROPERTIES LIMITED PA
7324 SW DURHAM ROAD STERN FAMILY LIMITED PARTNERSHIP
PORTLAND, OR 97224 STERN FAMILY LLC
6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/22/2020 $75.00
12%State Surcharge-Electrical 09/22/2020 S9.00
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
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: 1D Permittee Signature: See. 11 C.Gn O�
OWNER INSTALLATION ONLY l
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.
V Electrical Permit Application R a FOR OFFICE USE ONLY
City of Tigard d " � +`'0eiv _ 2�y ��t
Date/Bed: 08-Zd ZCJZO/.., ennit#: �W ✓!/�Q s
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
. III Phone: 503.718.2439 Fax: 503.598.1960 AUG 1 0 2020 DateB : = Related Permit Al;
Inspection Line: 503.639.4175 ,.Ready Date/By: HI See Page 2 for
TIGARD Internet: wvw,.tigard-or.gov ' 0F Notified/Method: 7// „„ •'>I• Supplemental Information
TYPE OF WOW.- I NO LAV IQ'IL+1 PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/ilems checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition ❑ Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial D Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family D Master builder ❑ Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:109324 Job site address:13190 SW 68th Pkwy 100HP or more. ❑"A","E","I-z","l-3",
City/State/ZIP:Tigard, OR 97223 ❑Six or more residential units. occupancy.
g o 0 Recreational vehicle parks.
❑Health-care facilities.
Suite/bldg./apt.#: z06 Project name:Aspen Capital ❑Hazardous locations. 0 Supply voltage for more than
ElService or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each 1 Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
i-r't. DESCRIPTION OF WORK Limited energy,residential
INSTALLATION OF FIRE ALARM SYSTEM CONSISTING OF:NEW AUXILIARY POWER SUPPLY (with above sq.ft.) 75.00 2
wl BATTERY BACKUP.ADDRESSABLE DETECTORS AND MODULES,NOTIFICATION APPLIANCES Limited energy,multi-family 75.00 2
(STROBES, HORN-STROBES),and TIE TO EXISTING FIRE ALARM SYSTEM residential(with above sq,ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps _ _ 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 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 1
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 ® CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Performance Systems Integrated above service or feeder fee, 7.42 2
each branch circuit
Contact name:Katie Harbaugh B.Fee for branch circuits without
service or feeder fee,first
Address: 56.18 2
7324 SW Durham Rd branch circuit
City/State/ZIP:Portland, OR 97224 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( )5036412222 Fax: :( )5036411464 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:katieh@psintegrated.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Performance Systems Integrated Sign or outline lighting 67.84 2
Address:7324 SW Durham Rd Signal circuit(s)or limited-energy ® See Page 2 1 2
panel,alteration,or extension. ___
eityistate/zIP:Pcrtland, OR 97224 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( )5036412222 Fax:( )5036411464 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:katieh@psintegrated.com I/t c/y Inspections for which no fee is
CCB Lie.:227526 Electrical Lic.:C 569 . ie.:4062 specifically listed(Ye hr min) 90_00/hr
ELECTRICAL PERMIT FEES „,
Suprv.Electrician signature,required:L Subtotal: i Ri
Print name:Michael Brooks Date:7/21/2020 ❑Plan Review Required(25%of permit fee):
11 �,�, � State surcharge(12%of permit fee): ��
Authorized signature: Plr, 'ti"I TOTAL PERMIT FEE: LkCCCCC This permit application expires if a permit is not obtained within 180
Print name:Katie Harbaugh Date:7/21/2020 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I:sBuilding\Permits iELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/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
Description
Fee for all residential systems combined: $75.00 Qty. Each ,et,
Y 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
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n Garage Door Opener* >100 kva(fee in accordance 552.26 2
_ with OAR 918-309-0040)
❑ 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:_
n Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90 00l hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ 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
f'BuildingOermittELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
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