Permit r y CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
= COMMUNITY DEVELOPMENT Permit#: ELR2014-00082
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2014
-T
Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11117 SW GREENBURG RD
Project: Kayu International Subdivision: HILLSBORO Lot: PTS 1-2
Project Description: Low voltage for fire alarm
Contractor: AMERICAN SECURITY ALARMS, INC. Owner: GREENBURG SPACE CENTER LLC
5411 SE MCLOUGHLIN BLVD PO BOX 91305
PORTLAND, OR 97202 PORTLAND, OR 97291
PHONE: 503-231-0303 PHONE:
FAX: 503-230-1044
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/27/2014 $75.00
12%State Surcharge-Electrical 03/27/2014 $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: 0
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 actor•.. .- with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspe CrTRQfi"tt18 t66
days. ATT ION: Oreg. law re•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule are set forth in OAR
952-001-8'00 10 through OAR 95 '5 -8098 Y, may obtain a copy of the rules or direct questions to OUNC by calling 503.232.x,987 or 1 332.23
I 'r
Issu d 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 OIFIC'F: I sF:Oil.\
Ci}�, of Tigard Received Permit No.: ��2� )
`, g Dateiv d �� ..A'
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: �y.,��� �
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: azuf Q
Inspection Line: 503.639.4175 Date Ready/By: Juns. HI See Page 2 for
1 1 Inte
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction 'Addition/alteration/replacement 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 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 150 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.: Job site address: /1// 7 ,SK/ Crr, p,� 6,,,.� I 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
['Health-care facilities. ❑Supply voltage for more than
City/State/ZIP: T��� l/� 7 ZZ 3
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ir-A YGQ /Al%_ ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total 1
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
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
�i7 T 6AJ� / �/S a3 £ 7-z;•
Limited energy,multi-family
iqy ft.) 75.00 2
'/ residential(with above ft.
,yv', ,, ,, Renewable Energy ❑ See Page 2
fi—f 711 A 7-�`�1 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,per panel _
PLICANT I lErCONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name: enC,vL. 1Grr.s,r/'f 5-- r•-1 c_ each branch circuit
/,, B.Fee for branch circuits without
Contact name: ,4 c!, /</MA, service or feeder fee,first 56.18 2
branch circuit
Address: 51/// S t /N`G Lern.,4. " Zs'it a i Each add'l branch circuit 7.42 2
City/State/ZIP: ,W t---/ OW_ Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:663 ) 7c)L /`as Fax: :( 57)) - 30 /0,4 4- dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: r c ( C5 At a–c Net S • Car h1 Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: .�/L�.0 cz,14.., 4/„...„.44 Signal circuit(s)or limited-energy / See pr.pU
e_ l/y. panel,alteration,or extension. Page 2 2
Address: 5// S� HC /C� ,,, Z3/t�, Each additional inspection over allowable in any of the above
/ Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: fr-7/44 / / Investigation(1 hr min) 66.25/hr
Phone:( ) Fax:( ,X .2 6—263 C L ' Industrial plant(l hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: �6�a Electrical Lic.: 2G-2 CL.ESuprv.Lic.: /21/ CE,4 specifically listed(V2 hr min) _
Suprv.Electrician signature,required: L / , ,,, ELECTRICAL PERMIT FEES pU
/n� M Subtotal: / 5.
Print name: t2 �. -4 / ►t'L�.tc Date:,-2 7 1 il Plan review(25% permit fee):
State surcharge(12%of permit fee): 9.00
Authorized signature: �/re: . e TOTAL PERMIT FEE: g�.oO
tu
Print name: C? - /2,c 4 /11 ii--Sl Date: 3 - 27• /I/ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Perrnits\EL.C_PcemitApp_ELR ERE.doc Rev 05/21/2013 440-46151(1l/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 Qty. 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
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 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
ElOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(%l 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
❑ HVAC
❑ Instrumentation
❑ 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
I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 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
11117 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
2014-03-31 10:22:00
ELR2014-00082
PASS - No C of O
Violation Summary:
Inspector Contractor