Permit (27) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
2'' COMMUNITY DEVELOPMENT Permit#: ELR2017-00076
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 04/26/2017
TtCatjt.L 9
Parcel: 2S 114AA00100
Jurisdiction: Tigard
Site address: 8680 SW DURHAM RD
Project: Tigard Aquatic Center Subdivision: None Lot: None
Project Description: Low voltage for fire alarm.
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
7324 SW DURHAM RD 6960 SW SANDBURG ST
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/26/2017 $150.00
Type of Use: COM 12%State Surcharge-Electrical 04/26/2017 $18.00
Class of Work: ALT
Total Number of Systems: 2
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: 1
Security Alarm: 0 Other: 0 Total $168.00
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 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co e rules or direct questions to OUNC by calling 503.232.1987 or 800.332.2344.
Issued Byf� c... f� Permittee Signatur . — 4----.
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 503.639.4176 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 1JCEIVE FOR OFFICE USE ONLY
City O Tl and Received /�
- `J f g AD /7 MP , Permit#: Et. D/7-eXO 7
II
11 13125 SW Hall Blvd.,Tigard,OR 97223 DateB
Phone: 503.718.2439 Fax: 503.598.1960 APR 1 0 2017 Plan Review
Date/B Related Permit#:
Inspection Line: 503.639.4175 I) Ready Date/By: Juris. El See Page 2 for
TIGARD Internet: www.tigard-or.gov CITY OFTIG,AR.11 Notified/Method: Supplemental Information
TYPE OF w9BUILDING DIVISION PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition ❑Other: ❑Service or feeder 400 amps or more 12Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fireum .
p p 0 Installation of 150 KVA or
JOE SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
El Addition of new motor load of system.
Job#: 107872 Job site address:8680 SW Durham Rd 100HP or more. ❑"A","E","1-z","1-3",
City/State/ZIP:Tigard,OR 97224 El Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Tigard Aquatic Cntr 0 Hazardous locations. ❑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
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 sqft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
INstallation of Fire Alarm and Security Wiring
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 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 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
APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit 56.18 2
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder
Email: 67.84 2
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
Signal circuit(s)or limited-energy
Address:7324 SW Durham Rd panel,alteration,or extension. El See Page 2 i co.t5o 2
City/State/ZIP:Portland,Oregon 97224 Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
Phone:(503)641-2222 Fax:(503)641.1464 Investigation(1 hr min) 90.00/hr
Email:dan@psintegrated.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 205924 Electrical Lic.: CLEE444007�� Suuprv.Lic.: t o l tiradiZ specifically listed(V2 hr min)
!�yi G/�" ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: e-- ,_ Subtotal: / Sl9.00
Print name: l!(. - 6 r0�l k. . Date: 4/7/17 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): I`'.cc
Authorized signature: TOTAL PERMIT FEE: t(B T.00
This permit application expires if a permit is not obtained within 180
Print name: Dan Schelhaas Date: 4/7/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(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
Description Qty. I Each I Total I .
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70
5.01 to 15 kva 133.56 2 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n Garage Door Opener*
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
n 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:
n 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
Subtotal Enteron Page 1):
Fee for each commercial system: $75.00
3r s Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
M Protective Signaling
❑ Other:
Total number of commercial systems: 2
*No licenses are required. Licenses are required for all
other installations
1\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8680 SW DURHAM RD, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2017-00076
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor