Permit (38) , CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
tri ....- COMMUNITY DEVELOPMENT
Permit#: ELR2017-00109
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2017
Parcel: 2S112AD00200
Jurisdiction: Tigard
Site address: 6830 SW BONITA RD
Project: JH&DK,LLC Subdivision: BONITA GARDENS Lot: 4
Project Description: Security system.
Contractor: NORTH LAKE CONTRACTORS Owner:
STEMS FAMILY HOLDINGS LLC
12900 NW LOVEJOY CT BY JOHN E SMETS
PORTLAND, OR 97229 PO BOX 560
AURORA, OR 97002
PHONE: 503-709-0985 PHONE:
FAX: 503-641-3168
FEES
Description Date Amount
Specifics:
Restricted Energy Permit 05/23/2017 $75.00
Type of Use: COM 12%State Surcharge-Electrical 05/23/2017 $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: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 1 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 wo k is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Th.se rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. •- -.tain a copy of the rules or direct questions to OUNC by calling 503.232.1' 1.8.r.3 .2344.
Issued By. , _.�.� , ,
Permittee Signature: V
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 i . FOR OFFICE I. SI:.Oyl.1
''-
City of Tigard Received
_r i' .- Date/By: 5 • 3/l / j
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 Each 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
Wind generation systems in excess of 25 kva:
Burglar Alarm 25.01 to 50 kva 301.04 2
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning solareneration systems in excess of 25 kva:
System* g y
Each additional kva over 25 7.42 3
❑ Vacuum 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
specifically listed(V2 hr min) 90.00/hr
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:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
ElOutdoor Landscape Lighting*
Protective Signaling $.ecyt✓t `
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
IABuilding\Penults\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015