Permit (50) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2018-00068
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/07/2018
Tri;;lh.n g Parcel: 2S101DA01000
Jurisdiction: Tigard
Site address: 7100 SW FIR LOOP
Project: Kelvix Subdivision: 72ND BUSINESS CENTER Lot: 10
Project Description: Limited energy for data and security system for TI.
Contractor: AMBIENT AUTOMATION LLC Owner: BKS INVESTMENTS LLC
8313 SW CIRRUS DR 8313 SW CIRRUS DR
BEAVERTON, OR 97008 BEAVERTON,OR 97008
PHONE: 503-616-2749 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/07/2018 $150.00
12%State Surcharge-Electrical 05/07/2018 $18.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 $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. Thqse rules are set forth in OAR
952-001-0010 through OAR 95_-001-0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or1. 0.332.2344.
Issued By: � � 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.
' lectrical Permit Application FOR OFFICE USE ONLY
C.;FT:,
City of Tigard C.; i V age Received
Date/B : 1 Penmt#:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 7 ,/, '''
1111 �t
Phone: 503.718.2439 Fax: 503.598.1961MAY 7 2018 Date/B : Related Permit#y5 tf pozo/ / UL
Inspection Line: 503.639.4175 Ready Date/By: Juris: H See Page 2 for
TIGARD Internet: www.tigard-or.gov r ' v,.;'D Notified/Method: Supplemental Information
. t oa. 9.211#a H,J [ t: ,,g. a + ;,ar k .�':..
...,.,«,z,v,. ,_..,.mai., ti�v . .,. �,..... �,/�//„M,< i, . �>�. �, ..�
►/ New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
_ where the available faultcurrent Marinas and boatyards.
ar
,,,,,,,a-r: ✓,CA ,; cON .., i Ate.. ��., ” exceeds 10,000 amps at 150 volts or IDFloating buildings.
0 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑commercial-use agri«dtural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA orD13 g Y Y g P Y
, toit)i 1 ;Y UCAS ll //f y y, ❑EAr enc s stem. lar er se aratel derived
❑Addition of new motor load of system.
Job#: Job site address:7100 SW Fir Loop Dr IOOHP or more. ❑"A">"E",`°I-z",``l-3",
City/State/ZIP:Tigard,Oregon.97223 ❑six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Kelvix ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:72nd Ave �
43 e...'• FEE SPACIA*. moi, t
_.. Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#
�
j","%"" ''- .���� 5:"1.11'TjON Q '.'Wp� ::442:4-r' „ , Limited
. .• .4° energy,residential ion 33.92 1
LV wiring-Data/Security (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
,ryJ Renewable Energy CI See Page 2
'
m, - w I ' •a� Aht"�”;••�•�•y -‘-,,,-'•' 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 l
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
T""" Branchcircuits—new,alteration or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email
Reconnect only 67.84
.62 i,:,;.. ti .it .. .. " Pump or irrigation circle 67.84 2
Business name:Ambient Automation LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy SP2 2
Address:8313 SW Cirrus Drive panel,alteration,or extension. ee age
City/State/ZIP:Beaverton,Oregon.97008 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)616.2779 Fax:(503)715.5379 Investigation(1 hr min) 90.00/hr
Email:jkill@ambientautomation.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 191626 Electrical Lic.: CLE247 Suprv.Lic.: 4615LEA spectficall listed(/2 hr min)
Fay((t.T.RI~Al E� `' '
{bdl ...=a
Suprv.Electrician signature,required: Subtotal: 150.00
Print name: Seth Darlin Date: 5.7A8 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): l 8.00
( / /
Authorized signature: �Z7. TOTAL PERMIT FEE: 168.00
/ This permit application expires if a permit is not obtained within 180
Print name: Jeff Ki Date: 5.7.18 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELCPer . ELRERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
PPP°
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
� � Qty. I Each ......... \\
Fee for all residential systems combined: $75.00 DescriptionTotal
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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System*
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 90.00/hr
specifically listed(%hr min)
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
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: Security System
Total number of commercial systems: 2
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELRERE.doc Rev 06/17/2015