Permit (34) 11111
CITY OF TIGARD ELECTRICAL PERMIT
/ COMMUNITY DEVELOPMENT Permit#: ELR2018-00032
T UJARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2018
Parcel: 2S101AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE 200
Project: Dr.Steven Gabel MD PC Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Fire alarm system.
Contractor: POINT MONITOR CORPORATION Owner: TIGARD TRIANGLE PARTNERS LLC
5863 LAKEVIEW BLVD STE 100 18187 SIERA DR
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97034
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Quantity Description Date Amount
Specifics: 1 ea Restricted Energy Permit 03/13/2018 $75.00
1 ea 12%State Surcharge- 03/13/2018 $9.00
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $84.00
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 sus nded for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a cop c I direct questions to OUNC by callin 232.1987 or 3 3 4.
Issued By:so .....-:— ..e.--• Permittee Signature: /
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
RECEI
34_, h 012 OFFl('t: USI:OV'1.1
City of Tigard "=.
ill 13125 S W Hall Blvd.,Tigard,OR 97223 D�teB v I i NI) Permit#:
Phone: 503.718.2439 Fax: 503.598.1960 FEB 1 6 ir'':' Review
sate/By: Related Permit#: ri t1 cr6oie
I l G A R D Inspection Line: 503.639.4175 ate/By: ]oris.
Internet: www.tigard-or.gov Cf OFrr�� ® See Page 2 for
ethod:
Suppl46. emental
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v , ,.;.q, tater . N� 1s {F-.t:1� � .8 .:6.- k � d 414. J?. 1:8 ¢. 1 :•:: a .,Z t,
-it;
®New construction CI Addition/alteration/replacement Please check all that apply
❑Demolition 0 Other: ❑Service or feeder 400 amps or more of plans w/items checked):
I ^m r where the available fault current ❑Building overthreestories.
❑Marinas and boatyards.
r� 3 ► k ff ` exceeds 10,000 amps at 150 volts or
,.:: a ..a� .c.,'e� � :.tu„I.x a�i� fi��.t �. ��".�x ” >. ❑Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrialless to ground,or exceeds 14,000
0 Accessory building ❑Commercial-use agricultural
❑Multi-family ❑Master builder 0 amps for all other installations. buildings.
Other
r ❑Fire pump. 0 Installation 150 KVA or
❑Emergency system. larger separately derived
Job#: Job site address:12115 SW 70th Ave Building C ['Addition of new motor load of system.
10011P or more. ❑"A","E' "1-2","l-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
Suite/bldg./apt.#:Z00 ❑Health-care facilities. 0 Recreational vehicle parks.
[ Project name:Red Rock-Dr.Gabel 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: y
❑Service or feeder 600 amps or more. 600 volts nominal.
Description Qty. Each Total'
Subdivision: New residential single-or multi-family dwelling unit.
1 Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
ti {Aa r Ea.add'l 500 ft.orportion
• • ' ,M ,.. ' a „x . sq. 33.92 1
Limited energy,residential
(with above sq.ft.)
Fire Alarm Notification Devices 75.00 2
\ Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
'.:66
s , rar:;: , , ` "' Services or feeders installationzalteration,and/or relocation
Name:Red Rock Center-Dr.Gabel
200 amps or less 100.70 2
Address: 12115 Sw 70th Ave.Building C Suite 200 201 amps to 400 amps 133.56 2
City/State/ZIP:Tigard,OR 97223 - 401 amps to 600 amps 200.34 21
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
rcation
Owner installation:This installation is beingmade on property200 amps or 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 amps125,08 2
Owner signature: Date: 401 amps to 599 amps 168.54
2
- t .1 _ Branch circuits-new,alteration,or extension, r panel
Business name:Point Monitor Corp, A.Fee for branch circuits with
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'1 branch circuit 7.42
2
Phone:(503)627-0100 Miscellaneous(service or feeder not included)
Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder
Email:bwilliams@pointmonitor.eom67.84 2
Reconnect 67.84 2
1; ' ,i
� �
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 circuit(s)or limited-energy
Panel,alteration,or extension. El See Page 2 1 2
Each additional inspection over allowable in any of the above
City/State/ZIP:Lake Oswego,OR 97035
Phone:(503)627-0100 I Additional inspection(1 hr min) 66.25/hr
Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:bwilliams@pointmonitor,com
CCB Lic.: 135901I. Inspections for which no fee is
Electrical Lie.: 34508CLE Suprv.Lie.: 4460LEA specifically listed(Yr hr min) 90 00/hr
w&ti'icli•i. � t .t'::::14,
t'sa^� „�
aSuprv.Electrician signature,required_
��
Subtotal:
Print name: Ben Breit f Date: 2/15/18 0 Plan Review Required(25%of permit fee):
/ ) fr State surcharge(12%of permit fee):
Authorized signature: ` � TOTAL PERMIT FEE:
IPrint name: Ben Breit This permit application expires if a permit is not obtained within 180
I Date: 2/15/18 I days after it has been accepted as complete.
Huildina\Permits\ELC Permit/kmELR ERE.doc Rev 06/17Y2015 ' Number of inspections allowed perpermit.
I:\
440-461 ST/I I/OS/COM/WER
Electrical Permit Application—City of Tigard
Pate 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
4.:4., x.. �j`71 d'F '147,1'1'1 .''f„ t "a^r.M3 16D"aF43 '$
Fee for all residential systems combined: $75.00 Description Qty. Each Total
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
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva T 301.04 2
0 Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
fpwith OAR 918-309-0040) 55226 2
Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 r 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0
Each additional Inspection over allowable in any,of the above:
❑ Other: Each additional inspection is
charged at an hourly(1 hr min) 6625/hr 1
Inspections for which no fee is `
s ificall listed ''A hr min 90.00/hr
Q` t t spa
Fee for each commercial system: $75.00 _ Subtotal(Enter on Page I):
(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: 1
*No licenses are required. Licenses are required for all
other installations
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE 200, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00032
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
Scheduled
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE 200, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00032
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor