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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT Ill 1s: COMMUNITY DEVELOPMENT Permit#: ELR2013 00295 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2013 Parcel: 1 S135DD01800 Jurisdiction: TIGARD Site address: 11565 SW HALL BLVD 180 Project: Bella Institute Subdivision: METZGER ACRE TRACTS Lot: 32 Project Description: Installing(3)low voltage systems: Data telecommunications,audio,and security systems. Contractor: POINT MONITOR CORP Owner: BKB PROPERTIES LLC 5863 LAKEVIEW BLVD STE 100 11255 SW DAVIES RD,APT 1014 LAKE OSWEGO, OR 97035 BEAVERTON, OR 97007 PHONE: 503-627-0100 PHONE: FAX: 503-627-0110 FEES Description Date Amount Specifics: Restricted Energy Permit 11/18/2013 $225.00 12%State Surcharge-Electrical 11/18/2013 $27.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 3 Audio&Stereo: 1 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 1 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: 1 Other: 0 Total $252.00 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 co of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By. r— Permiftee Signature: , rC�,?l� ___ 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. 11/18/2013 11:34 503527011j10 POINT MONITOR CORPOR PAGE 02 RECEIVEE i 1,1,-.)R i>I 1 1(:R USE ONLY Permit Application ..... Received Permit No.: i ,, -. 0 ,2/5—S City of Tigkird V 1 2013 Date/I3 : .>.i 13125 SW Hall Blvd.,Tigard,OR 3 Plan Review Other Permit: 0 Phone: 503.71$2439 Fax: 503.598.1960 pate/B See Page 2 for CITY OF TIGARD Date Ready/By: Supplement"1 See Page 2 Information.I I .;API, inspection Line: 503,639.4175 Not Read ethod' Internet: www.tigard-or.gov ryrtnNt m ai nntt r 1+ �1�j' ;film , 1 ijiti•L Y ,,I,.:'�1? 5' 47''P P i•rlJ i�r,1 ,r}�t}lf t ig '4 ilrtyd!Ir(1'I.Iig titp��ry'in'u9',lI'IJ Ii J]rryJI�I1 1rIr1 f t g1 f[f�((�1�I.��n lie10 1' 1 rif l I��ilr�l }l(tlli]!i{f''l11i116'lilf�'ININ -f. ..'...- : t �l l: I i ll P 1 '' 1 ill ri 1} G tla/k Billy"'"I"1 l /:i'11, .'IIP f1U1C1!Iwi .��tlV l:�4 �r' Ht04444,,hlwi40:i;i4,11 ll.d.i IIJ.i.I r r 1 LI1 -;ty it''il,„ i >„ ,f+1f 8 Pleas¢check all that apply(submit?sets of plans w/itemn checked below). F, �!i-;:�,�' a.d °rrt%•r,?t"✓<'^"�•.`rL�rilir l(rnT:7tjllrti x-1iI;MnGK,rr.�r i�il!�i,t.IJlcrl�y+llaf.'t..•.Ji 0 New construction ❑Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories. 0 ❑Other: where the available fault current ❑Marinas and boatyards. ii; Demolition nl ran„,+7�ty a n r r lr7{��lr �(+ �rtf( "r II�(�r exceeds 10,000 amps at 150 volts or ❑Floating buildings. li•. ,v 5'r.1,1•i:rpinr:t'g;l 477:rr>;Fi Im1otF�11lira�f n�1i �:;.;� Irlmj � 1 if(l l j'IltiN1Y'll Nt� IHk1�'Irl J1k{i�, g onunerciat-uses ricultura) I_ a ii a inner.,7c,,:,'1i 'I'.'•1+J:H,tIY a.11thhia•A;/+,ttr;z1 1.,1:kr 11thtuA t,fIcL7M,",("1/!1 r+ : r,rl. r' • •I i i' less so round,or exceeds 14.000 ❑�: g ❑ 1-and 2-family dwelling El Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Fire pump. ❑Installation of 150 KVA or Multi-family ❑Master builder 0 Other: larger separately derived system. �}� `', , , ❑Fir Emergency system. ❑ a'.', /154( 7g1Id f r 1 I:' I�� tr J�1l vJ xal f14fi�i'lpl r ilifP�r•,.Nn pfirtm.t�,rp/,ji tET„il:., f tl t j dl ijJ'i ..E., ..1 2„ ,.1.3,. ilY.;a t '. .1 r•I�,, t a i 1 t1:r 1� ( 141 r(.Ti r1rrJl4l:;',! J1�'i rJ t C Ju+;r d�1LR,'J Ni l4,lrl..1' ❑Addition of new motor load of ❑-A”, `•" •. 1111'!' iFJlr,Jr1:�:A!far171,i,: id,r l7nfo?itil(hll.r �a1 i'm.,. occupancy. 100HP or mare, Job site address: 11565 SW Hall Blvd. ❑Recreational vehicle parks. Job no.: ❑Six or more residential units. ❑Health-care facilities. fl supply voltage for more than City/State/Z1P:Tigard,OR.97223 ❑Hazardous locations 600 volts nominal, ❑Service or feeder 600 amps or mom Suitebldg/apt.no.: I Project name:Bella Institute '4411pNNfigniN a , Z n,EmI n t 0RudT Qty. Fee. Total Si Cross street/directions to job Site: Deter New residential single-or multi-family dwelling unit. includes attached garage. 1,000 sq.ii.or less 168.54 4 Lot no.: 33.92 4 Subdivision: Ea.add'/500 sq.R.or portion MI Tax map/parcel no.: Limited energy,residential 75.00 -.r,.r t^iic' �;'3c 4 .',g 1 (��+`>��'T,,: aitnerJ,grm1'f'71reem_"4' '{ �il,' �t ��ttlij I , (with above s•.ft.) li i-i :::5ir. T> y r ri r :J I'3 f1'11fil tnitn r,i I, Limited energy,multi-family fiJ . # ,I y�y� y�75w.�U0 Teledata,Audio Security "',ru n.rsty nhtiiii m,Nil 1,rulnll ll li7YUa:r; u. ?tla. residential lwitlVhabove t`s..ft. :::ltli"!!Plw r'�' e� Audio, Y . . pnnrrr,7i a1 / I Services or feeders Installation,alteration,and/or relocation J 200 amps or less 1 1 100.70 2 ..: ,r w7,,7r nw:rrclktti' 171 1 ' 1 11 d J+ 1 rl ,16!fl.t n --I 1 "111!1 2 �,�;� �,r,� yam, f , :1..,t z I Yial t r s :" t c ,1, .,91 11.,11 J.../i1,4ifiH 1i 1�t „a llrilr.rta..m11 if 1'?t,• Iffi,m I•. 201 amps to 400 amps a,,;:e;:�I-Bella��(r titut.G�4,dr�s,iva .,_ 133 56 Name:Bll institute W 401 amps to 600 amps 200.34 2 _G01 amps to 1,000 amps 301.04 2 Address: !15b5 SW Hall Blvd. Over 1,000 amps or volts 552,26 2 City/State/ZiP:Tigard,OR 97223 Temporary services or feeders installation,alteration,and/or - relocation Phone:( ) Fax:( ) 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,•er panel Sf 1-� n,d�lrn p /l f' � i} i�ik z" �1 i s a j t '• h �7 nJ :w,aS d r . A.Fee for branch circuits with :1 ..."44-4434 n ,r..i.E....., . j 11/18/2013 11:34 5036270110 POINT MONITOR CORPOR PAGE 03 Electrical Permit Application—City of Tigard Page 2—Sapptement'al.Wofmation Limited Energy Permit Fees: Renewable Energy Permit Fees: �,/ /� lil �,II�I'I.1. I µ'{l��II.1 I' } 1'ilk, 411RT+. h, 1 1 � 1�I�I rJ 1 - 1•rlljj iiM:I•I' I ,1, l'i 1 ,, {� Ali f�( I:, ,4"1,, f� l�l'Il.l., t�;�.lE5.7 If, 7111SiI�>v. v I i ail,�,�� I y1 rl '�,�r,�yQ.�°I. a iyi ;l I I':i ,t� �I' .1IL,l!�ll l Ali � ° � iu ..,„m°n�'»,r 1l ,N.,�.:,UEF..LkNn._.,y eI...,, o u 1 ��.tan Igi>� Fee for all residential systems combined $75.00 Renewable electrical energy systems: 5 kva or less 100.70 Check Type of Work Involved: 5.01 to 15 kva 133.56 ❑ Audio and Stereo Systems* 15.01 to 25 kva - 200.34 © WInd generation systems In excess of 25 kva: ❑ Burglar Alarm 301.04 2 25.01 to 50 kva 50.01 to 100 kve 552.26 2 ❑ Garage Door Opener* >100 kva(fce in accordance with 552.26 2 OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 Ell 7.42 MIN© ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional Inspection over allowable in an of the ebove:II Other: ❑ Each additional inspection is II 66.25/hr charted at an hourly(1 hr mm) Inspections for which no fee is ill 90 00I hr''`S 1{t1 1 „ lei Ir i II . .,i 91iY cif-mall ter/ihrn11 ?f'� I Gtlil 1l�C N7Hf1!► ,It. 11 1 r., I1 {I{I j{Cl!I l lANNS u....►J.w.wJ+1 ,,,,�II.4_.,.�:.13ufGy...- Il listed It ii3�If 1�,�$i °.? i.;. �r � i i {i��'.B_,i�Y t I' ,1 I>!'�,� I' •l'' I�'u 1# ,t 11 �•.: 1'.. � �„�,., 1 . ,1 I . .. Subtotal: 225.00 Fee for each commercial system $75.00 Plan review,if requited(25%of permit fee): (SEE OAR 9l 8-309-0000) State surcharge(12%of permit fee): 27.00 Check Type of Work Involved: TOTAL PERMIT FEE: 252.00 This permit application expires if a permit is not obtained within l eo Fldays after It has been accepted as complete. Audio and Stereo Systems • Number of inspections allowed per permit, ❑ Boiler Controls ❑ Clock Systems ® Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC Fl Instrumentation ❑ Intercom.and Paging Systems ❑ Landscape Irrigation Control* . ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ® Other Security Total number of commercial systems: 3 *No licenses are required. Licenses are required for all other installations I:1AUilaing`.PermlisTI,C_PmnitApp et.R ERE.doe Rev 05!21/2013 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 11565 SW HALL BLVD 180, TIGARD, OR, 97223 Commercial - Electricial Limited Energy 199 Electrical final 2014-03-10 00:00:00 ELR2013-00295 PASS - No C of O Violation Summary: Inspector Contractor