Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT N 4
_ COMMUNITY DEVELOPMENT Permit#: ELR2014-00032
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/11/2014
TIGARD Parcel: 2S1120A01100
Jurisdiction: Tigard
Site address: 6600 SW CARDINAL LN
Project: SWEET TOMATOES Subdivision: 1995-098 PARTITION PLAT Lot: 2
Project Description: Fire alarm system.
Contractor: INTERFACE SECURITY SYSTEMS LLC Owner: PACIFIC REALTY ASSOCIATES
3773 CORPORATE CENTER DR EARTH ATTN: N PIVEN
EARTH CITY. MO 63045 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 314-595-0100 PHONE:
FAX 314-595-0376
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 02/06/2014 $75 00
12%State Surcharge-Electrical 02/06/2014 $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 o the rue ct questions to OuNC by calling 503 232 1987 or 1 800 332 2344 174/ ./.....77-- \
Issued By _ — E." ` 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 �l` V FOR OFFICE I •r ONLY' —
City of Tigard �C� Received e &//mot aj-- Permit No.: G C� U
IN i 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
= Phone: 503.718.2439 Fax: 503.598.1 r�V( Date/By: Other Permit ,j�rY Cv Y� �
I I Li A K l7 Inspection Line: 503.639.4175 6 (- Date Ready/By: luris See Page'2 for
Internet: www.tigard-or.gov <V , % Notified/Method: Supplemental Information
TYPE OF WORK ` ��NW ` - IA PLAN REVIEW
C3 New construction Addition/alteration/teN c 1 ‘� e� Please check all that apply(submit h sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: 0' 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
❑ I-and 2-family dwelling ' ommercial/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","l-3",
Job no.: Job site address: /�f card, I OOHP or more. occupancy.
LPl_fJ� Y)SW rt4, ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: (�a q ^^ ❑Health-care facilities. ❑Supply voltage for more than
T� `-� '\ r \ K�� ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: 1 Project name: S LvC c..4.- TQ Ii��-F 5 ❑Service or feeder 600 amps or more.
1 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'l 500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
r
11 !' 1 Limited energy,multi-family 75 00 2
Ft r Pc, e l r t° I"�Q c e vii vi l residential(with above sq.ft.) _ _
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ 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,_perpanel
❑ APPLICANT I LI—CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: I _I P_r V' C each branch circuit
B.Fee for branch circuits without
Contact name: MCI' K !y.t S t,n L t- service or feeder fee,lust
56.18 2
branch circuit
Address: 1��3,5 Mi t3 k.111_ c_1rd Each add'l branch circuit 7.42 2
City/State/ZIP: `_ ' i-- t l nn D C�'0 68-'
Miscellaneous(service or feeder not included)
vV Rr Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Phone:( ) I fltax: :( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline Iighting 67.84 2
Business name: Znitt lc,C Signal circuit(s)or limited-energy /
panel,alteration,or extension. Page 2 _ 75.0C) 2
Address: 32 73 coy ar G&L Cedote- ►Ul,►�"'1U Each additional inspection over allowable in any of the above
y� Additional inspection(I hr min) 66.25/hr
City/State/ZIP: �(--V h C i fiyf / k t 67'3°4_5 Investigation(I hr min) - _ 66.25/hr .
Phone:(319 ) 59 r 0( D ! Fax:(3 i4 )5c?5-03 )lp Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: ict A) �q
Electrical Lic.:.3 L fSuprv.L ^(F 36 specifically listed(Y hr min) -
t Ith ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: aj f� -71i Itf Subtotal: -7; `
Print name: MGl* NSV5 Date: D " _ 1
Plan review(25%of permit fee):
(� State surcharge(12%of permit fee): y'
Authorized signature: TOTAL PERMIT FEE: ffai,
This permit application expires if a permit is not obtained within 180
Print name: �i j? . 7 Date:02-pt/ -/1 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I'.\Building\Permi ts\ELC_PermitApp-ELR_ERE.doc Rev 05/2I/2013 440.46151(11/05/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 Qtr. 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
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opencr* 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
❑ Vacuum Systems* >100 kva—no additional charge 0.0
ElOther: additional inspection over allowable in any of the above:
OtheC Each additional inspection is
charged at an hourly(I hr min) 66.25/hr
Inspections for which no fee is 90.001 hr
specifically listed(V2 hr min)
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
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ 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''Building'Permits'•F.LC PermitApp El.R ERE doc Rev 05/21/2013