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Permit
... ELECTRICAL PERMIT - C I TY OF TIGARD RESTRICTED ENERGY `; �;� DEVELOPMENT SERVICES PERMIT #: ELR2001 -00018 - " '- �- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/24/01 PARCEL: 1S136DA-00100 SITE ADDRESS: 11308 SW 68TH PKWY SUBDIVISION: ZONING: MUE BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of restricted energy system for fire alarm. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: : TOTAL # OF SYSTEMS: 1 Owner: Contractor: BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP KEY LLC, THE 1010 SE 11TH AVE BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214 WORCESTER, MA 01615 Phone: Phone: 234 -9900 Reg #: LIC 203 SUP 1302S ELE 26 -95C FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 1/23/01 $75.00 2720010000 Elect'l Final 5PCT CTR 1/23/01 $6.00 2720010000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires to • • rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 -0010 throu• • OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1 87. �/ Issue by _, :k ;; Permittee Signature / t p / •I ag a A ee, - .i / OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day . (95.°---/l Electrical Permit Application Date received: it -a /- 6d Permit no.: EL 4..900 / ••OGD/ _,� :' City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory )$Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job addres41 308 S W 68th P kwv Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: Project name: Prc ridencg Info 1 Description and location of work on premises Fire Alarm Add — • Estimated date of completion/inspection: Services CONTRACTOR APPLI CATION FEE SCHEDULE Job no: 68071 Fee Max Business name: Description Qty. (ea.) Total no. limp Oregon Electric Group New residential - sirrgleor multi- family per Address: 1 01 0 SR 1 1 th ANT dwelling unit. Includes attached garage. City: Por t t a n rStat . R I ZIP: 9 7214 Service Winded: Phone: 503-23 ' —1q.5131 E -mail: 1000 sq. ft. or less 4 CCB no.: • s ec. bus. lie (5..: Each additional 500 sq. ft. or portion thereof y ' , Lirnitedenergy,esidential 2 City/metro lie. no.: , , ' Lirnited energy, non- residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date 1 1 4 ©0 Service and/or feeder 2 Sup. elect. name (print): • License no: Services or feeders — installation, alteration or relocation: 200 amps or Tess 2 Name rint : — 201 amps to 400 amps 2 • (P ) Prncric Hagjtjl 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to hrsYallation , alteration, orrelocation: 20 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 _ Owner's signature: Date: 401 to 600 amps 2 ENG IN EER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase . of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) misc. (Service or feeder not included): • O Service over 225 amps- commercial xx la Health -care facility Each pump or irrigation circle 2 O Service over 320 amps rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* I 2 ❑ Building over three stories 0 Feeders, 400 amps or more *Description: 6/1 AL 9 i(?. - O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan 0 Other Per inspection 1 I 1 1 Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 75 • O0 O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ .a 0 Expires accepted as complete. TOTAL $ • e' Name of cardholder as shown on credit card $ Cardholder signature Amount f 440-4615 (6/00 /COM) • Electrical Permit Fees: - Limited Energy Fees: " . Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY /� Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders in Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 n Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or r relocation 200 amps or less $66.85 2 Fee for each system $75.00 201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see "b" above. Branch Circuits 1:11 Audio and Stereo Systems New, alteration or extension per panel . ' a) The fee for branch circuits Boiler Controls with purchase of service or feeder fee. ❑ Clock Systems Each branch circuit $6.65 2 b) The fee for branch circuits n Data Telecommunication Installation • without purchase of service or feeder fee. a Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 Minor Labels (10) $125.00 ❑ Landscape Irrigation Control* Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 Per hour $62.50 ❑ Nurse Calls In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ F Other 8% State Surcharge $ 25% Plan Review Fee Number of Systems See "Plan Review" section on $ front of application. * No licenses are required. Licenses are required for all other installations Total Balance Due $ Fees: 0 Trust Account # Enter total of above fees $7 5 0 0 - 8% State Surcharge $ 6.00 . Total Balance Due $81.00 i:\dsts \forms \elc- fees.doc 10/09/00 • •