Permit (2) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
114
COMMUNITY DEVELOPMENT Permit#: ELR2020-00028
T i G A R u 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02l20l2020
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 160
Project: Ameriprise Financial Subdivision: 1996-048 PARTITION PLAT Lot: 2
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 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/20/2020 $75.00
12%State Surcharge-Electrical 02/20/2020 $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 952-001-0090. You ay obtain a py of e rules or direct questions to OUNC by calling 503.22.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 5r-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 Application colt OFF 1' 15I elyI.ti
City of Tigard Received
Dat11{/3y: A /y/ems A'f . '142 010-00- -
IN ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ��
Phone: 503.718.2439 Fax: 503.598.1960 Datetly: -!i ;.c•t
Inspection Line: 503.639.4175 Ready Date/By: ® See Page 2
I I G A I`L) 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):
❑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.
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 ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 RVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
AddJob#: Job site address:6650 SW Redwood Lane ❑I0OHP0HP o of new motor load of system.
or more. ❑"A","E•, "1-2""1-3"
City/State/ZIP:Portland,OR 97224 ❑Six or more residential units. occupancy.
, ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldgJapt#:160 Project name:Ameriprise Financial 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Bath I Tslal I •
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 I
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Fire Alarm (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
❑ PROPERTY OWNER l ® TENANT Renewable Energy El See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Ameriprise Financial 200 amps or less 100.70 2
Address:6650 SW Redwood Lane Suite 190 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,OR 97224 601 amps to 1,000 amps 301.04 2
Over 1,000or volts 552.26 2
Phone:( ) Fax:( ) amps
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 I lir ❑ CONTACT PERSON Branch circuits—new,alteratio or extension, •er panel
A.Fee for branch circuits with
Business name:Point Monitor Corp. above service or feeder fee, 7.42 2
each branch circuit
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 ranch circuit or feeds fee fire
b 56.18 2
branch
City/StateJZIP:Lake Oswego,OR 97035 Each add'I branch circuit 7.42 _ 2
Miscellaneous(service or feeder not included)
Phone:(503)627-0100 Fax::( ) Each manufactured or modular 67 84 2
dwelling,service and/or feeder {
Email: Reconnect 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 panel,`treason or extension.
® See Page 2 1 2
panel,alleratioM or extension.
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/br
Phone:(503)627-0100 Fax:( ) Investigation(1 hr min) 90.00/hr i
Email:bwilliams@polntmOIIkOY.COm •
Industrial plant(I hrmin) 78.18/hr _____
Inspections for which no fee is
CCB Lic.: 135901 Electrical Lic.: 34508CLE Suprv.Lic.: 4460LEA specifically listed(/hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: • Subtotal:
Print name: Ben Breit Date: 2/17/2020 0 Plan Review Required(25%of permit fee):
/ Slate surcharge(12%of permit fee):
y
•
Authorized signature:
TOTAL PERMIT FEE:
vw , This permit applietttioa expires If a permit ie dot obedeed wIthin 180 `
Print name: Ben Breit . Date: 2/17/2020 days after it has been accepted as complete:
* Number of inspections allowed per permit.
1:`auildina Permits ELC_PemisApp ELR_ERE,doc Kee 061"2015 4404615T(11105srOM•WEB
Elactrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
DcrFee for all residential systems combined: $75.00 Rennewa eewa o E,ea Yam .
ble electrical energy systemm s:
Check Type of Work Involved: s kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio 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
n Garage Door Opener* 50.01 to 100 kva 552.26 2
-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:
❑ Other: Each additional inspection is 66.25/hr 1
charged al an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed 04 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): 1
(SEE OAR 918-309-0000) ` Number of inspections allowed per permit
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
n Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
n Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
1.Budding Pem.in'.ELC_PennitApp ELR ERE.dec Rnv 06 1-2015