Permit (93) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 : COMMUNITY DEVELOPMENT Permit#: ELR2018-00108
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2018
T [,;ARD
1z g Parcel: 2S1060001400
Jurisdiction: Tigard
Site address: 17051 SW APPLEDALE RD
Project: River Terrace East Apartments,Building A-Clubhouse Subdivision: RIVER TERRACE EAST Lot: None
Project Description: Limited Energy for fire alarm.
Contractor: FIRE PROTECTION SERVICES Owner: POLYGON WLH, LLC
5573 SW ARCTIC DRIVE 703 BROADWAY ST,SUITE 510
BEAVERTON, OR 97005 VANCOUVER,WA 98660
PHONE: 503-590-3732 PHONE: 360-695-7700
FAX: 503-628-6214
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/08/2018 $75.00
12%State Surcharge-Electrical 08/08/2018 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
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 $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all • -r ppli -•e-law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if , • is -•spended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce Tho -. rules are -t forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. .19 or :01.332.2344.
Issued By: "1Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Applica e-‘5"--�" 3 _i FOR OFFICE USE ONLY
Cl of Tigard Received '0°9 g Date/B �� Permit No.: / ,
13125 SW Hall Blvd.,Tigard,OR 976L 1 2 2Q18 Plan Review
Phone: 503.639.4171 Fax: 503 59811111
1960Other Permit. / Q
Date/B EC
TIGARD ,Inspection Line: 503.639.4175 Ci`: Date Ready/By: loris: See Page 2 for
Internet: www.tigard-or.gov x4 „.. ®:,i. Notified/Method: Supplemental Information
t TYPE OF WOE iPLAN,`RE'1$E '
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current
0 Marinas and boatyards.
EGORY-OF CONSTRtI 0 ui exceeds 10,000 amps at 150 volts or 0 Floating buildings.
�' less toground,or exceeds 14,000
1-and 2-familydwelling ❑Commercial-use agricultural
❑ El ❑Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. 0 Installation of 75 KVA or
J-04'SITE INFORMATION AND;LQAT�QIY 0 Emergency system larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","I-3",
Job no.:3001 Job site address: 17051 SW Appledale rd I00HP or more occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: j v14.)0e ,D �7,/L° 0 Health-care facilities. ❑Supply voltage for more than
/ T ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:'i0' j. ❑Service or feeder 600 amps or more.
V P..l'vCccc �J� f ��
Cross street/directions to job site:
FI„E'S `$EDI;ILE
Description I Qty. I Fee. I Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 145,15 4
Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.40 1
Limited energy,residential
DESCRIPTION'OF WO1J l (with above sq.ft.) 75.00 2
install new Fire Alarm Panel y,,t thPev,
energy,multi-family
1_4, Pe�(t(. 5 i 11St(sie 75.00 2 4 ill residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
*t' bvite 1 ny 200 amps or less 80.30 2
PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps_ 160.60 2
601 amps to 1,000 amps 240.60 2
Address: ---
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax:( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps _ 133.75 2
Owner signature: Date: Branch circuits–new,alteration,or extension,per panel
— A.Fee for branch circuits with
Q APPLICANT ❑'CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Fire Protection Services Inc B.Fee for branch circuits
Contact name:David M Phipps without service or feeder fee, 46.85 2
first branch circuit
Address:9950 SW Arctic Dr Each add'l branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Beaverton Or 97005 Each manufactured or modular
90.90 2
Phone:(503)590-3732dwelling,service and/or feeder
Fax: : (503)628-6214 Reconnect only 66.85 2
E-mail: phipps@fpsnw.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name:Fire Protection Services Inc Signal circuit(s)or limited-
energy panel,alteration,or
Address:9950 SW Arctic Dr extension.Describe: 1 Page 2 75.00 2
City/State/ZIP:Beaverton,OR 97005 Each additional inspection over allowable in any of the above
Per inspection 1 62.50
Phone:(503)590-3732 Fax:(503)628-6214
Investigation per hour(I hr min) 62.50
CCB Lie.: 154333 Electrical Lie.: CI.,E3488 Suprv. Lie.: 4120LEA Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES r,IVII
Suprv. Electrician signature,required: Subtotal: 75.00
Print name: David M Phipps Date: 7/12/18 Plan review(25%of permit fee):
State surcharge(12%of permit fee): 9.00
Authorized signature: TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: David M Phipps Date: 7/12/18
days after it has been accepted as complete.
* Number of inspections allowed per permit.
I ABuilding\Permits\ELC-PermitApp doc 05/23/06 440-4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating,Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
RCI .W�RK.ONL,Y
Fee for each commercial $75.00
system
(SEE OAR 918-260-260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
- B• oiler Controls
ri C• lock Systems
E Data Telecommunication Installation
® Fire Alarm Installation
n HVAC
Instrumentation
- Intercom and Paging Systems
Landscape Irrigation Control*
❑ M• edical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC-PermitApp.doc 03/23/06
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17051 SW APPLEDALE RD, SHERWOOD,
OR, 97140
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00108
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor