Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2013 00262
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Date Issued: 10/22/2013
Parcel: 1 S 136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE#200
Project: Kronos Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Access control system.
Contractor: PRIME SYSTEMS LLC Owner: PNWP LLC#2
16869 SW 65TH AVE#387 PNWP LLC
LAKE OSWEGO,OR 97035 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-312-0901 PHONE.
FAX. _
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/22/2013 $75.00
12%State Surcharge-Electrical 10/22/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo' 0 Boiler Controls 0
CCTV 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
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. 1 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 may obtain a copy• direct questions to OUNC by calling 5987-,r 1.800 3 2344
Issued B Permittee Signature: I
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 503.839.4175 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 c5/ FOR OIFICE USi ONLY City of Tigard Date/B Jo ij 13 Permit No -u q Lie 13125 SW Hall Blvd,Tigard,O 01� Plan Review
C.:` Phone: 503.718.2439 Fax. 5033 1% 60 q.% Date/By Other Permit 6.1 P I _W i g(
T I ci A R u Inspection Line: 503.639.4175 OC' Cl0 Date Ready/By Juts ® See Page 2 for
Internet- www tigard-or gov N\�� ey Notified/Method Supplemental Information
TYPE OF WOK\%�!�-��`t, PLAN REVIEW
❑New construction v ��� Please check all that apply(submit 2 sets of plans w/items checked below)
❑Addition/alterati .1 (lhe'.
V6i ❑Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards
CATEGORY OF'CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system
❑Addition of new motor load of ❑"A","E","I-2","I-3",
Job no.: Job site address: i i 85C� Stj: Co/T 1t Six or or more residential Recreational V� ID or more residential units ❑Recreational vehicle parks
City/State/ZIP: 11 G fl-fzp t2) ❑Health-care facilities ❑Supply voltage for more than
❑Hazardous locations 600 volts nominal
Suite/bldg./apt.no.: ti-jJ1 Project name: K 126)4 t5 ❑Service or feeder 600 amps or more
"'�� FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 168 54 4
Ea.add'l 500 sq ft or portion 33 92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq II) 75 00 2
Limited energy,multi-family
OKIO R CL-0---35 residential(with above sq ft) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100 70 2
201 amps to 400 amps 133 56 2
Name: 401 amps to 600 amps 200 34 2
Address: 601 amps to 1,000 amps 301 04 2
Over 1,000 amps or volts 552 26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
_ 200 amps or less 59 36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168 54 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
❑ APPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with
above service or feeder fee, 7 42 2
Business name: each branch circuit .
B Fee for branch circuits without
Contact name: service or feeder fee,first 56 18 2
branch circuit
Address: Each add'l branch circuit 7 42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67 84 2
Phone:( ) Fax: :( ) dwelling,service and/or feeder
Reconnect only 67 84 2
E-mail: 0 rel/--b4� e Pump or irrigation circle 67.84 2
J CONTRACTOR . Sign or outline lighting 67.84 2
Business name: 1242'9 ,S/ G� Signal circuit(s)or limited energy See
panel,alteration,or extension ( Page 2 2
Address: X6869 514) 66--i--,,14*—..3g'7 Each additional inspection over allowable in any of the above
p Additional inspection(I hr mm) 66 25/hr
City/State/ZIP: 1,114e OS 1.L- _ O� /70 35 Investigation(I hr min) 66.25/hr
Phone:(5-03) 2_—0/0/ Fax:( ) Industrial plant(l hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.:/q(6 9 Electrical Lie.:ae
' C! Suprv.Lie.: 3674/ 9 specifcally listed(%2 hr mm)
Suprv.Electrician F?g41,r eq uired: t g• di ?My /opy ELECTRICAL CAL PERMIT FEES ES
/ Subtotal.
Print name: j �c..9-
Date:/O— -2_„2 Plan review(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
1\Building\Permits\ELC_PermitApp_ELR_ERE doc Rev 05/21/2013 440-4615T(t I/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 Fee I Total I •_
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5 01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15 01 to 25 kva 200.34 2
ElAlarm Wind generation systems in excess of 25 kva:
25 01 to 50 kva 301 04 2
❑ Garage Door Opener* 50 01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
El Heating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7 42 3
❑ 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
charged at an hourly(1 hr min) 66.25/hr -
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
ElAudio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
El Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
❑ Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1\Building\Permits\ELC_PermitApp_ELR_ERE doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-10-29 00:00:00
ELR2013-00262
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
135 Low voltage
2013-10-29 00:00:00
ELR2013-00262
PASS
Violation Summary:
Inspector Contractor