Permit 'i
:
_ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
v
'. pi '; E COMMUNITY DEVELOPMENT Permit #: ELR2013 00024
Ti GARD; 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013
Parcel: 1 S 135DA03900
Jurisdiction: Tigard
Site address: 11155 SW HALL BLVD 41
Project: St James Apartments Subdivision: METZGER ACRE TRACTS Lot: 19
' Project Description: (1) low voltage to install sprinkler monitoring system with notification. Fire repair is to units 41, 42, 43 & 44.
Contractor: WESTERN STATES FIRE PROTECTION Owner: KAULUWAI CORPORATION
13896 FIR ST STE B 2445 -A MAKIKI HEIGHTS DRIVE
OREGON CITY, OR 97045 HONOLULU, HI 96822
' PHONE: 503 -657 -5155 PHONE:
FAX: 503 -657 -5182
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/29/2013 $75.00
12% State Surcharge - Electrical 01/29/2013 $9.00
Type of Use: MF
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 =rid - I 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 issue • ., or if ork is suspended for more the 180
days. ATTENTION:' Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Th�'e rules are set forth in OAR
' 952- 001 -0010 through OAR 9 2- 001 -00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503. '32.1987 o • 1.81' .23 •
Issued By: A, . A �, , 1. _ � . Permittee Signature: .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' 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 Tigard RECEIVED Received T- Pennit No.
71 ' I � ► 3 s t Gam- 90 3 - c,r�� -,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Phone: 503.718.2439 Fax: 503.598.1960 Date /B : Other Permit:
T I GA R D Inspection Line: 503.639.4175 j p., N 2 9 2013 Date Ready /By: Juris: // __ RI See Page 2 for
Internet: www.tigard- or.gov Notified /Method: � ✓' ICJ Supplemental Information
TYPE OF WOR PLAN REVIEW
❑ New construction ® Addition /alteratldM h4ZIPN Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 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 ", "I -2 ".' l -3 ".
Job no.: LA0872 Job site address: 11155 SW Hall Blvd IOOHP or more. occupancy.
❑ 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.: Project name: Saint James Apartments ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: SW Pfaffle Description I Qt.. 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. II. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DES CRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Install sprinkler monitoring system with notification 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
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
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
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
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
each branch circuit
Business name: 13. Fee for branch circuits without
service or feeder fee, first
56.18
Contact name: branch circuit
Each add'1 branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZIP: dwelling, service and /or feeder 67.84
Phone: ( ) Fax: : ( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: Western States Fire Protection panel, alteration, or extension. I Page 2 75.00 ,
Each additional inspection over allowable in any of the above
Address: 13896 Fir Street, Suite B Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Oregon City, OR 97045 Investigation (I hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: (503) 657 - 5155 .x: (503) 657 - 5182 Inspections for which no fee is 90.00 / hr
specifically listed ('A hr min)
CCB Lie.: 104570 Electrical ' E11 Suprv. Lie.: 3860LEA ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require.. (t \' Subtotal: 75.00
Su
p g 9 � i PPlan review (25% of permit fee):
Print name: Duston W. Yacapi • Date: 1/29/2013 State surcharge (12% of permit fee): 9.00
`
Authorized signature: G i TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: Duston W. Ya '* ' t in Date: 1/292013 days after it has been accepted as complete.
* Number of inspections allowed per pennit.
t:\ Building \Permits \ELC- PermitApp.doc 07/01 /10 440 4615T( I I /05 /COMIWEB
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*
❑ 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
❑ 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 \Permits \ELC- PermitApp.doc 07/01/10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11155 SW HALL BLVD 41, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
135 Low voltage
02/20/2013 00:00
ELR2013-00024
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11155 SW HALL BLVD 41, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
135 Low voltage
02/20/2013 00:00
ELR2013-00024
PASS
Violation Summary:
Inspector Contractor