Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
�° COMMUNITY DEVELOPMENT Permit#: ELR2016 00046
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2016
Parcel: 25101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#310
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: Low voltage for fire alarm
Contractor: PORTER ELECTRIC INC Owner: TRIANGLE POINTE TWO LLC
7320 NE ST JOHNS RD 901 NE GLISAN ST, STE 100
VANCOUVER,WA 98665 PORTLAND, OR 97232
PHONE: 360-574-1366 PHONE:
FAX: 360-573-3723
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/08/2016 $75.00
12%State Surcharge-Electrical 03/08/2016 $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. ATTENTIO - -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 t ough OAR 2-001-06.0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987O4f )
or 1.800.332.2344.
Issued B • r l i / i 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 Aupli .' ~: I% l,�z l t l 1 k < I .1 ). ,
City of Tigard ;,;;;1 ,f Pest#: EZ . - !o-et504/6
Iii 13125 SW Hall Blvd.,Tigard,01/14401i23
8 2016
s Phone: 503.718.2439 Fax 503.598.1960 11RiiiiMilliall Related Permit#: Fp/(p— Jl1/
r Inspection Line: 503.639.4115 g y kris: 61 Sec Page for
Internet: www.tigard-or.gov‘, d 1irAtit) N SSo pkm d2Information
T IS ►IVIS1O1N PLAN'UMW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
ngs.
❑Multi-family 0 Master builder 0 Other �umfor all other installations. baikllati
❑Fire purr Q Installation of 150 KVA or
?OR SITE"INFbRiii lliift AND LOCATION ❑Emergency system larger separately derived
❑Addition of new motor load of system.
Job#:5688 Job site address:13333 SW 68th Parkway iooitP or more. 0"A","E","1-2","1-3",
City/State/Zit:Tigard Oregon 97223 ❑six or more residential turtle. occupancy.
❑Health-care facilities. 0 Recreational vehicle packs.
Suite/bldgJapt#X39(3(0 Project name."iANgLt QO.0* ❑Hazardous locations. ❑�ovltagefrmorethan
sr ❑Service or feeder 600 amps or more.
Cross street/directions to job site:Near 68th Parkway and SW Hampton 'FEE SCHEDULE
-
nneriraan I Qtr. I Earp I Teed I •
New residential single-or multi-family dwelling unit
Subdivision: Lot 0: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea add'I 500 sq.ft.or portion 33.92 I
- DESCRIPTION OF WORK Limited energy,residential 75.00 2
Space is being demoed to shell for build out by future tenant (with above sq.R)
Limited energy,multi-family 75.00 2
Relocate existing horn strobes to with in 15 feet from entry/exit residential(with above sq.ft.)
0 PROPERTY OWNER 0TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Email Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
❑ CONTACT PERSON Branch circuits—new,alteration,or extension,eer panel
❑ APPLICANT I
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
Email: dwelling service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:PORTER Electric Inc Sign or outline lighting 67.84 2
Address:7320 NE St Johns Rd Signalnlee ations)or extension.
® See Page 2 75.00 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98665 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(360)574-1366 Fax:(360)573-3723 Investigation(1 hr min) 90.00/hr
Email:Theresa@porterekctricinc com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 9000/hr
CCB Lie.: 46678 Electrical Lic.: 37-334C Suprv.Lie.: 2909S specifically listed(va hr min)
ELECTRICAL PERMIT FEES
t
Suprv.Electrician signature,required: i 51=4 Subtotal: 75.00
Print name: Kenneth D Boal Date: 3/2/16 0 Plan Review Required(25%of permit fee):
t State surcharge(12%of permit fee): 9.00
Authorized signature: j ,rrr �. ()1✓ TOTAL PERMIT Fes: 84.00
Print name: Kenneth D Boal Date: 3/2/16 This permit daays after it ntion �beenaaccepted as complete.permit is not 180 within
* Number of inspections allowed per permit.
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