Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
C' • COMMUNITY DEVELOPMENT Permit#: ELR2013 00250
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2013
Parcel: 2S 113AB00500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD 320
Project: Spec Space Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Fire alarm.
Contractor: LEAR ELECTRIC CO INC Owner: G&S FC LLC
PO BOX 573 16083 SW UPPER BOONES FERRY RD,
GRESHAM,OR 97030 STE
TIGARD,OR 97224
PHONE: 503-255-0733 PHONE:
FAX: 503-255-0676
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/15/2013 $75.00
Type of Use: COM 12%State Surcharge-Electrical 10/15/2013 $9.00
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' law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set • h i OAR
952-001-0010 ugh OAR 952 101-1*90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.3 .2344.
r
Issued By: � .��� �r�. - 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.
10/09/2013 11:31 5032550676 LEAR ELECTRIC PAGE 01/02
Electrical Permit A licatio � � EON OFE•ICF. USE ONLi
tga d City of Tigard Received JO !%0 Permit No,:���y %Q,Sd
13125 SW Hall Blvd.,Tigard,OR 97223 Q CT 9 2013
nate/B : /0
11
• Phone: 503.718.2439 Fax: 503,398.1960 Plan Review Other Permip 0,,i3 p0/y7
Inspection Line: 503.639.4175
Ready/15y: H See CITY OFTIGARD Internet; www.tigard-or.gov Date .
upplemental Information
TYPE OF b DI C v1Gl8!®!\.1
PLAN REVIEW • -
El New construction Addition/alteration/replacement — Please cheek all that apply(submit,?sets of plans w/items checked below):
❑Demolition ID Other: ❑Service or feeder 400 amps or more ID Building over three stories.
where the available fault current El Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑Floating buildings.
less to ground,or exceeds 14.000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling 14 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.: 3_List, Job site address:I(Pp$3 SSW awe( �jS Six or more a res. Recreational%' � ❑Six or moro residential units, ❑Rec7eational vehick parka.
City/Stare/ZIP: Z'16\arck Me_ et -?.. .14 Fern/ D Health-care facilities. El Supply voltage for more than
1 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: 3�i\ Project name:_arlro Cret k t )u� ❑Service or feeder 600 amps or more.
Cross street/directions to job slue: /� �/V 'y�p FEE SCHEDULE
�LOtCe. S/ tq-( a j ' m tka I On-. I Pee. I Twat I •
Ncw residential single-ur molt!-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: _ Ea.add'I 500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
fi 9-i /7a Limited energy,multi Family 75.00 2
L �2'� , (�/J residential(with above sq.8,)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation_
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100,70 2
Name: _201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2-
Address: 601 amps to 1,000 amps 301,04 2
City/State/Z.1 P: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
Owner installation:This installation is being made on property that 1 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
401 amps to 599 amps 168.54 2
Owner signature: Date: -Branch circuits—new alteration,or exteosion,.er panel
❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42
Business name: each branch circuit
B.Fee for branch circuits without Contact name: service or feeder fee,first
Address:
branch circuit 56.18 2
Each add'Ibranch circuit • 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2_
Phone:( ) Fax::( ) dwelling,service and/or feeder
E-mail:
- Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
CONTRACTOR r Sign or outline lighting 67.84 2
Business name:Lear Electric Co.,Inc. Signal circuit(s)orlimited-energy See r
panel,alteration,or extension. l Page 2 15 2
Address:6002 NE 112th Ave Each additional ins.ection over allowable in an of the above
City/State/ZIP:Portland,OR 97220 Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(503)255-0733 Fax:(503)255-0676 Industrial plant(1 hr min) 78.18/hr
CCB Lie.: 52278 Electrical Lie.: 26-411C Suprv.Lie.: 3786S speclflcally iisted6icth�no fee is
90.00/hr
Suprv.Electrician signature .-quire—c1"-:"
, ELECTRICAL PERMIT FEES
a+- 7 Subtotal; �j
Print name: David Mu .ord P.M: (8 q-13 Plan review(25%of permit fee):
• — State surcharge(12%of permit fee): C —
Authorizc signature: t / � 1' F - TOTAL PERMIT FEE: Q0�. Y ✓
Print name: David Mumford / 10 r�� Thus permit application expires if a permit Is nut obtained within 180
Date: 1 ` days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:1BuildingTermits16LC_PennitADp_ELR_ERE.doc Rev 05/21/2013 440.4615T(11/05/COM/WEB
10/09/2013 11:31 5032550676 LEAR ELECTRIC PAGE 02/02
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 Darriptioa T� ;rte I Taw 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
❑ Burglar Alarm Wind generation terns in excess of25 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
55226.26 2
Heating,Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100{t-va—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(1 hr min) 6625/hr 1
Inspections for which no fee is 90.00/hr
COMMERCIAL WORK ONLY: specifically listed E A hr 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: TOTA1,PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Audio and Stereo Systems days after it has hero accepted as complete.
Number of inspections allowed per permit.
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:UiuddingTermits1ELC_PctmitApp ELR_ER.R.doc RBv 05/21/2013
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16083 SW UPPER BOONES FERRY RD 320,
TIGARD, OR, 97224
Commercial - Electricial Limited Energy
199 Electrical final
2013-10-22 00:00:00
ELR2013-00250
PASS - No C of O
Violation Summary:
Inspector Contractor