Permit ' n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2014-00153
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/02/2014
Parcel: 1 S136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE,STE#210
Project: Greenwing Company Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Low voltage for data
Contractor: FIRE PROTECTION SERVICES Owner: PNWP LLC#2
5573 SW ARCTIC DRIVE PNWP LLC
BEAVERTON, OR 97005 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-590-3732 PHONE:
FAX: 503-628-6214
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/02/2014 $75.00
Type of Use: COM 12%State Surcharge-Electrical 07/02/2014 $9.00
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 iss -• ---•.- 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 `- ordance with app •ved 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. A NTION: Oregon law r.quir ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001 0010 throug OAR 952-001-0 . You may tain a copy of the rules or direct questions to OUNC by calling 503.23 or 1.800 332.2344.
Iss ed 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 Applicatl FOR OFFICE USE ONLY
City of Tigard Received 7 / � permit No.: ss I / _490
114 '1 5Date/By: 0- •.3
13125 SW Hall Blvd.,Tigard,OR 9722311 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1 L 2 201'
Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Juris: to See Page 2 for
I .A 1:11 CITY�'i3UAk ,
Internet: ww.tigard or.gov � LL Notified/Method: Supplemental Information
��
TYPE OF ii'86Kr 't`T>lG� -:"1-1'r.
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
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ['Addition of new motor load of ❑"A","E',"I-2", '1-3',
Job no.: Job site address: 11850 SW 67th Ave 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.:210 Project name:Greenwing Company ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 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
Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
Add Voice/Data Lines. residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 '_
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 I
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
❑ APPLICANT ❑ CONTACT PERSON ! A.Fee for branch circuits with
above service or feeder fee,
Business name:Fire Protection Services,Inc.
each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name:David Phipps service or feeder fee,first 56.18 2
branch circuit
Address:5573 SW Arctic Drive Each add'/branch circuit 7.42 2
City/State/ZIP:Beaverton,OR 97005 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)590-3732 Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Fire Protection Services,Inc. Signal circuit(s)or limited-energy / See ...,5-.4v-
panel,
alteration,or extension. ! Page 2 _ f 2
Address:5573 SW Arctic Drive Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Beaverton,OR 97005
Investigation(1 hr min) 66.25/hr
Phone:(503)590-3732 Fax:( ) 111 Industrial plant(1 hr min) 78.18/hr
1 Inspections for which no fee is 90,00/hr
CCB Lic.: 154333 Electrical Lic.: 34-488Cit Suprv. Lic.: specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: '75 vc7
Print name: David M Phipps Date: 7-2-2014 Plan review(25%of permit fee): '—
State surcharge(12%of permit fee): tO v
Authorized signature: �Z,,mil,,(,./ � �� TOTAL PERMIT FEE: e' ,Od
Print name: David M Phipps Date: 7-2-2014 This permit application expires if a permit is not obtained within 180
PP days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Build ng\Pe mits\ELC_PamitApp_ELR_ERE.doc Rev 05/21/2011 440-4615T(I I,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
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
111 Burglar Alarm Wind generation systems in excess of 25 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 552.26 2
OAR 918-309-0040)
n 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 kva—no additional charge 0.0 3
nEach additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr I
Inspections for which no fee is 90.00/hr
specifically listed(/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
n Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
El 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
l:\Budding\Permits\ELC_PamitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 210, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
198 Low voltage final
PASS - No C of O
ELR2014-00153
Herb Stabenow
Violation Summary:
Inspector Contractor