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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT " • - COMMUNITY DEVELOPMENT Permit#: ELR2014-00288 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/23/2014 Parcel: 2S112DB00400 Jurisdiction: Tigard Site address: 7337 SW KABLE LN Project: Consolidated Supply Subdivision:'HERN PACIFIC TIGARD INDUSTRIAL I Lot: 4 Project Description: Low voltage for fire alarm. Rewire tampers to report correctly. Contractor: FIRE SYSTEMS WEST INC Owner: TILLAMOOK LIGHT LLC 600 SE MARITIME AVE#300 1740 SW HAWTHORNE TER VANCOUVER,WA 98661 PORTLAND, OR 97201 PHONE: 360-693-9906 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 12/23/2014 $75.00 12%State Surcharge-Electrical 12/23/2014 $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 do ccor•: - 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 da . ATTENTION: Oreg•• law r ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 2-001-0010 through OAR 95 I -00''. u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 0.332.2344. _ Issued By: 4rif �i "J Permittee Signature: /‘, 'VV 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' c ( 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 Applicat' CEIVEP FOR OFFICE USE ONLY City of Tigard 11+ Date By fL- 3/4/ Permit No.: ,e4,42_,26/ _ , 2-s'g' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review b Phone: 503.718.2439 Fax: 503.598b96t 2 3 2014 Date:By: Other Permit: TI ; \:: ? r' Inspection Line: 503.639.4175 C Date Ready By: Juris: ES See Page 2 for C . Internet: www.tigard-or.g u Notilied/Method: Supplemental Information �'iTY FTIt ARI) TYPE OOF,tl�`OR nT ,S PLAN REVIEW ❑ New construction AddIt101WdH t l�CC1 C�tt�o 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. ❑ Pc,,,,I i r i. ❑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?-lamilydwelling 'Ct>mmercial/industrial ❑ Accessory builcltog 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", L.+h no.: Job site address: / ^-� ` ` / IOOHP or more. occupancy. / / .W )1 e1.a4� ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP © ��'7 Z ❑Health-care za do (cations. ❑Supply voltage for more than ��9( v ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: Project name: C�50 l I 40_ ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qtv. 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'I 500 sq.fl.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 0-44 _j residential(with above sq.ft.) �"'t'� Renewable Energy ❑ See Page 2 �A��\�- Services or feeders installation,alteration,and/or relocation _ YI' 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 PPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: each branch circuit SS e--_--;-1-- � B.Fee for branch circuits without Contact name: t SJ service or feeder fee,first 56.18 2 ,^ branch circuit Address: ,�J se #116,---4( � /�, # u Each add'I branch circuit 7.42 2 City/State/ZIP: yaamc�Q-�c- OA l ( ,( Each manufactured(service or feeder not included) Each manufactured or modular 67.84 2 (Ste) 77 77( 7' 3 ( ) dwelling,service and/or feeder I Phone: /( Fax Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: r(IQ V--S Signal circuit(s)or limited-energy See 75'� panel,alteration,or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr City/State/ZIP: / Investigation(1 hr min) 66.25/hr Phone:( ) Fax:( ) if//((7 Industrial plant(I hr min) 78.18/hr IUUAII Inspections for which no fee is 90,00/hr CCB Lie.: Li 173Z Electrical Lic.: 37 LS D Suprv. Lie.: 344C)Lryrk specifically listed(''G hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required:S1:104„,,.. ' ,,� Subtotal: •-„,)5 CC Plan review(25%of permit fee): _------- Print name: S Oa n CQ .,1 Date: 1 712,3 I/a to U State surcharge(12%of pennit fee): 9, Authorized signature: � .— TOTAL PERMIT FEE: FL/,C0 Print name: ��((�� Date: / // This permit application expires if a permit is not obtained within 180 J"ta,/� Sr%IA'a ft ) S 2,a3t / ly days after it has been accepted as complete. 7 • Number of inspections allowed per permit. 1:\Building\Pemits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440.4615T(th/05/COM/WEB