Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111111 " COMMUNITY DEVELOPMENT Permit#: ELR2014-00158
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2014
Parcel: 1 S136CD00102
Jurisdiction: Tigard
Site address: 11681 SW PACIFIC HWY
Project: Jimmy John's Subdivision: 2006-016 PARTITION PLAT Lot: 3
Project Description: Low voltage for data.
Contractor: SAFE TECHNOLOGY GROUP INC Owner: WILSAL LLC
6400 NE HWY 99 STE G375 834 SW ST CLAIR ST
VANCOUVER,WA 98665 PORTLAND, OR 97205
PHONE: 360-699-2130 PHONE:
FAX: 360-719-1527
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/14/2014 $75.00
12%State Surcharge-Electrical 07/14/2014 $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: 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 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. ATTEN ••• • -•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001 •• 0 through OAR 9 • .01-0r:1. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
lisued By: • 1 ,O, / J - . 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 Applica • FOR 01:11( BI
FI( F. I SL O .)
City of Tigard PEE V E Received 7 1I,,
• Date/By: 17 /Y/ Permit No.: G I I do 1 5-p
1111 13125 SW Hall Blvd.,Tigard,OR 972 n ,,`
1 1 4 2014 DPlan ate/By: .Aao� .100 4:262 r
Phone: 503.718.2439 Fax: 503.598, Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: tuns ® See Page 2 for
Internet: www.tigard-or.gov CITY OF t I6AAD Notified/Method: Supplemental Information
TYPE 64! r 1114riQJf t` PLAN REVIEW
New construction Please check all that apply(submit 2 sets of plans w/items checked below):
❑ Z Addition/alteration/replacement
❑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","l-3",
Job no.: Job site address: 11681 SW Pacific Hwy IOOHP 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.: Project name:Jimmy Johns ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. 1 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
Fax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
`I Limited energy,multi-family
LO t V b L —era�[ roa_ r residential(with above sq.ft.) 75.00 2
-11)f11-6- Renewable Energy 0 See Page 2• Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ 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 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,
7.42 2
Business name:SAFE TECHNOLOGY GROUP INC. each branch circuit
B.Fee for branch circuits without
Contact name:JASON SWEET service or feeder fee,first 56.18 2
branch circuit
Address:6400 NE HWY 99 SUITE G375 Each add'l branch circuit 7.42 2
City/State/ZIP:VANCOUVER WA 98665 Miscellaneous(service or feeder not included)
Each manufactured or modular
Phone:(360)699-2130 Fax: :(360)719-1527 dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail:SALES @SAFETECHNOLOG.NET Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:SAFE TECHNOLOGY GROUP INC. Signal circuit(s)or limited-energy 1 See DO
panel,alteration,or extension. Page 2 S' 2
Address:6400 NE HWY 99 SUITE G375 Each additional inspection over allowable in any of the above
City/State/ZIP:VANCOUVER WA 98665 Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(360)699-2130 Fax:(360)719-1527 Industrial plant(1 hr min) 78.18/hr _
Inspections for which no fee is 90,00/hr
CCB Lic.: 173731 Electrical Lic.: CLE79 Su rv.Lic.: 4272LEA specifically listed CA hr min)
�''"_✓
Suprv. Electrician signature,required: 92 7, ELECTRICAL PERMIT FEES Subtotal: -7 5•°O
Print name: JASON SWEET Date: 07/14/2014 Plan review(25%of permit fee):
State surcharge(12%of permit fee): 9.ao
Authorized signature: ..., �4 TOTAL PERMIT FEE: gei.00 -
This permit application expires if a permit is not obtained within 180
Print name: JASON SWEET Date: 07/14/2014 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(l1/05/COM/WEB
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees:
Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00 FEE SCHEDULE
Description I Qty. Fee I Total I •
Check Type of Work Involved: Renewable electrical energy systems:
. 5 kva or less 100.70 2
❑ Audio and Stereo Systems* 5.01 to 15 kva 133.56 2
❑ Burglar Alarm 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El
Door Opener* 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with
Heating, Ventilation and Air Conditioning OAR 918-309-0040) 552.26 2
System* Solar generation systems in excess of 25 kva:
❑ Vacuum Systems* Each additional kva over 25 7.42 3
>100 kva—no additional charge 0.0 3
❑ Other: Each additional inspection over allowable in any of the above:
Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
COMMERCIAL WORK ONLY: specifically for which no fee is 90.00/hr
specificc ('h ally listed hr min)
Fee for each commercial system $75.00 ELECTRICAL PERMIT FEES
(SEE OAR 918-309-0000) Subtotal:
Plan review,if required(25%of permit fee):
Check Type of Work Involved: State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
n Audio and Stereo Systems 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.
Boiler Controls
n Clock Systems
® Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I.\Building\Permits\ELC_PermilApp_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
11681 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
198 Low voltage final
PASS - No C of O
July 21, 2014 at 9:54:09 AM
ELR2014-00158
Jeff Grove
Violation Summary:
Inspector Contractor