Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
n
11 • COMMUNITY DEVELOPMENT Permit#: ELR2015-00005
T[G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/12/2015
Parcel: 1 S135ACO2550
Jurisdiction: Tigard
Site address: 9346 SW MANDAMUS CT
Project: The Reserve at Ashbrook Subdivision: ASHBROOK FARM Lot: 19
Project Description: Low voltage for fire alarm
Contractor: PERFORMANCE SYSTEMS INTEGRATION CORP Owner: COMMUNITY FINANCIAL CORP
7324 SW DURHAM RD ATTN: JOHN SATTERBERG
PORTLAND, OR 97224 412 A ST, STE 150
LAKE OSWEGO, OR 97034
PHONE: 503-641-2222 PHONE:
FAX: 503-641-1464
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/12/2015 $75.00
12%State Surcharge-Electrical 01/12/2015 $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/I-rigation: 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 a • • ith 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. AT TION: Oregon -w requ' - you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are t forth in OAR
952-00 -0010 through OAR 952-0:1-0,•0. Y• m' .btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800. .234
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les ed 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 V I lrr � FOR OFFICE Sl'.ON 1.1
City of Tigard Received Permit No.: I ,
1111
• 13125 SW W Hall Blvd.,Tigard,OR 97223 Plan Review ``` 1_�■
a Phone: 503.718.2439 Fax: 503.598.1960 DEG $ 1201' DateB : Other Permit: r..-�! 02,015-_000.) (
1 I ,I`l Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov ' t FTIGA',4;ifed/Method: I NMI Supplemental Information
TYPE OF WORK . PLAN REVIEW
❑New construction Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stones.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
Jam-and 2-family dwelling JZQ Commercial/industrial Accessory building ess to ground,or exceeds 14,000 ❑Commercial-use agricultural
y g///����` ❑ ry g 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:9346 SW Mandamus Court 10011?or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,Oregon 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Reserve at Ashbrook ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. l 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 I
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
' Limited energy,multi-family 75.00 2
New fire alarm 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 extension,per panel
® APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
Business name: Performance Systems Integration each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name: Edward Chiong service or feeder fee,first 56.18 2
branch circuit
Address:7324 SW Durham Road Each add'I branch circuit 7.42 2
City/State/ZIP:Tigard,Oregon,97224 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)641-2222 Fax: :(503)641-1464 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:edward@psintegrated.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Performance Systems Integration Signal circuit(s)or limited-energy See
panel,alteration,or extension. I Page 2 2
Address:7324 SW Durham Road Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Tigard,Oregon 97224 Investigation(I hr min) 66.25/hr
Phone:(503)641-2222 Fax:(503)641-1464 III t 1 l� Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 150747 Electrical Lic.: 34-522CL Suprv. Lic.: 4623LEA specifically listed(A hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
/ / Plan review(25%of permit fee):
Print name: �o rr- C4.1)I Date: 1Z 30 i Lt— State surcharge(12%of permit fee):
Authorized signature: � ,c/...—/"..' , TOTAL PERMIT FEE:
z This permit application expires if a permit is not obtained within 180
Print name: el>wActb, 6K1 0 Date: I'/=p I� 14.� - days after it has been accepted as complete.
7 / • Number of inspections allowed per permit.
1\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(t t/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
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
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
El 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
ElOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(A 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
❑ 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
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ 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
:\Building\Permits\ELC_PermitApp_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
9346 SW MANDAMUS CT, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
198 Low voltage final
PASS - No C of O
ELR2015-00005
Jeff Grove
Violation Summary:
Inspector Contractor