Permit INCITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' COMMUNITY DEVELOPMENT Permit#: ELR2018-00042
TtGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2018
Parcel: 2S 101 CA00200
Jurisdiction: Tigard
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Corp. Subdivision: None Lot: None
Project Description: Fire alarm.
Contractor: FIRST RESPONSE SYSTEMS INC Owner: WALL STREET INDUSTRIAL LLC
4970 SW GRIFFITH DR#100 7900 SW HUNZIKER RD
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503-207-5300 PHONE:
FAX: 503-207-5301
FEES
Description Date Amount
Specifics:
Restricted Energy Permit 03/21/2018 $75.00
Type of Use: COM 12%State Surcharge-Electrical 03/21/2018 $9.00
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: Q Fire Alarm: 1
•
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: Q
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. 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 rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Air,f` �—_ Permittee Signature: .Lf ��-�� ....4C,r ,vl
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 FCaPermit TFFt 1 33 Fi lCFt)Fl RECEIVE FOR OFFICE F'SE ONLY
liCity of Tigard MAR 1 6 2018 Received l►� EN
a 131_'5 4V'Ball f3hd TI card,OR 97223 Date:Bv: rl_ J �.� F tS
Phone: 503.718.2439 fax: 503.598.19('q/��]��/y� 'FIG q yt Related Permit:i:,O 020/, - •
VI 1 I OF Aflt,3 ��
TIGARD Inspection Line: 503.639.4175 Ready Date By: El See Page 2 for
Internet: vvww.tigard-or.gov UIDIG IVII ' otitied/Method: Supplemental Information
T1"PF: OF Y ORK PLAN REVIE1%
0 New construction _Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0 Other: ❑Service or feeder 400 amps or more 0 Building over three stories.
whew the available fault current 0 Marinas and boatyards.
CA"FEGOR\ OF CO\S"IRt C ION exceeds 10.000 amps at ISO volts or 0 Floating buildings.
El1-and 2-family dwelling EICommercial/industrial 0 Accessory building less to ground.or exceeds 14.000 [I Commercial-use agricultural
amps for all Other installations. buildings.
❑ Multi-family ❑ Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
.108 SITE, INFORM Al'ION AND LOCATION ❑Emergency system. larger separately derived
0 Addition of new motor load of system
Job 5--,14.5i-' Job site address: �1.(kAJ Ni ‘At,Ul l?t kl.t 03([ ❑
IOOIiP or more. A• :L "I?"."I-T'_
City/State/ZIP:- (.1 i ,)' ❑Health-care ue tacllitiesow resident i11 units occupancy.
, �\ creational vehicle parks.
Suite/bldg./apt.#: Project name: i ❑Hazardous locations. Supply voltage tot more than
/ A 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FF:1'. SCIIEDI .I?
Description I Qtr. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#:
1.000 sq.ft.or less 168.54 4
Ea.add`I 500 sq.It.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
L (,� (with above sq.ft.) 75.00 2
r rr"L iN�% Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
AER
❑ ('RUFF:RTI' ONRenewable Energy 0 See Page 2
0 I F.NAv I 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
Email:
Temporary services or feeders installation,alteration,and/o-
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
Branch circuits-new,alteration,or extension,per panel
0 :1PPLI('.1\T 12'CONTACT PERSON
A.Fee Ibis branch circuits with
Business name: above servicefeeder fee.
v c 5 or?(2s c)(.1(r... - 7.42 2
each branch circuit
Contact name: V '\fl %----z�til V-i, ,t F j c F-•- B. Fee for branch circuits without
Address: C service or feeder fee.first
1 �: (1;..k. v k r t t.k '� l LJ t.- branch circuit 56.18 2
City/State/ZIP: ( Each add'I branch circuit 7.42 2
�(� _ ) \` C ;Miscellaneous(service or feeder not included)
Phone:(t-k...i)) 2C7.3 -5., i jL Fax: :( ) Each manufactured or modular
Email: ..'\ a':'1L''(t{..i I P r ,.. .c. (-_ \ tom.
service and/or feeder 67'84 2
dwelling
l �.L' 1 Reconnect only 67.84
CON' \('TOR Pump or irrigation circle 67.84 2
Business name: ��(�`-)l . ()..c2,7-�30ay yl Sign or outline lighting 7.84 2
�
Address:ss: t �` Signal circuit(s)or limited-energy"
Lick' an ,ce Page 2 C- 2
JC,-,•-.0---‘k-'4-',..tj L� _ p el,alteration,or extension. t
City/Stale/ZIP: � �__ Each additional inspection over allowable in any of the above
t�`'� � IC Y l C I 1 t '`-1 ) Additional inspection(I hr min) 66.25/hr
Phone: `-i1.�. ) .(„i„.t (' 1 `[..c) Fax:( ) Investigation(I hr min) 90.00/hr
Ismail: V Industrial plant(I hr min) 78.18/hr
`3 ' t.V l..{-1.�..(. I E.t c l t( ' 'LC\I 1 Inspections for which no fee is
( 1 --113 ' specifically listed(r;hr min 90.00/hr
CCB B Lie.: Electrical Lic.: L Suprv. Lic.:L E Yr Pe )
LUCFRIC\I. PERM!1' FEES
Suprv. Electrician signature. required: -A..._.... Cd :�
Subtotal: ,j;..2
Print name: 6 t ir/ �"y �� Date: `? ,t�'„ ❑Plan Review Required(25%of permit fee):(J State surcharge(12%of permit fee): e1 `�
TOTAL.PERMIT FFF' c
Authorized signature: ,, j,1
This permit application expires if a permit is not obtained within 180
Print name: a,y�t.� Date: g ` days after it has been accepted:)s complete.
��--JJ 1 ' Number of inspections allmved per permit.
I-auilding'Pernut ...t:a-C_Remit.VI, Et R riRE doe Res 0s-17.^_015 440-4615T(11:05-CM:win
Electrical Permit Application–City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
e U'a I a j V $: 0 1 .,..�Jr..40,3 �. +k.,, ea1.=.11. I `4�r�,, aw';0,, y
i_ s T .§.D scI1pd fl ii E.eh 1 That I''
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
❑ 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
50.01 to 100 kva 552.26 2
p Garage Door Opener* >100 kva(fee in accordance 55226 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
p Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
Each additional inspection is 66.25/hr I
Other: charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(V2 hr mm)
cO1 CIAL woi 0101Y: A.,ff. LMT*Ids`•;
Subtotal(Enter on P 1):
Fee for each commercial system: $75.00 . Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ ata 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: —
*No licenses are required. Licenses are required for all
other installations
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7904 SW HUNZIKER RD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00042
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor