Permit (125) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY-00182 PERMIT
PerII _ COMMUNITY DEVELOPMENT
Imit#: ELR2018
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2018
TIC.;ti r n g Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 310
Project: Fairway mortgauge Subdivision: None Lot: None
Project Description: Limited energy for data telecommunications installation.
Contractor: LOW VOLTAGE SOLUTIONS OF OREGON Owner: GK TRIANGLE CORPORATE PARK III L
PO BOX 883 ATTN KBS REALTY ADVISORS
GLENDALE, OR 97442 P 0 BOX 28270
SANTA ANA, CA 92709
PHONE: 541-203-7582 PHONE: 206-292-6023
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/16/2018 $75.00
12%State Surcharge-Electrical 10/16/2018 $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: 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: 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 f more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are et forth in OAR
952-001-0010 through OAR 952-.: )090. You `n obtain a copy 4 the rules or direct questions to OUNC by calling 503.232.1987 or 1. . 44.
� / LLf�Issued By: ✓�G rav1� . i (v. ' Permittee Signature:
j
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 FOR OI FI( F LSI.Oy►.v
City of Tigard Received
14 OR 97223 Date/B : /I MIME'
13125 SW Hall Blvd.,Tigard,
Plan Revi w
lig C ' d%'Phone: 503.718.2439 Date/B : E Ci i 1rZi,
T I c;n I:I> Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: Anis: ® See Page 2 for
Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling 4_3 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
am0 Multi-family 0 Master builder ❑Other: mall other installations. buildings.
0 Fire Fire for pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
l� r� ,;�_Y 0 Addition of new motor load of system.
Job#: Job site address: l 3 2.2 \ Sid tJg Th ir` e._ 100HP or more. ❑"A","E","1-2",°°l-3",
City/State/ZIP: -1-7-kr OK -/1- ZZ3 /1 - ❑Six or more residential units. occupancy.
6L / ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: E' Project name: �' K ) 1 ❑Hazardous locations. ❑Supply voltage for more than
t f I✓ '_ .:41r- 0 600 volts nominal.
Cross street/directions to job Site: � '�-❑Service or feeder 600 amps or more.
FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
l „. _/ V'lh _2
C4` eneg ,ml� hLimited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT 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:( ) 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 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
0
APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: fiV' V I : b fills 6c ® above service or feeder fee,
� each branch circuit 7.42 2
Contact name: , I i%c-`Ac r B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
3 branch circuit
City/State/ZIP: Each add'1 branch circuit 7.42 2
ty p'Y t ffe
`k' ) 0 q'�- Miscellaneous(service or feeder not included)
Phone:( �) "Z'y -- 2 3 3 Each manufactured or modular 67.84 2
7c dwelling,service and/or feeder
Email: i...1/S o -7O ge c - 0 Reconnect only 67.84 2
V
CONTRACTORPump or irrigation circle 67.84 2
/t
Business name: h J Vo 44 LJiy.s e -1 optrt Sn or outline lighting 67.84 2
oc3`'� Signal circuit(s)or limited-energy
Address: 3`„� panel,alteration,or extension. -See Page 2 • 2
Ci /State/ZIP: -1._...
Each additional inspection over allowable in any of the above
City/State/ZIP: �} r 0 � Z Additional inspection(1 hr min) 66.25/hr
Phone: - 3 l
3 z Investigation(1 hr min) 90.00/hr
!� Industrial plant(1 hr min) 78.18/hr
Email: _v S u i2 ' L�'�0 r-" 9i (li ,. G3,
Inspections for which no fee is 90.00/hr
CCB Lic.: 3.05 b 31 Electrical Lic.: Lg.- i Super Lic.: C- ,,,,47‘ specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: �,.y Subtotal:
,
Print name:. t` /� - t;J e_.44----- Date: I0'I Jo .1 lg 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCPEDVLE
DescriptionI
Fee for all residential systems combined: $75.00 ( 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
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 552.26 2
with OAR 918-309-0040)
n 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/hr min)
COMMERCIAL WORK ONLY:
LEC CAL PERMIT FEES
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:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
L\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13221 SW 68TH PKWY 310, TIGARD, OR, 97223 November 20, 2018 at
9:43:22 AM
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00182
Inspection Type: Inspector:
198 Low voltage final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor