Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 a ° COMMUNITY DEVELOPMENT Permit #: ELR2013 -00139
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/27/2013
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 115
Project: Davidson Benefits Planning Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Low voltage for fire alarm
Contractor: POINT MONITOR CORP Owner: PORTLAND SW CENTER LLC
5863 LAKEVIEW BLVD SUITE 100 BY FELTON PROPERTIES INC
LAKE OSWEGO, OR 97035 ATTN. FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE 503 - 627 -0100 PHONE:
FAX 503 -627 -0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/27/2013 $75.00
12% State Surcharge - Electrical 06/27/2013 $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 = - - ith 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 ENTION Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -■ 11- 0010th ough OAR 952 -'0 .19 • may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800.332 2344
41 , ;i •
/
sued By: / Permittee Signature:
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
Cl of Tl and CE�D Date /B i Received
Permit No : 1 , Q �&'
`J g / 4 5y /3
13125 SW Hall Blvd., Tigard, OR 9 tl Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date /B : Other Permit
Tic A R D Inspection Line. 503.639 4175 4 Date Ready /By. tuns El See Page 2 for
Internet www.tigard- or.gov JUN 2 2013 Notified/Method. Supplemental Information
TYPE OF WIN OFTIGARD PLAN REVIEW
❑ New construction ® Addition/aBIMMINV4SION 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 agncultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ",' 1 -2 ", "1 -3 ",
Job no.: Job site address: 7632 SW Durham Road 100HP or more occupancy
❑ Six or more residential units ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: / /5 Project name: Davidson Benefits TI ❑ Service or feeder 600 amps or more
i 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
Modify Fire Alarm notification for Ti remodel residential (with above sq. ft.)
Renewable Energy ❑ See Page 2 '
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100 70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200 34 2
Address: 601 amps to 1,000 amps 301 04 2
Over 1,000 amps or volts 552 26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee, 7 42 2
Business name: Point Monito Corporation each branch circuit
B. Fee for branch circuits without
Contact name: Steve Bruns service or feeder fee, first
branch circuit 56.18 2
Address: 5863 Lakeview Blvd, #100 Each add'I branch circuit 7.42 2
City/State /ZIP: Lake Oswego, OR 97035 Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: (503) 627 - 0100 Fax: : (503) 627 - 0110 dwelling, service and/or feeder
Reconnect only 67 84 2
E - mail: SBruns @PointMonitor.com Pump or irrigation circle 67 84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Point Monitor Corporation Signal circuit(s) or limited- energy
I See 75
panel, alteration, or extension. Page 2 2
Address: 5863 Lakeview Blvd, #100 Each additional inspection over allowable in any of the above
City/State /ZIP: Lake Oswego, OR 97035 Additional inspection (I hr mm) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
Phone: (503) 627 - 0100 Fax: (503) 627 -0110 Industrial plant (1 hr min) 78 18/ hr
Inspections for which no fee is 90 00! hr
CCB Lic.: 135901 Electrical Lic.: 345081ea Suprv. Lic.: 7t p LEA specifically listed (' /z hr min)
Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES
Subtotal: 75.00
Print name: Cx n g t + Date: Plan review (25% of permit fee):
G State surcharge (12% of permit fee) 9.00
Authorized signature: C yr
' / � LcvyV� TOTAL PERMIT FEE 84.00
This permit application expires if a permit is not obtained within 180
Print name: Steven M. Bruns Date: 6/21/13 days after it has been accepted as complete.
• Number of inspections allowed per permit
\ Building \ Permits \ELC_PermitApp_ELR ERE doc Rev 05/21/2013 440- 46t5T(I1 /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
Fee for all residential systems combined $75.00 Description I Qa. I Fee I Total I *
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
111 Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301 04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva (fee in accordance with 552.26 2
❑ Heating, Ventilation and Air Conditioning
OAR 918- 309 -0040)
System* Solar generation systems in excess of 25 kva:
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:
Other: Each additional inspection is
charged at an hourly (I hr min) 66.25/ hr 1
Inspections for which no fee is 90.00/ hr
specifically listed (' /z hr mm)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):
State surcharge (12% of permit fee)
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit
❑ 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
1 \ Budding \Permits \ELC_PermtApp_ELR_ ERE doe Rev 05/21/2013