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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' COMMUNITY DEVELOPMENT Permit #: ELR2011 -00154 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/29/2011 Parcel: 25101 DC00200 Jurisdiction: Tigard Site address: 13535 SW 72ND AVE 200 Project: Optilink Subdivision: 72ND AVE OFFICE BUILDING Lot: Project Description: Fire alarm system. Contractor: POINT MONITOR CORP Owner: PNWP LLC #2 7869 SW NIMBUS AVE BY PACIFIC NW PROP LTD PTNSP BEAVERTON, OR 97008 PO BOX 2206 BEAVERTON, OR 97075 PHONE: 503 -627 -0100 PHONE: FAX: 503 -627 -0110 FEES Description Date Amount Specifics: Restricted Energy Permit 06/29/2011 $75.00 12% State Surcharge - Electrical 06/29/2011 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: Y HVAC: N Instrumentation: N Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N 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 OA' r..2- 001 -0090. You ma o. -.• - •.y of ;..irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: L���� .G Permittee Signature: , ,L.PC : e-L" -.1 > 4 te- 4 -1-- - "" '' 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 Application FOR OFFICE USE ONLY � City of TlTigard Received // IN Date /B : !D Lam/ �,�� P i - i _ S ° 13125 SW Hall Blvd., Tigard, 0 , 4' ";� 1‘ Plan Review ��� _ . Phone: 503.718.2439 Fax: q W" , A Date/13 MI :� 5 : Other Permit: �l j 01 T I G A R D Inspection Line: 503.639.4175 .` �. Date Ready /By: Fa See Page 2 for Internet: www.tigard- or.gov � © Notified /Method: Supplemental Information TYPE OF WOE, , '� PLAN REVIEW ❑ New construction ® Addition /altera' �. :s cement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: t 4 y ❑ Service or feeder 400 amps or more ❑ Building over three stories. where the available fault current El Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at I50 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ( ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB . SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 "I -3 ", nd I00HP or more. occupancy. Job no.: Job site address: 13535 SW 72 Avenue ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Sute 200 Project name: Reduction of Suite 200 ❑ Service or feeder 600 amps or more. • FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I * New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 Install additional notification in an existing Fire Alarm system. residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City/State /ZIP: relocation _ Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ® APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: Point Monitor Corporation B. Fee for branch circuits without service or feeder fee, first Contact name: Steve Bruns branch circuit 56.18 2 Each add') branch circuit 7.42 2 Address: 7869 SW Nimbus Ave Miscellaneous (service or feeder not included) City/State /ZIP: Beaverton, OR 97008 Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: (503) 627 - 0100 Fax: : (503) 627 - 0110 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: SBruns @PointMonitor.com Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy 75.00 Business name: Point Monitor Corporation panel, alteration, or extension. 1 Page 2 2 Each additional inspection over allowable in any of the above Address: 7869 SW Nimbus Ave Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr City/State /ZIP: Beaverton, OR 97008 Industrial plant (1 hr min) 78.18/ hr Phone: (503) 627 -0100 Fax: (503) 627 - 0110 Inspections for which no fee is 90.00/ hr specifically listed (' hr min) CCB Lic.: 135901 Electrical Lie.: 3 � 08FLE Suprv. Lie.: ELECTRICAL PERMIT FEES ' J / � 4 3 Subtotal: 75.00 Suprv. Electrician signature, required n �- �fs, (— . Plan review (25% of permit fee): Print name: ` A� / 6, f(!6 6666 " fit/ s Date: (j Z f _. / 7 / State surcharge (12 %ofpermit fee): 9.00 f/ t — / - / I TOTAL PERMIT FEE: 84.00 Authorized signature: This permit application expires if a permit is not obtained within 180 _ .- 7 Q days after it has been acc as complete. Print name: 744.,,,X 6 ( G r Date: (� LQ / t * Number of inspections ections allowed per permit. ermit. I:\ Building \Permits\ELC - PermitApp.doc 07/01/10 440- 4615T(1 I /05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* H Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls H Clock Systems n Data Telecommunication Installation 1 Fire Alarm Installation n HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations C \ Building \ Permits \ELC- PefmitApp.doc 07/01 /10