Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' I COMMUNITY DEVELOPMENT Permit#: ELR2021-00009
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/27/2021
TIC;r\R C- g Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 220
Project: Spec Space Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Fire Alarm system
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 01/27/2021 $75.00
12%State Surcharge-Electrical 01/27/2021 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
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 OAR952-001-0090. 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: \�0\ -�`�n �e�Q Permittee Signature: CI N- ck p`t L C.Lk
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 ApplicatiRECEIVED 1fiit01•Ill r 1 tii O\1.1
City of Tigard JAN 1 2 2021 DECC1at et/ 2 /4jc2 f 'a pennitt: F R2O J- /?J '
13125 SW Hall 81vd.,Tigazd,OR 97223 Plan Review. y.�„ ��h�, Z
g Phone: 503.718.2439 Fax: 503.598 Da tell : �� Related Permi'pr WV
Inspection Line: 503.639.4175 °Y OF TIGARD Ready DateBy: /s� _ El See Page 2 for
I I(,�1Ht) Internet: www.tigard-or.gov -LJ1LDII11G DIVISIOp, Noufleei/Metla)drX��� Supplemental Information
�VV DIVISION ..
.... ....TYPE OF ''d 1. i`i AN REVIEW -.
❑New construction ®Addition/alteration/replacement Pleaso check all that apply(submit a sets of plans w items checked):
0 Service or feeder 400 amps or more 0 Building over these stories.
❑Demolition 0 Other:
When the available fault current 0 Marinas and boatyards.
CATEGORY,QF CONSTRUCTION; exceeds 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 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
, i -JQB S I'k) ORMA PION tIA f/'Io 1 ,;;"'�µ ❑Emergency system' larger separately derived
v, _. _
Job#: Job site address:6650 SW Redwood Lane ❑loolip Addition of new motor load of system.
100HP or more. ❑"A" "E" "1-2""1-3"
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:220 Project name:PCC240 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
�?LE CC11T+,UUL6
Description i Qiy. I Each I Total I '
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.R.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft or portion 33.92 1
'°'`.'°-$:',` "DEStitiFi OI'i"O `*AtV'` Limited energy,residential
75.00 2
(with above sq.ft.)
Fire Alarm Notification Devices .
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
❑ PROPERTY OWNER,. - ®.TENANT... Renewable Energy 1 El See Page 2
Services or feeders installation,alteration,and/or relocation
Name:PCC240 200 amps or less 100.70 2
Address:6650 SW Redwood Lane Suite 220 201 amps to 400 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 ❑ 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 fee, 7.42 2
each branch circuit
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 brche ciorfurcuit fa,first
bra nnch 56.18 2
t
City/State/ZIP:Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2
Phone:(503)627-0100 Fes:. Miscellaneous(service or feeder not included)
:( ) Each manufactured or modular
Email:bwilliams@pointmonitor.com
dwelling,service and/or feeder
67.84 2
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 pineal alterat(s)ion,
or limited-energy
® 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(1 hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(I hr min) 90.00/hr
Email:bwilliams@pointmonitor.com Industrial plant(1 hr min) 78.I SJ hr
Inspections for which no fee is
CCB Lie.: 135901 Electrical Lic.: 34508CLE Suprv.Lic.: 4460LEA specifically listed CAhrmin) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name: Ben Breit Date: 1/12/2021 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: --ram} TOTAL PERMIT FEE:
This permit application expires ifa permit is not obtained within 180
Print name: Ben Breit Date: 1/12/2021 days after It has been accepted as complete.
---- • Number of inspections allowed per permit.
1:Bui1ding'Prnnits.ELC PemitApp_ELR_ERE.doe Rev 0( I7'2015 440.46157(I1,05^COM+WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
DescrFee for all residential systems combined: $75.00 Renews. ° Each Total
Renewable electrical energy systemnta:
Check Type of Work Involved: s 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
❑ 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 an of the above:
❑ Other Each additional inspection is 6g,25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90 o0/hr
�y s._ 'ficali listed Y,hr min_
S' �5T;2vllii aTJA -
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) ' Number of inspections allowed per permit
Check Type of Work Involved:
n Audio and Stereo Systems
❑ 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: 1
*No licenses are required. Licenses are required for all
other installations
I.Building 8enniuDLC PermiiApp EIA_ERE dcc RCN 0f 1'3015