Permit (2) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2020-00030
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2020
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST
Project: Atrium West 4th floor common area Subdivision: ASHBROOK FARM Lot: 5
Project Description: Limited energy for fire alarm.
Contractor: POINT MONITOR CORPORATION Owner: PLAZA WEST OWNER LLC
5863 LAKEVIEW BLVD STE 100 BY CHIEF FINANCIAL OFFICER
LAKE OSWEGO, OR 97035 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
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 OA -001 90. Y u may obtain cop of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: `y%l Permittee Signature: /r A /(eGe 5 /
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 Applicatipn FUR OFFICE L SE OM 1,
AIIIMP
Cl25rSW Hall Bl of AvdaTigard,OR 97223 Received
jievi�ew _— —'_A _ ,• „v /
j• gin
Phan: 503.718.2439 Fax: 503.598.i960 Ha - •►glens '.J .
Inspection Line: 503.639.4175 Ready DeteMy: Ruin: Hi See Page 2 for
1 1 i'"'t.1) 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):
['Demolition El Other: 0 Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas end boatyards.
. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Addf
Job#: Job site address:9600 SW Oak St. 0 I0OHP 0HP o moew motor load of system.
or more. ❑"A""E" "I-2""I-3"
City/State/ZIP:Tigard,OR 97223 ❑six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:4th Floe Project name:Atrium West 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 1 Qtr. I Each I Total l •'
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.it.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 75.00 2
Fire Alarm (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER ® TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Atrium West 4'Floor Common Areas 200 amps or less 100.70 2
Address:9600 SW Oak St.41b Floor 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 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 j
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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 smite 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 be ranch
or feeder f e first 56.18 2
bch circuit
City/State/ZIP: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 67.64 2
Email:bwilliams®pointmonitor.com dwelling service and/or feeder
CONTRACTOR aal connect only 67.84 2
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 Stgmlalter tionor limited-energy El See Page 2 1 2
panel,alteration,or extension.
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any oldie above
• Additional inspection(I hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(I In min) . 90.00/hr -
Industrial plant(I hr min) 78.18/hr
Email:bwilliams®pointmonitor.com
Inspections fur which no fee is
CCB Lic.: 135901 Electrical Lic.: 34508CLE Suprv.Lic.: 4460LEA specifically listed(n hi min) 90.00:hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name: Ben Breit 1 . Date: 2/17/2020 0 Plan Review Required(25%of pe mit fee):
State surcharge(12%of permit fee): _
Authorized signature: I` }_ TOTAL PERMIT FEE:
_ Tab permit application expires If a permit Is not obtained within 18g
Print name: Ben Breit Date: 2/17P2020 days after it has been accepted as complete. i
* Number of inspections allowed per permit I
1:Building s e mip'ELC_PermitApp_ELR,ERE.doe Rev 06 1"2015 44P46157t1 P05,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
lerl *
Fee for all residential systems combined: $75.00 Rene y Q I Roth I Total I
Renewable electrical energy systems:
Check Type of Work Involved: s kva or leas 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
❑ Ur laT Alarm Wind generation systems In excess of 25 kva:
B
g 25.01 to 50 Ina 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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 a. of the above:
❑ Other: Each additional inspection is 6625/hr
charged at an hourly(I br min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT FEES
i
Fee for each commercial system: $75.00 • Number of Inspections allowed per permit Subtotal(Enter on Pa )
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
El 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.nuildiog'Powitt,ELC_PemitApp ELR_ERE.doc Rev 06'I"2015