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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I. COMMUNITY DEVELOPMENT Permit#: ELR2014-00292 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/31/2014 Parcel: 2S113AB01400 Jurisdiction: Tigard Site address: 7324 SW DURHAM RD Project: Performance Systems Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Private radio network antenna installation. Contractor: PERFORMANCE SYSTEMS INTEGRATION CORP Owner: PACIFIC REALTY ASSOCIATES LP 7324 SW DURHAM RD ATTN: N PIVEN PORTLAND, OR 97224 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-641-2222 PHONE: FAX: 503-641-1464 FEES Description Date Amount Specifics: Restricted Energy Permit 12/31/2014 $75.00 12%State Surcharge-Electrical 12/31/2014 $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: 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: 1 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 =•• • the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rule - • - ••- tions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ermittee Signature: ,...„.V. 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. -7„ • , ,,�■_ <e, 1 Electtical Permit Application REC FOR OFFICE USE ONLY City of Tigard E trate,B •_ �� Permit No.. I . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 Date/B I I c,1i.1 Inspection Line: 503.639.4175 DEC 312014 Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: AMII Supplemental Information TYPE OF WORD a'[tI 01,' fll>,A1to PLAN REVIEW ❑New construction ®Addition/alterat Please check all that apply(submit 2 sets of plans w/items checked below) F` 9 i���C`� I ❑Service or feeder 400 amps or more ❑Building overthree stories.Demolition ❑Other: where the available fault current ❑M aias and bo atya rds. 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","I-2", 1-3", Job no.: Job site address:7324 SW Durham Road IOOHP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,Oregon 97224 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: Radio antenna ❑Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site:72ad Avenue 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 - 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 Private radio network antenna installation 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:Performance Systems Integration Corporation 401 amps to 600 amps .. 200.34 2 Address:7324 SW Durham Road 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP:Tigard,Oregon 97224 Temporary services or feeders installation,alteration,and/or Phone:(503)641.2222 Fax:(503)641.1464 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 tom. APPLICANT 17,.CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: each branch circuit eR•FOp.r.1 A 5_,c . B.Fee for branch circuits without Contact name: EDtuA1" o f-1(j service or feeder fee,first 56.18 2 branch circuit Address: 1.3.2.4— s t, D"t 'RCA . Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: -P01t.r * / O i)../pt 12Z�— Each manufactured or modular dwelling,service and/or feeder 67.84 2 `` Phone:(Say) 641-L227 ax:'(503) 6q / - 1 `F C Reconnect only 67.84 2 ZE-mail:service @psintegrated.com Pump or irrigation circle 67.84 2 I CONTRACTOR Sign or outline lighting 67.84 2 ..,tame Business name: Performance Systems Integration Corporation Signal circuit(s)or limited-energy 1 See 75.00 I panel,alteration,or extension. Page 2 2 Address:7324 SW Durham Road Each additional inspection over allowable in any of the above . City/State/ZIP:Tigard,Oregon 97224 Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr ( Phone:(503)6411222 Fax:(503)641.1464 Industrial plant(1 hr min) 78.18/hr f 1 Inspections for which no fee is •'� CCB Lic.: 150747 1/t`SIIY Electrical Lie.* 34-522CL Suprv. Lie.: 4623LEA specifically listed(%hr mm) 90 00/hr Suprv.Electrician signature,rewired: ELECTRICAL PERMIT FEES /��I� Subtotal: 75, Date: 12/22/2014 Plan review(25%of permit fee): Print name: LE CC State surcharge(12%of permit fee):j YA Authorized signature: z3 /� TOTAL PERMIT FEE: �." Print name: f Date: This permit application expires if a permit is not obtained within 180 1-INWR('LD CHI Drs 6 ) 1_ 1�.3 a Zo 0.1-- days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR ERE.doe Rev 05/21/2013 440-46151(11/05/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 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 111 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 66.25/hr I charged at an hourly(1 hr min) Inspections for which no fee is 90 00/hr specifically listed(9:hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: 165.0 (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): 19.8 Check Type of Work Involved: TOTAL PERMIT FEE: 184.80 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 n Data Telecommunication Installation n Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ® Other Antenna Installation 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 7324 SW DURHAM RD, TIGARD, OR, 97224 Commercial - Electricial Limited Energy 198 Low voltage final PASS - No C of O ELR2014-00292 Chip Barnett Violation Summary: Inspector Contractor