Permit (127) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•' COMMUNITY DEVELOPMENT Permit#: ELR2018-00190
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2018
T t�; + I<:D9 Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 250
Project: The Filkins Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Limited energy for fire alarm.
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/01/2018 $75.00
12%State Surcharge-Electrical 11/01/2018 $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 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 OA 952-001- 090. You may
�obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �iGt, °C'(r9""r btin' 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.
NOISIAIa JNla1In-
Electrical Permit Application 01:1V911 JO Allo FOR OFf4( i: I Si:ON Ll
City of Tigard 8.--
Received /
il
:71 " 13125 SW Hall Blvd.,Tigard,OR 97223 8.-Z 0 13 Q Date/; ; G / j / i _�
= Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 9,:te/B t i
Inspection Line: 503.639.4175 ®3 A 1 3 0 3 ! y Date/By; IMO ® See Page 2 or
1 I t'`�R 1) Internet: www.tigard-or.gov otifted/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ®Addition/aiteration/replacement Please check all that apply(submit 2 sets of plans n items checked):
❑Demolition ❑Other 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
El1-and 2-family dwelling •®Commercial/industrial 0 Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: ❑Fireum .
P P ❑installation of 150 KVA or
JOB SITE INFORMATION AND LOCArION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 12909 SW 68th Parkway Suite 25 100HP or more ❑"A""E 'l-2^ 'I-3"
Cit)./State/ZIP:Portland,OR 97223 ❑Six or more residential units. occupancy,
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:250 Project name:Filkinsl 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qtr....I Each I Toni 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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION=OF WORK K°°
Limited energy,residential 75.00 2
Fire Alarm Devices (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
❑"PROPERTY OWNER TENANT I Services or feeders installation,alteration,and/or relocation
Name:The Filkins Group 200 amps or less 100.70 2
Address: 12909 SW 68th Parkway Suite 250 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,OR 97223
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/or
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
APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Point Monitor Corp. above service or feeder fee,
7A2 2
each branch circuit
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Lake Oswego,OR 97035 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)627-0100 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:bwilliams@pointmonitor.com Reconnect only 67.84 2
CONTRACTOR 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, SeePage 2 1 2
panel,alteration,or extension. . a g
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bwilliams@pointmonitor.com Industrial plant(1 hr min) 78.18/hr
inspections for which no fee is
CCB Lie.: 135901 Electrical Lie.: 34508CLE r Suprv. Lic.: 4460LEA specifically listed(4 hr min) 90.001 hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:' " Subtotal:
Print name: Ben Breit Date: 10/30/18 0 Plan Review Required(25%of permit fee):
,.— mss=: State surcharge T %L f fee):EE
Authorized signature;.—r� TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Ben Breit Date: 10/30/18 days after it has been accepted as complete.
r Number of inspections allowed per permit.
1.Building'Permits ELC_PermitApp_ELR ERE.doc Rev 06+1-2015 440-4615T(11/05'COM'WEB
1
M
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
•
Fee for all residentialsystems combined: $75.00 Description Qty. men I Tia I
Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
El Garage Door Opener* 50.01 kvao 00 kva 552.26 2
>100 (fee in accordance 552.26 2
with OAR 918-309-0040)
0 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 SA hr min)
COMMERCIAL WORK ONLY:
N y .t. , ELECTRICAL.PERNIIT FEES
Fee for each commercial system: $75.00Subtotal(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
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El 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
I.Building+Penniu'ELC_PenaitApp_ELR_ERE.doe Rev 06'17 2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12909 SW 68TH PKWY 250, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00190
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor