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Permit (232) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2018-00005 11:' 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/16/2018 fG�'� t� g Parcel: 2S101DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 500 Project: Centene Corporation Subdivision: None Lot: None Project Description: Fire alarm. Contractor: POINT MONITOR CORPORATION Owner: GK TRIANGLE CORPORATE PARK III L 5863 LAKEVIEW BLVD STE 100 ATTN KBS REALTY ADVISORS LAKE OSWEGO, OR 97035 P 0 BOX 28270 SANTA ANA, CA 92709 PHONE: 503-627-0100 PHONE: FAX: 503-627-0110 FEES Description Date Amount Specifics: Restricted Energy Permit 01/16/2018 $75.00 12%State Surcharge-Electrical 01/16/2018 $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 m e the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set f h in OAR 952-001-0010 through OAR 952-001-0090. Y u may obtain a copy of the rules or direct questions to OUNC by calling 50 32.1987 or 1.800.3 344. Issued By: ' Permittee Signature: /44 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 ApplicationFOR OFFICE USE ON11 , City of Tigard A E _I ved "" 13125 SW Hall Blvd.,Tigard,OR 97223 DEC e/B ` i'® 7� uF , ' *I Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/B : Related Permit#: t t t C.A K u Inspection Line: 503.639.4175 Ready Date/By: Internet: www ti and or ov See Page 2 for g g t aiyfiedMethod j Supplemental Information :-- *- " ,,, ';'� f; 41'1.7'.,. T ifs'''71'x 1 1 it :' ''. f.;,*';* s A 6 1'';. ." . ®New construction ®Addition/alteration/re lacement Please check all that apply Addition/alteration/replacement pp y(submit 2 sets of plans w/items checked): 0 Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. '° where the available fault current e'5 f•-,-'7• gt ..F t« '' ❑Marinas and boatyards. e ) ,,%4 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 ❑Commercial-use agricultural 0 Multi-familyamps for all other installations. buildings. 0 Master builder ❑Other: 0 Fire pump. �r„ 0 Installation of 150 KVA or 11'27—... „, . <, ,., • ❑Emergency system. larger separately derived Job#: Job site address: 13221 SW 68th Pkwy ❑Addition of new motor load of system. 100HP or more. 0"A","E","1-2","1-3", City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#:500,520 I Project name:Centene 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal. ;2:.,:,:,.•••:',..' ,ate`?. ::„:' h` .,*� Description Qty• Each Total New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 .,, Limited energy,residential Fire Alarm Notification Devices (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 . ';' .., E.t ' R Ir• , . ;1r Renewable Energy 0 See Page 2 °""" �" mom4>, Services or feeders installation,alteration,and/or relocation Name:Centene 200 amps or less 100.70 2 Address: 13221 SW 68th Pkwy-Suite 500 and 520 201 amps to 400 amps 133.56 2 City/State/ZIP:Tigard,OR 97223 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) I 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 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 '� 'rm: ^.��� us=, , ,,4.:.,Z 7:;...",-;;:� ' ._ r _ v s1 Branch circuits-new,alteration,or extension,per panel a ` .f A.Fee for branch circuits with Business name:Point Monitor Corp. above service or feeder fee, Contact name:Brooke Williams each branch circuit 7.42 2 B.Fee for branch circuits without Address:5863 Lakeview Blvd.Suite 100 service or feeder fee,first branch circuit 56.18 2 City/State/ZIP:Lake Oswego,OR 97035 Each add'l branch circuit 7.42 2 Phone:(503)627-0100 I Fax: :( ) Miscellaneous(service or feeder not included) Each manufactured or modular dwelling,service and/or feeder Email:bwilliams@pointmonitor.com 67.84 2 Reconnect only 67.84 2ea s�� " ' : . Pump or irrigation circle 67.84 2 Business name:Point Monitor Corp. Sign or outline lighting 67.84 2 Signal circuit(s)orlimited-energy r4 See Page 2 panel,alteration,or extension. g 1 2 Address:5863 Lakeview Blvd.Suite 100 Each additional inspection over allowable in any of the above City/State/ZIP:Lake Oswego,OR 97035 Additional inspection(1 hr min) 66.25/hr Phone:(503)627-0100 I Fax:( ) Investigation(1 hr min) 90.00/hr Email:bwilliams@pointmonitor.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 135901 I Electrical Lic.: 34508CLE Suprv.Lic.: 4460LEA s ecificall listed(%:hr min) 90.00/hr Suprv.Electrician signature,requir > Subtotal: /,,;�-� Print name: Ben Breit Date: 12/19/17 0 Plan Review Required(25%of permit fee): ( State surcharge(12%of permit fee): ft %�'• Authorized signa TOTAL PERMIT FEE: '1' g Li -=�' This permit application expires if a permit is not obtained within 180 Print name: Ben Breit Date: 12/19/17 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Bui]ding\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: Fee for all residential systems combined: $75.00 Dom` °°" �© Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less mg 100.70 _© 5.01 to 15 kva 1.1 133.56 ❑ Audio and Stereo Systems* 15.01 to 25 kva - 200.34 _© Wind "eneration s stems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva - 301.04 _© ❑ Garage Door Opener* 50.01 to 100 kva - 552.26 _© >100 kva(fee in accordance III with OAR 918-309-0040 552.26 _© ❑ Heating,Ventilation and Air Conditioning * Solar generation systems in excess of 25 lova: System _ Each additional kva over 25III 7.42 13 ❑ Vacuum Systems* >100 kva-no additional charge - 0.0 Each additional ins ection over allowable in an of the above: ❑ Other: Each dd t hourl ioninspection is ■ 66.25/hr -� charl eed at an 1 hr min Inspections for which fee is ■in 90.00/hr _. t ° .:. .,. Yeo k § Iso ificall listed 'A hr mlt1 '# 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 ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: 3 *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015