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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT _.. COMMUNITY DEVELOPMENT Permit#: ELR2014-00168 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/24/2014 Parcel: 1 S 136AD06507 Jurisdiction: Tigard Site address: 11460 SW PACIFIC HWY Project: Quality Inn Subdivision: WAY LEE Lot: 3 Project Description: Low voltage for fire alarm radio communicator. Contractor: ACTION TECHNOLOGY SYSTEMS LLC Owner: AISLING CREATION LLC 835 SE 17TH AVE PO BOX 1120 PORTLAND, OR 97214 BEAVERTON, OR 97075 PHONE: 503-231-1992 PHONE: FAX: 503-231-1402 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: 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 b the Oregon Utility Notification -• - Thos- rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain as8ov of the uestions to OUNC by calling 50 32.198.1 ;0r�, � 3 Issued 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 OFFICE USE ONLY Received City of Tigard DateB : Permit No.: , • 13125 SW Hall Blvd. Tigard, 9 ` AA y / /y /7j �� y `��"`� �� +R Plan Review %� 8 A ^O` Other Permit: �J �u ._�i Phone: 503.718.2439 Fax: 503.598. p t3 !. Date/By: I TIGARD Inspection Line: 503.639.4175 ```� Y Date Ready/By: �� ® See Page 2 for Internet: www.tigard-or.gov J ified/Method: i Supplemental Information TYPE OF WORK 0 PLAN REVIEW ❑New construction ®Addition/alteration/re.P i!' 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 ❑ I-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","1-2","1-3", Job no.: Job site address: 11460 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:QUALITY INN ❑Service or feeder 600 amps or more. 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 Ea.add'l 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 Limited energy,multi-family 75 00 ' 2 ADD FIRE ALARM RADIO TRANSCEIVER/COMMUNICATOR 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 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 ex tension,per panel ❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee,first branch circuit 56.18 2 Address: Each add'I branch circuit 7.42 _ 2 Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular Phone:( ) Fax: :( ) dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 _ 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name:ACTION TECHNOLOGY SYSTEMS LLC Signal circuit(s)or limited-energy I See I panel,alteration,or extension. Page 2 2 Address:835 SE 17TH AVE Each additional inspection over allowable in any of the above City/State/ZIP:PORTLAND OR 97214 Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr Phone:(503)231-1992 Fax:(503)231-1992 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 157630 Electrical Lie.: 26775CLE Suprv.Lic.: 100LEA specifically listed('/z hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 75 Print name: JAMES A KIRKLAND Date: 7-24-2014 Plan review(25%of permit fee): State surcharge(12%of permit fee): 9 Authorized signature: TOTAL PERMIT FEE: 84 • Print name: STEVEN A BARRY Date: 7-24-2014 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. 1\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(I1/05/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 n Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 n 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 ❑ Each additional inspection over allowable in any of the above: Other: Each additional inspection is charged at an hourly(I hr min) 66.25/hr Inspections for which no fee is 90.00/hr specifically listed('/x 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 nAudio and Stereo Systems days after it has been accepted as complete. * Number of inspections allowed per permit. n Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ® Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling n Other Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations 1.\Building\Permits\ELC_PermitApp_ELR_ERE.doe 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 11460 SW PACIFIC HWY, TIGARD, OR, 97223 Commercial - Electricial Limited Energy 198 Low voltage ﬁnal PASS - No C of O ELR2014-00168 Jeff Grove Violation Summary: Inspector Contractor