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Permit
IIIIIICITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT '' COMMUNITY DEVELOPMENT Permit#: ELR2016-00219 TIC;A.R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/01/2016 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 215 Project: Home Mortgage Alliance Subdivision: 1996-048 PARTITION PLAT Lot: 2 Project Description: Fire alarm. Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES 5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN LAKE OSWEGO,OR 97035 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-627-0100 PHONE: 503-624-6300 FAX: 503-627-0110 FEES Description Date Amount Specifics: Restricted Energy Permit 09/01/2016 $75.00 Type of Use: COM 12%State Surcharge-Electrical 09/01/2016 $9.00 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. ATTENTIQN; Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001 through-o,AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. COLLIssued B • 6\_. • Permittee Signature: ,(;V / u- 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. CFW Electrical Permit Appl• ic >< E 1,OROF110E lSEOld1'4' City of Tigard 1/26,4 G 3 i 2016 Received Dateill w 13125 SW Hall Blvd.,Tigard,OR 9 d Plan : { it /] Plan Review Phone: 503.718.2439 Fax: 504*5 Dare/B : Related Permit it: ,61- t2 Inspection Line: 503,639.4175 t.5 t ' � � 0 See Page 2 for TIGARDF. I' pr-., rs� 4t� Ready Internet: www.tigard-or.gov BU LO NG a "'li�i • 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): is Service or feeder 400 amps or more 0 Building over three stories. 0 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 ►e/ Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 0 commercial-use agricultural amps for all other installations. buildings. ❑Mul ti-family 0 Master builder 0 Other: ©Fire pump, 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ❑'Addition of new motor toad of system. Job#: Job site address:6650 SW Redwood Lane 100HP or more. City/State/ZIP:Portland,OR 97224 0 Six or more residential units. occupancy. ❑Health-sale facilities. 0 Recreational vehicle parks. Suite/bldg./apt.4:215 Project name:Home Mortgage Alliance 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 Qrv. i Each I Total I New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage, Tax map/parcel 4: 1,000 sq.ft.or less 168.54 4 Ea.addl 500 sq.H.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75,00 2 vk+st:nrir:n.,rfai,;nyi 1 (with above sy.ft.) �r ' G Ice Limited energy,multi-family residential(with above sq.ft.) 75.00 2 0 Renewable Energy 0 See Page 2 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Home Mortgage Alliance 200 amps or less i00,70 2 Address:6650 SW Redwood Lane#2.15 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Portland,OR 97224 601 amps to 1,000 amps 301.04 2 Phone: (503)558-1009 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 1 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 C APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Point Monitor Corp. above service or feeder fee, 7.42 2 each branch circuit Contact name:Brooke Williams B.Fee for branch circuits without Address:5863 Lakeview Blvd.Suite 100 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Lake Oswego,OR 97035 Each add''branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)627-0100 Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:bwilliams(apointmonitor.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Point Monitor Corp. Sign or outline lighting 67.84 2 Address:5863 Lakeview Blvd.Suite 100 Signal circuits)or limited-energy panel, See Page 2 I 2 panel,alteration,or extension. City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)627-0100 Fax:( ) investigation(l hr min) 90.00/hr Email:bwilliams@pointmonitor.com Industrial plant(I hr min) 78.18/hr inspections for which no fee is CCB.Lie.: 135901 Electrical Lie,: 34508CLE Suprv. Lic.: 4460LEA specifically listed(,z hr lain) 90.00/hr ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: ro - Subtotal: 75,00 Print name: Ben Breit Date: 8/30/16 0 Plan Review Required(25%of permit fee): --7State surcharge(12%of permit fee): 9.00 Authorized signature: 2" ""' TOTAL PERMIT FEE: 84.00 m- This permit application expires if a permit is not obtained within 180 Print name: Ben Breit Date: 8/30/16 days after it has been accepted as complete. * Number of inspections allowed per permit. t:'Buildintg'Permits it.C,PermitApp f LR,_lah.:.doc Ret 06'17;2015 440.4615r(t 1!05'COtvt'Wtitt Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qtv. j Each Total j Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 E Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: E Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 I- Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) 0 Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva no additional charge 0.0 3 Each additional inspection over allowable in any of the above: E Other: Each additional inspection is 66.251 hr charged at an hourly(1 hr min) Inspections for which no fee is 90.001 hr specifically listed(V2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL. PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 Number inspections allowed per pennit (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems E Boiler Controls E Clock Systems Data Telecommunication Installation Fire Alarm Installation E HVAC T Instrumentation 1: Intercom and Paging Systems E Landscape Irrigation Control* E] Medical E Nurse Calls E Outdoor Landscape Lighting* El Protective Signaling O Other: Total number of commercial systems: I *No licenses are required. Licenses are required for all other installations 1.Budding Perrnir App FRE doe Re%00 17.2015