Permit (28) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT
Permit#: ELR2019-00001
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/02/2019
T[r;; R.C• 9 Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 70
Project: Bi-Mart Subdivision: None Lot: None
Project Description: Limited energy for fire alarm.
Contractor: VISION SECURITY SERVICE Owner: ROIC OREGON LLC
10874 SW ROLAND CT 8905 TOWNE CENTRE DR, STE 108
WILSONVILLE, OR 97070 SAN DIEGO, CA 92122
PHONE: 503-502-3909 PHONE:
FAX: 503-200-2907
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/02/2019 $75.00
12%State Surcharge-Electrical 01/02/2019 $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 applic-.e la 11 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 wor s s•••-nded • •re the 180
days. ATTENTION: Oreg• law requires you to follow the rules adopted by the Oregon Utility Notification Center. •.se r ar= orth in OAR
952-001-0010 through O 52-001-0r-a. Yo' ay obtain a c..yof the rules --- •<: •- ' ,C by calling 503.232.1987• it.33.44.
c
Issued By: , / Permittee Signature:
�r
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 ApplicationR ECEIVFD FOR Of FILE FSE ONI.1
City of Tigard i Received /
JAN 2 2019 ' ` ,_ , C���'��
II
13125 SW Hall Blvd.,Tigard,OR 97223 DateB : f
Plan Beview I j, -Zoo/o/
= Phone: 503.718.2439 Fax: 503.598.19 ^
i Y r- i(7pR-t i.
Inspection Line: 503.639.4175 I i ,.., R, Ready Date/By: Juries H See Page 2 for
TIGARD Internet: www.tigard-or.gov ��i��'s! Lx 1�1 sL.,i, 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):
❑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.
❑ 1-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: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address:13500 SW Pacific Hwy#70 ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Bi Mart#640 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 Qty. I Each I Total f *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Upgrade of combination Fire Alarm,Burg Panel Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 TENANT
0 PROPERTY OWNERServices 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 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 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
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
Email:
dwelling,service and/or feeder •
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Vision Security Service Inc. Sign or outline lighting 67.84 2
Address:10874 SW Roland Court
Signal lern or extension.
7See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Wilsonville,OR 97070 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)502.3909 Fax:(503)200.2907 Investigation(1 hr min) 90.00/hr
Email:visionsecurityservice@gmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 171552 Electrical Lic.: LE214 Suprv.Lic.: 3899LEA specifically listed(%2 hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: / ,/OF / Subtotal:
Print name: Andrew Leondar �� Date: 12/26/18 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.
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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 residential systems combined: $75.00 Description Qty. Each Total
3' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
0 Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
0 Garage Door Opener* >100 kva(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
El V• acuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
C 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(%z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal Enteron Page 1):
Fee for each commercial system: $75.00
y • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
L Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
[] H• VAC
O Instrumentation
❑ Intercom and Paging Systems
O Landscape Irrigation Control*
❑ Medical
O Nurse Calls
O Outdoor Landscape Lighting*
►1 Protective Signaling
❑ Other:
Total number of commercial systems: 2
*No licenses are required. Licenses are required for all
other installations
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