Permit (24) 441CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'> COMMUNITY DEVELOPMENT Permit#: ELR2019-00106
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2019
T +, Ft• Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 250
Project: Good Life Company Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Limited energy for fire alarm.
Contractor: PROTEK SYSTEMS Owner: G&S FC LLC
305 SE CHAKLOV DR SUITE 111 #361 16083 SW UPPER BOONES FERRY RD,
VANCOUVER,WA 98683 STE
TIGARD, OR 97224
PHONE: 360-314-2017 PHONE: 503-684-6000
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/05/2019 $75.00
12%State Surcharge-Electrical 06/05/2019 $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 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 OAR 52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19967 or 1.800.332.2344.
Issued By: ` '� .> Permittee Signature: C 42.r-A
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 Applicatio : r%Icn FOR OFFICE ISE ONLY
City of Tigard Received C=
1114
• 13125 SW Hall Blvd.,Tigard,OR 97223 I N - t. 4 q Date/13 : U- 5\1 A •
(J �y f Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: -`eZ C\. ( (j
T t G A RD Inspection Line: 503.639.4175 ( 1-f ' ()t-. 1:(17) Ready Date/By: Juris H See Page 2 for
Internet: www.tigard-or.gov ail i F(G DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
0 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.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fireum .
p p El Installation of 150 KVA or
JOB SITE INFORMATION"AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 16083 SW Upper Boones Ferry Road 10OHP or more. ❑°`A",°E °°l-z",°`l-s",
City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. occupancy.
El Health-care facilities. 0 Recreational vehicle parks.
❑Supply voltage for more than
❑Hazardous locations.
Suite/bldg./apt.#:250 Project name: The Good Life 600 volts nominal.
❑Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: 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
Relocate fire alarm notification devices Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
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:( ) 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
: APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: PROTEK SYSTEMS, LLC above service or feeder fee, 7 42 2
each branch circuit
Contact name: Adam Sweet B.Fee for branch circuits without
service or feeder fee,first
Address: 305 SE Chkalove Drive Suite 111 #361 branch circuit 56.18 2
City/State/ZIP: Vancouver,WA 98683 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 360 ) 314-2017 Fax: :( 360 ) 314-2017 Each manufactured or modular 67.84 2
Email: admin@protek.systems
dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: PROTEK SYSTEMS, LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 305 SE Chkalov Drive Suite 111 #361 panel,alteration,or extension. 0 See Page 2 1 2
City/State/ZIP: Vancouver,WA 98683 Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
Phone:( 360 ) 314-2017 Fax:( 360 ) 314-2017 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: admin@protek.systemS Inspections for which no fee is
CCB Lic.: 216574 Electrical Lic.: CLE495 Suprv.Lic.:3505LEA
specifically listed(%3 hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: CN+".. ,,$_ Subtotal:
Print name: Adam Sweet Date:6-5-19 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ^,� ,2.4..".32-AXTOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Adam Swept nate• 6-5-19 day'after it hao hPPn arrepted no rn.npl.t.
— * Number of inspections allowed per permit.
I:Building\Permits\ELC_PermitApp_ELRERE.doe Rev 06/17/2015 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 SCHEDULE
Fee for all residential systems combined: $75.00 Description I Qty. I Each I Total I
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:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
ri G• arage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
n Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n 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(V2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
3 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
1 Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16083 SW UPPER BOONES FERRY RD 250,
TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2019-00106
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor