Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1,114 q
11 COMMUNITY DEVELOPMENT Permit#: ELR2014-00038
TI C A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2014
Parcel: 1 S126BC01506
Jurisdiction: TIGARD
Site address: 9020 SW WASHINGTON SQUARE RD 250
Project: LoanStar Home Lending Subdivision:CONDO,THE SUPPLEMENTAL PLAT Lot: 25-4
Project Description: Low voltage for fire alarm
Contractor: FIRE PROTECTION SERVICES Owner: WISCO REAL ESTATE EQUITY FUND I
5573 SW ARCTIC DRIVE 1501 SW TAYLOR ST STE 100
BEAVERTON, OR 97005 PORTLAND, OR 97205
PHONE: 503-590-3732 PHONE:
FAX: 503-628-6214
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/20/2014 $75.00
12%State Surcharge-Electrical 02/20/2014 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
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. ATTENT : Orego aw requ' == you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 roug OAR 952- 1-,.•0. •u •,y obtain a copy of the rules or direct questions to OUNC by calling 503. r 1.8-0.33 .2344.
Issued By. 01 Permittee Signature: Aar
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
E���� DateiBed
IN `J g Permit No.:
_ • 13125 SW Hall Blvd.,Tigard,0 Date/By: /� l� ,� e� — 3�
g Date/By:tow Other Permit: 7-
Phone: 503.639.4171 Fax: 50 .5 60
TI G A R D Inspection Line: 503.639.4175 FEB 13 2014 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov nn�(� ++(�'. Notified/Method: Supplemental Information
TYPE OFG4V. t" i 1lIttB - PLAN REVIEW
❑New construction ® Addition/ ailiAptabeiiteiit ' Please check all that apply(submit 2 sets of plans w/items checked below):
CI Demolition CI Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
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","l-2","1-3",
Job no.:2 Job site address:9020 SW Washinton Square rd 100HP or more. occupancy.
_ ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard Oregon 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:250 Project name: loanstar home lending ❑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 145.15 4
Ea.add'I 500 sq.ft.or portion _ 33.40 I
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
add(3)horn strobe/strobes to existing system residential(with above sq.ft.) 75.00 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax:( ) 200 amps or less 66.85 l
Owner installation;This installation is being made on property that I own which is not 201 amps to 400 amps . 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps - 133.75 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,
each branch circuit 6.65 2
Business name: FIRE PROTECTION SERVICES,INC. B.Fee for branch circuits
without service or feeder fee,
Contact name:DAVID M.PHIPPS first branch circuit 46.85 2
Address: 5573 SW ARCTIC DRIVE Each add'l branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:BEAVERTON,OR 97005 Each manufactured or modular 90.90 2
dwelling,service and/or feeder
Phone:(503)590-3732 Fax: :(503)628-6214 Reconnect only 66.85 2
E-mail: phipps @fpsnw.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: FIRE PROTECTION SERVICES,INC. Signal circuit(s)or limited
energy panel,alteration,or
Address: 5573 SW ARCTIC DRIVE extension.Describe: 1 Page 2 1 S 2
City/State/ZIP:BEAVERTON,OR 97005 Each additional inspection over allowable in angof the above
Per inspection 62.50
Phone:(503)590-3732 Fax:(503)628-6214 Investigation per hour(I hr min) 62.50
CCB Lic.: 154333 Electrical Lic.: 344 S pry.Lic.: 4120LEA Industrial plant per hour 73.75
lam/ ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: „,j Subtotal: 7 5,Ge)
Print name: DAVID M.PHIPPS Date: 02-13 2014 Plan review(25%of permit fee): r-'
State surcharge(12%of permit fee): .OD
Authorized signature: TOTAL PERMIT FEE: O q, (50
This permit application expires if a permit is not obtained within 180
Print name: DAVID M.PHIPPS Date: 02/13/2014 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doe 05/23/06 440-4615T(11/05/COM/WEB
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
9020 SW WASHINGTON SQUARE RD 250,
TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
2014-02-24 00:00:00
ELR2014-00038
PASS - No C of O
Violation Summary:
Inspector Contractor