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Permit (149) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 14 -. COMMUNITY DEVELOPMENT Permit#: ELR2019-00032 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/05/2019 T I r._"ti I;.Dg Parcel: 25101 BB01500 Jurisdiction: Tigard Site address: 12250 SW GARDEN PL Project: Language Solutions Subdivision: CROW PARK 217 Lot: 3 Project Description: Limited energy for Installation of clean agent fire alarm system. Contractor: COSCO FIRE PROTECTION INC Owner: ICON OWNER POOL 1 WEST LLC 2501 SE COLUMBIA WAY SUITE 100 BY RYAN VANCOUVER,WA 98661 PO BOX 460169 HOUSTON,TX 77056 PHONE: 360-816-8418 PHONE: FAX: 360-883-6390 FEES Description Date Amount Specifics: Restricted Energy Permit 03/05/2019 $75.00 12%State Surcharge-Electrical 03/05/2019 $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 $84.00 Other Desc: Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes nd all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, •r if work is spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cen -r. ' ose es are set forth in OAR 952-001-0010 through OA -001-0090 You%=y obtain a c/% of the rules or.• t questions to OUNC by calling 232.19:7 or 1 800.3 . 44 Issued By: ,/ I. Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application ► FOR OFFICE USE ONLY �� City of Tigard 571ili�� d r. ill : �- . 13125 SW Hall Blvd.,Tigard,OR 97223 �i Plan lan Review Phone: 503.718.2439 Fax: 503.598.1960BE�Ia, Date/By: , tO '� , L r'0 - Inspection Line: 503.639.4175 Ready Date;By: Anis: 5 See Page 2 for TIt<tRD Internet: www.tigard-or.gov VE' 2 O 0 Notified/Method: Supplemental Information ❑New construction (4 Addition/alteration/rep ' G©l v`$,0 Please check all that apply(submit 2 sets of plans w/items checked): BU1 ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. GORY(1O(CNSTRCJCT Olvl exceeds 10,+00 amps at 150 volts or 0 Floating buildings. 0 ,T 1-and 2-family dwelling 'Commercial/industrial LI Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or io of02:fti 4A•'ITION< II CAT*O(�i o es motor load of Y envied ❑Emergency system largez separatel d ❑Addition f n system Job#: Job site address: l Z 2.S0 5J cAeO,J 'L loop*or more. ❑"A" '.E„ "1-2' 'l-3» ❑Six or more residential units. occupancy. City/State/Z1P: T t (r A a Dt U R D 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: �. 6.%).04.1._ ❑Hazardous locations. 0 Supply voltage for more than l IN E 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: fl SCIIEDIJL ::. Description _... I Qty. I Each ' Total I New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. L000 sq.ft.or less 168.54 4 Tax map/parcel#: p/P Ea.add'1 500 sq.ft.or portion 33.92 1 II�RIPTION OF;, I$' Limited energy,residential 75.00 2 (with above sq.ft.) t bk.) Sl -L- C L.FiA� A .� 7 Ft>2t $ (!Qt' Limited energy,multi-family 75.00 2 %J �. residential(with above sq.ft.) 1 Renewable Energy ❑ See Page 2 OWN R. I O ANt Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: 401 amps to 600 amps 200.34 2 City/State/`LIP: 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 nits—n era extension' l t*'P It'',48T 'C4 8, Ii i{}N ew,alt tion,or ,Pe panel , Branch circ n r a .� � 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 service or feeder fee,first 56.18 2 Address: 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 aadior feeder Email: Reconnect only 67.84 2 _ ( _ �. Pump or irrigation circle 67.84 2 Business name: C 0 S ca c 2t P1Qzr c crt 0A) Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See page 2 1 2 Address: 2 c0 I • C foci/Mg l A W S )\i I Q O panel,alteration,or extension. tit/ Qv'b 6 , Each additional inspection over allowable in any of the above City/State/ZIP: V l�+N Co v Additional inspection(11rr min) 66.25/hr Phone:(30 )8 e 631/3 Fax:&c0 ) 893-‘390 Investigation(1 hr min) 90.00/In Email: �1 /� Industrial plant(1 hr min) 78.18/hr v`e t 'Lt2.O 3e C 3 C,,i'2 C a3 tee C 01 Inspections for which no fee is /� p1`(t� 90.00`hr (O1So L Z l p I c Zv A 9)e ifrcallY hated(1.'„1.11.mm) CCB Lic.: Electrical Lic.: a rv.Lic.: �t�� �� � , Suprv.Electrician si:i atur required: Subtotal: Print name: J�p� c„ ,.D Date: 2 2o) 1 g ❑Plan Review Required(25%of permit fee): VV666 State surcharge(12%of permit fee): Authorized si TOTAL PERMIT FEE: Print name: Date: 2! o 1 l ^ This permit application expires if a permit is not obtained within 180 l? days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Buildng'•.Pemrits'•ELC_PemiitApp_ELR_ERE.doc Rev 06/17!2015 440-4615T(11i05iCOM/WEB Electrical Permit Application—City of Tigard ,Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: S �lhlLl nescripnn I QtY• I EachI Total , Fee for all residential systems combined: $75.00 Renewable electrical energy systems: kvCheck Type of Work Involved: 5 5.01 or less 100.702 to 15 kva 133.56 2 El A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: Fl B• urglar Alarm 25.01 to 50 kva 301.04 2 n Gars a Door O ener* 50.01 to 100 kva 552.26 2 ' + g p >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) H Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 El Vacuum Systems* >100 kva—no additional charge 0.0 a 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25r'hr 1 charged at an hourly(1 hr min) Inspections for which no fee is specifically listed(ii hr min) 90.00,hr COMMER IAAL:WORKONLYt Fee for each commercial system: $75.00 Subtotal(Enter on Page I). y * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n A• udio and Stereo Systems F7 Boiler Controls (1 Clock Systems LI Data Telecommunication Installation Kt&Fire Alarm Installation (� H• VAC (l Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* I I Medical r-I U Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations I:\Building\Pemnits'ELC_PeunhiApp_ELR_ERE.doe Rev 06/1712015