Permit (40) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2016-00073
T fGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2016
Parcel: 2S115AB00200
Jurisdiction: Tigard
Site address: 16164 SW 113TH AVE
Project: Woodspring Apartments Subdivision: WILLOW-BROOK-FARM Lot: 25
Project Description: Fire alarm system.
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: ED ENVIRONS WOODSPRING LLC ET AL
7324 SW DURHAM RD BY HAMILTON, ZANZE&COMPANY
PORTLAND, OR 97224 THE PRESIDIO OF SAN FRANCISCO
37 GRAHAM ST STE 200B
SAN FRANCISCO, CA 94129
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/19/2016 $75.00
12%State Surcharge-Electrical 04/19/2016 $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. ATTEN • •on law equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 6 through OAR • -601-6 690. You may obtain a copy of the rules or direct questions to OUNC by calling 503 -2.1987 or 1.800.332.2344.
Issue• By: ; /l r Permittee Signa e:
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.
III
C
RECEIVED
Electrical Permit Application MR uFFICE l SI.().\1.)
City of Tigard MAR 21 2016 Received
Date/B , 1 ;Willa! Permit#: r ' , /(o- __4.-73III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie "
= Phone: 503.718.2439 Fax: 503.591111/OF TIGARD Date/B : i ii. e
Inspection Line: 503.639.4175 BUILDING DIVISION ReadyDate/By: ions ® SeePage2for
l ",1Z l) Internet: www.tigard-or.gov Notified/Method: 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):
❑Service or feeder 400 amps or more ElBuilding over three stories.
❑Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-famil y dwellin less to ground,or exceeds 14,000 0 Commercial-use agricultural
g ®Commercial/industrial ❑Accessory building
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fireum .
p p 0 Installation of 150 KVA or
JOB SffE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: 107646 Job site address:16164 SW 113th Ave ❑Add
I O0HPHP o of new motor load of system.
or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard/OR/97224 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:Bldg#3 Project name:Woodsprings Apts Bldg 3 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I r
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Replace existing fire alarm control panel with new. (with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNERRenewable Energy 0 See Page 2
0 TENANT 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
Temporary services or feeders installation,alteration,and/or
Email:
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
® APPLICANT ® CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Performance Systems Integration,LLC above service or feeder fee,
7.42 2
each branch circuit
Contact name:Edward Chiong B.Fee for branch circuits without
Address:7324 SW Durham Rd anct fuofee,first
branche circuit 56.18 2
brh t
City/State/ZIP:Portland/OR/97224 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)641-2222 Fax: :(503)641-1464 Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:edward@psintegrated.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Performance Systems Integration,LLC Sign or outline lighting 67.84 2
Address:7324 SW Durham Rd Signal circuit(s)or limited-energy ® See Page 2 1 2
panel,alteration,or extension.
City/State/ZIP:Portland/OR/97224 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)641-2222 Fax:(503)641-1464 Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:edward@psintegrated.com
Inspections for which no fee is 90.00/hr
CCB Lic.: 205924 Electrical Lic.: CLE407 Suprv.Lic.: 3172LEA specifically listed h min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 75
Print name: William J.Driver III Date: 3/8/2016 0 Plan Review Required(25%of permit fee): �..
State surcharge(12%of permit fee): ,'u' _
Authorizedsignature:
TOTAL PERMIT FEE � �
This permit application expires if a permit is not ob
Print name: Ebv„A Rp c.-{c L t-.5(4 , Date: 3/8/2016 days after it has been accepted as complete.
: Number of inspections allowed per permit.
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I
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Des *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n B• urglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ G• arage Door Opener*
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
n V• acuum 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
F1 Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
® Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: I
*No licenses are required. Licenses are required for all
other installations
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