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Permit q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 1111 2 : COMMUNITY DEVELOPMENT Permit#: ELR2015-00121 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/05/2015 Parcel: 2S112DD01400 Jurisdiction: Tigard Site address: 15686 SW SEQUOIA PKWY Project: Courtyard by Marriott Subdivision: PACIFIC CORPORATE CENTER Lot: 5 Project Description: Low voltage for fire alarm Contractor: WESTERN STATES FIRE PROTECTION Owner: PACIFIC REALTY ASSOCIATES LP 13896 FIR ST STE B PO BOX 58990 OREGON CITY, OR 97045 SEATTLE,WA 98138 PHONE: 503-657-5155 PHONE: FAX: 503-657-5182 FEES Description Date Amount Specifics:, Restricted Energy Permit 05/05/2015 $75.00 12%State Surcharge-Electrical 05/05/2015 $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: 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: 0 Total $84.00 Other Desc: Required Items and Reports(Conditions) This per issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be a in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 d s. ATTENTION: Oregon law re 'es ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 52-001-0010 throw h OAR 952-001- 90. Yotl '-y•btain a copy of the rules or direct questions to OUNC by calling•t�f1` 87 or 1 32.2344. � V C Issued By: _ d�/ Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Applicat- FOR OFFICE USE ONLY City o 1 1 and C E i V E C� Received Permit rr [ J C I 11111 t3' f g Date/B : r 5 L�� --• 13125 SW Hall Blvd.,Tigard,OR 97223 5 Plan Review Phone: 503.718.2439 Fax: 503.598. Ij�Y el 2015 Date/By: Related Permit#: T I G A R D Inspection Line: 503.639.4175 Ready Date/By: turfs: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information ❑New construction Addition/alteration/replacement Please check all that apply(submit j sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑Floating buildings. 1-and 2-family dwelling less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ y g ($�Commercial/industrial El building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or ❑Emergency system. larger separately derived r ` O, � ❑Addition 0H of new motor load of system. Job#: Job site address: �-� A� tooHP or more. ❑"A","E","t-r',°t-3", City/State/ZIP::—I^ V� ❑Six or more residential units. occupancy. l 4:77 Z2 ❑Recreational vehicle parks. 4 l ❑Health-care facilities. P Suite/bldg./apt.#: I Project name:GVp�-�/ ,'/ P44?—e.11511— ❑Hazardous locations. ❑Supply voltage for more than "" 7 ` 0 Service or feeder 600 amps or more 600 volts nominal. Cross street/directions to job site: ,`") C4 ,>.... A:)#z. ', ._» i Description Qty. Each Total • New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 O Tax map/parcel 4: cZ Ea.add'I 500 sq.ft.or portion 33.92 1 V Limited energy,residential 75.00 2 U VlR�— S tyE){ (we h ne ge, lti Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 • s .' 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 �pp 401 amps to 600 amps 200.34 2 ., City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) I 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 Branch circuits—new,alteration,or extension, r panel - A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 tJg ', t each Contact name: ���� — B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) I Fax: :( ) Each manufactured or modular 67.84 2 \a Ve l _Ale _ Q uS-' , 05 dwelling,service and/or feeder Email: C �(C C Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 Business name: 1 jG-4.A-01 (—tom Pte- l-kotJ Sign or outline lighting 67.84 2 l3 Signal circuit(s)or limited energy ❑ See Page 2 7( 2 Address: Co l2 �� panel,alteration,or extension. g City/State/ZIP: ©� CA-7 Or__ 9 7OLLS Each additional inspection over allowable in any of the above l Additional inspection(1 hr min) 66.25/hr Phone:(2)) (051 .51Sc Fax:(503.)6S-7 . S 1(9 2 Investigation(1 hr min) 66.25/hr Email: rife,\((? elc- L"' tosfp• v5 toll I( 1 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lie.:k 6 5 7 0 Electrical Lie.:('L 4 C B Suprv.Lic.:31)La s ificall listed Vs hr min �'�/hr Suprv.Electrician signature,required: Subtotal: "7, Print name: N1/40 kE � Date:S J CS ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): W-- �4 CO 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. I:t BuildinglPermitslELC_Pern itApp_ELR_ERE.doc Rev 04/21/2014 440.46151(11/05/COM/WEB