Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111111 �. ' COMMUNITY DEVELOPMENT Permit#: ELR2013 00274
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2013
Parcel: 1 S126DC03300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 130
Project: TIAA-CREF Subdivision: LEHMANN ACRE TRACT Lot: 4-5
Project Description: Fire alarm system.
Contractor: SAFE TECHNOLOGY GROUP INC Owner: ATHERTON REALTY PARTNERSHIP
6400 NE HWY 99 STE G375 2100 S WOLF
VANCOUVER,WA 98665 DES PLAINES, IL 60018
PHONE: 360-699-2130 PHONE:
FAX: 360-719-1527
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/13/2013 $75.00
12%State Surcharge-Electrical 11/13/2013 $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 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 OAR 952-001-0090. You may obtain a copy oft 1e ect questions to OUNC by calling 503.232.1987 or 1.80 . 32.2344.
Issued 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 IOR mi.-icy 1.51:. (-1,\1.1
• Received
City of Tigard ����� DateB : 0 I / S`� Permit No.: i , / r)
13125 SW Hall Blvd.,Tigard,OR 'i`:.'- Plan Review
C Phone: 503.718.2439 Fax: 503.5'1;:''t• Date/13 : Other Permit: `.S i,,1 — , ,
TIGARD Inspection Line: 503.639.4175 13 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov ((�� ay'�r° Notified/Method: )M , Supplemental Information
TYPE OF WORK�\ ``i7*��� PLAN REVIEW
❑New construction ®Addition/altera l' inu t ®- Please check all that apply(submit 2 sets of plans w/items checked below):
���1�� ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: Q 0141 where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONti7'KUCTION 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
El Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E""1-2""1-3"
Job no.: Job site address:9900 SW Greenburg Rd 100HP 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.: 130/160 Project name:TIAA/CREF ❑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
Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion _ 3392 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
FIRE ALARM Lim resential(with labove sq.ft.) 75.00 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ 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
ty 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 401 amps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
Branch circuits–new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name:SAFE TECHNOLOGY GROUP INC. B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name:JASON SWEET branch circuit
Each add'I branch circuit 7.42 2
Address:6400 NE HWY 99 SUITE G375 Miscellaneous(service or feeder not included) _
Each manufactured or modular
City/State/ZIP:VANCOUVER WA 98665 dwelling,service and/or feeder 67.84 2
Phone:(360)699•2130 Fax: :(360)719-1527 Reconnect only 67.84 2
E-mail:SALES @SAFETECHNOLOGY.NET Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:SAFE TECHNOLOGY GROUP INC. panel,alteration,or extension. 1 Page 2 75.00 2
Each additional inspection over allowable in any of the above
Address:6400 NE HWY 99 SUITE G375 Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:VANCOUVER WA 98665 Investigation(I hr min) 6625!hr
Industrial plant(1 hr min) 78.18/hr
Phone:(360)699-2130 Fax:(360)719-1527 Inspections for which no fee is 90.00/hr
specifically listed(Vz hr min)
CCB Lic.: 173731 Electrical Lic.: CLE79 Suprv.Lic.: 4272LEA ELECTRICAL PERMIT FEES
Suprv..Electrician signature,required: P.5.41r a
/ an Subtotal:
/ rmit
fee):
Print name: JASON SWEET Date: 10-29-13 State surcharge(12%of permit fee):
/Jg c TOTAL PERMIT FEE:
Authorized signature: // i�__wfyj This permit application expires if a permit is not obtained within 180
Print name: JASON SWEET Date: 10-29-13 • days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doc 07/01/10 410-4615T(11/05/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*
pBurglar 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
1:\Building\Permits\ELC-PermitApp.doc 07/01/10
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9900 SW GREENBURG RD 130, TIGARD, OR, 2013 -12 -02 (null)
97223
Record Type: Record ID:
Commercial - Electricial Limited Energy ELR2013 - 00274
Inspection Type: Result:
199 Electrical final PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor