Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
t"! 1 COMMUNITY DEVELOPMENT Permit#: ELR2014-00155
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/24/2014
Parcel: 25101 DA00105
Jurisdiction: Tigard
Site address: 13009 SW 68TH PKWY A
Project: Homestead Studio Suites Subdivision: VARNS ACRES Lot: 9
Project Description: Low voltage for fire alarm.
Contractor: FIRE SYSTEMS WEST INC Owner: BRE/HV PROPERTIES LLC
600 SE MARITIME AVE#300 TAX DEPTARTMENT
VANCOUVER,WA 98661 EXTENDED STAY HOTELS
OP BOX 49550
CHARLOTTE, NC 28277
PHONE: 360-693-9906 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/24/2014 $75.00
12%State Surcharge-Electrical 07/24/2014 $9.00
Type of Use:
Class of Work:
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: re on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Th. - rules are set forth in OAR
952-001-0010 ugh OAR 2-0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 :80 32.2344.
Issued By: Permittee Signature: a
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 ONI ti
City of Tigard t Dal't-e/B-; 7 PermitNo.: i — • /
11 4
13125 Blvd., ti
� �» \
3125 SW Hall Bi d,Tigard,OR 97223 q Plan Review
g Phone: 503.718.2439 Fax: 503.598.1960 11t yL a L01 Date/By: Other Permit:?P52 ill—00/11.0
T I Ci A K D Inspection Line: 503.639.4175 J to Ready/By: Juris: t®' See Page 2 for
Internet: www.tigard-or.gov [`,�f QLr'[1t i�tified/Method: --- .-6. Supplemental Information
TYPE OF WORK �d vt‘tt",:, ` PLAN REVIEW
❑New construction ❑Addition/alteration/reptht 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.
CA °i + i 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 o—mmercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
rOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
0 ❑Addition of new motor load of ❑"A" "E" "1-2","1-3"
Job no.: Job site address: / 100HP or more. occupancy.
/3" 5 W e/t P r� ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/Zl Q-..?u2 ❑Health-care facilities. ❑Supply voltage for more than aza, J J ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:1/g'C Project name: �,,,,J 1�0�, N ❑Service or feeder 600 amps or more.
TT�`�� �-+`" `- 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: l 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
(with abovesq.ft.)
u Limited ener
eoQiACo, Q� A/ �A c(Q�c l( multi-family ave q 75.00 2
T/i1 residential(with above sq.fl.)
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/Z1P: Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that 1 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, ∎■er panel
I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42
Business name: Wen each branch circuit
B.Fee for branch circuits without
Contact name: /'1PF 5Q_k,,�r,, J service or feeder fee,first 56.18 2
"�T',� branch circuit
Address: 6,e0 SE IMo,. -1-LA A. ..„L - Each add'I branch circuit 7.42 2
(� ` 9V&,[� Miscellaneous(service or feeder not included)
City/State/ZIP: o. youe/� ` J c ( Each manufactured or modular _
Phone: r,�p dwelling,service and/or feeder 67.84 2
771 Lt1-3� Fax: ( ) Reconnect only 67.84 2-
E-mail: i(\Q.rics op c, s`1r5T1=�'I5 of - GOia'. Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: c") ] Signal circuit(s)or limited-energy i See
,(�1It 5 panel,alteration,or extension. I Page 2 A 2
Address: Each additional inspection over allowable in any of the above
Additional inspection(i hr min) 66.25/hr
City/State/ZIP: Investigation(I hr min) 66.25/hr
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/n hr
Inspections for which no fee is 90.00/hr
L!CCB Lie.: l Z Electrical Lic.:0-37_L.55cie Suprv.Lic.: f eA specifically listed(''/hr min)
FEES
Subtotal:Electrician signature,required. /� ELECTRICAL PERMIT total: -g`
%'�{,•�-�' ! Plan review(25%of permit fee): '
Print name: Sr.: Ca` a Date: 1'r 7/Ze/`/
11�� State surcharge(12%of permit fee): s�
Authorized signature: TOTAL PERMIT FEE: 8 VP. ...�
'IA This permit application expires if a permit is not obtained within 180
Y•
Print name: 141-AC • Date: 7/7/2‘)// days after it has been accepted as complete.
* Number of inspections allowed per pennit.
1:\Building\Permits\ELC_PenmitApp_ELR_ERE.doc Rev 05/21/2013 440-461ST(II/05/COM/WEB
Fjectrical 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 l Qty. I Fee I Total
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
1-1
Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
I I * 50.01 to 100 kva 552.26 2
Garage Door Opener*
>100 kva(fee in accordance with 552.26
U 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
[1 Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
1 1 Other: Each additional inspection is
charged at an hourly(I hr min) 66.25!hr 1
Inspections for which no fee is 90.00/hr
specifically listed(" hr inin)
COMMERCIAL WORK ONLY: ELECTRICAL PE
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 IN
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El 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 1'ermits£LC_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
13009 SW 68TH PKWY A, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
198 Low voltage final
PASS - No C of O
ELR2014-00155
Jeff Grove
Violation Summary:
Inspector Contractor