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Permit (27) 1 p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ■ : COMMUNITY DEVELOPMENT Permit#: ELR2016 00023 T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/11/2016 Parcel: 1 S135BB00501 Jurisdiction: Tigard Site address: 10575 SW CASCADE AVE Project: Biamp Subdivision: OAKBURG Lot: 27 Project Description: Fire alarm system. Contractor: WESTERN STATES FIRE PROTECTION Owner: ICON OWNER POOL 3 WEST LLC 13896 FIR ST STE B BY INDCOR PROPERTIES OREGON CITY, OR 97045 2 NORTH RIVERSIDE PLAZA, STE 235 CHICAGO, IL 60606 PHONE: 503-657-5155 PHONE: FAX: 503-657-5182 FEES Description Date Amount Specifics: Restricted Energy Permit 02/11/2016 $75.00 12%State Surcharge-Electrical 02/11/2016 $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: 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 $84.00 Other Desc. Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other a licable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or ' w k is pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce hose/r es are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop of the rules or direct questions to OUNC by calling 503.23 : or .800.332 344. 40i Issued By: .... .......L _A Permittee Signature: 'k.---- OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 8'4V Electrical Permit Applicatio cYj1 ,FOR OFFICE USE ONLY City of aII Blvd., dd %\n Received _ ." 1 b 6- Permit x: ) (o-'CX. 3 Mill it 13125 SW Hall Blvd.,Tigard,OR 97223' � "� nn Review Phone: 503.718.2439 Fax: 503.598.1960 �� ,/g : Related Permit 9: ` ! °` -t ilio lnspectionLine: 503.639.4175 i/�► enle/B y: Jo El See age 2for xiJ43 T1GARU Internet: www.tigard-or,gov v,SN" 1 ` %)1Method: J,_ Supplemental Information ri g ,�« 3.� t i<'. o ^r'�rj Z' � Tie*�i�"." �y ���rt+ -�2fi �..^�� �#<� r y gy fd.4 l.2 .�° ata „7: t t RS �'ra + 'k�!'g,.,..+"'Y�_ '.`r,.. y'+ '.A.• dog fti�,�G 1: 11. 1 ,-, i';':: ""erg'$."`_. ❑New construction LQ'Addition/alteration/f AN, Please check ell that apply(submit guts of plans wltcros checked): ❑_ Demolition EI Othe Cl El or feeder 400 amps or more 0 Building over throe stories. r_•, r q where the available fault current Marinas cod boatyards. %' i ...•9f 6}se x f,,tdr •*'(iStip l 'MP" iAM,` ,} exceeds 10,000 amps nt 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling 2 Comrnereial/industrial ❑Accessory building lass to ground,or exceeds 14,000 0 Commercial-use agriculture] amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 installation of 150 KVA or ,Til x r, l:01b74 •',' 't14 '< y ._ WAWA J .'" S 0 Emergency system. larger separately derived ids r,_� Job#: 0 Addition of new motor land of system.IU �/ 0 5' Job site address: 1 p,.' SW CG ,C . s , 100HP or more. ❑"A" "E""1-2" "I-3", City/State/ZIP: �j ❑Six or more residential units. occupancy. TIGj�✓' lC� 7 3 Recreational vehicle arks. e! f 0 l L�Health-care facilities. ❑ P' Suite/bldg./apt.#: Project name: -ZF �� ❑Hazardous locations. 0 Supply voltage(or more than D 0 Service or feeder 600 amps or more, 600 volts nominal. Cross street/directions to job site: Mitw f + f'fs 4. •t :' „..,dpption IMMI Each Total " New residential single.or multi-femi y dwelling unit, Subdivision: Lot#; j Includes attached garage. •Tax map/parcel#. 1,000 sq.ft.or less 168.54 4 i _v a e x°« ,�., .r` y z s''_ty Ea add'1500 sq.ft.of portion 33.92 1 -VM .r.+il';3"zr, ,. ra"lair.1) Ss,C.st I '217:1 a, E �,Y/"tr'9 .�rrr"trti,1klAi Limited energy,residential , (with above S9.ft.) 75.00 - 2 Fire. 4(6lvM Sl /4 . Lia:itett energy,multi-family 75:00 2 residential(with above sg.ft.) rr.•, f +�,, Renewable) mer 'See Pa e 2 :.'„ c1,1 .i tri �s'f' .ti 1'S, -, �k.,1 :,+t ,w•' (,i.,rl'ijj' .' } ,' ct' a �'�__ ❑ ,,.sn .__ �.. r Services or feeders installation,alteration,and/or relocation Name: r _�4•,` .5451--e4,,,5 200 amps or less 100.70 2 Address: ,b t7 75 5("J 6,, cote j.°� 201 amps to 400 amps 133,56 2I 401 amps to 600 amps 200.34 City/State/ZIP: 1 Orrin a--� �a,��j 601 amps to 1,000 amps . 301.04 2 Phone:( ) t Fax:( )) + Over 1,005 amps or volts f 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 I 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps T 125.08 2 4.iir signature:_____ Date: 401 amps to 599 amps 168.54 2 7s,` _. p ,;4` t. , .. .,..,,,..„4,...--i7.,27,-,,„)0,4,4,::;4.4t3rancli circuits-new,alteration,or extension per panel i. ,s Q AI;I;l:, ,. yrAb.4 : air ,+.r.?a ..',14.1,:)*';''' • . :.,"1. .Z.,a:IA �I.g, A.1'co fur branch circuity with Business name: 1 i • I [ above service or feeder fee, _ a- •i.•r"� -61-f..-- //Z°?T�G I.C��� 7.42 2 j:��- each branch circuit Contact name: <,4,:j:-(- itfyry fa;,e/-°- E.Pee for branch circuits without Address: l'. .53_41 Ctit ^' 'y service or feeder fee,first 56.18 2 (7 r111^ 1, tl^ branch circuit City/State/ZIP: e r r',.1.-cf r �71Z e 70� �' Each adtt',branch circuit 7.42 2 d Miscellaneous(service or feeder nut included) Phone:(� - ) UI I'2 Fax: :( ) Bacli manufactured or modular 67.84 2 Email' �" l dwelling,service and/or feeder X' i,„ „1. i �a !`'p_ _Recunucct only 67.84 2. . ,# i9 e*»,. 1t'7,f �lTOR .h r rr' Po ,,ys, i ' Pump or irrigation circle r---- 67.84 2 Business name: �J t � t� -7•{Yn11• ft 9+n ?___ Sign or aurum)lighting 67.84 2 Signal circuitcs)or limited-energy ` Address: panel,cheration,or extension. 0 See Page 2 7J 2 City/State/ZCP: Each additional inspection over allowable in any of the above Additional inspcclion(1 hr min) 66.25/hr Phone:6-03) 6c-1.- 51.5' Fax: ( ) Investigation(1 hr min) 90.00/hr - Email: Industrial plant(I hr min) 78.18/hr Inspection for which no fee iv 90.00/hr CCB Lic.: I0115Electrical Lie,:G�. . i o 6 Suprv.Lic,:yy 1, ns ecil call 1,!i 1V�h hr min) :0%0' a, 131y ?/4CAl'eAl.R �'TE>✓ e 51In x0/4 = Suprv, Electrician signature,required. Suhwtal: 75° - Print name:5,,,,- 1.\) ,,,„.C,,,,A,,u (L_ Date: „--I 1 - A(0 0 Plan Review Required(25%of permit fee): ....----"^ State surcharge(12%of permit fee): 9.°() Authorized signatureTOTAL PERMIT FEE: ,pv - This penult application expires ire permit is not obtained within ISO Print name:S c , ‘10..p, ),0‘ts{l____ Date: t\- gOtc days after It brit been accepted as eumptule. " Number of inspections allowed per permit. i.VluikJingtPermitsuELC:_I'ermitApp_ELR_ERO.duc Coo 06!17/2015 440.4615ThI t/113/CUWWStl . Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: L-C.1 s°5`0-i l 1,, 1�� {a�'t` � r k '3' - �;t�s-�.fi t . b,r Fee for all residential systems combined: $75.00 t ■■0ii11■0 yRenewable electrical energy systems: Check Type of Work Involved: 5 kva or less 1111 100.70 �© 5.01 to 15 kva 1111 133.56 �© ❑ Audio and Stereo Systems* 15.01 to 25 kva 1111 200.34 Wind l eneration s stems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 _© 50.01 to 100 kva 11111 552.26 �© ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 �© ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 1.1 7.42 _© ❑ Vacuum Systems* >100 kva-no additional charge - 0.0 _© Each additional ins.•ction over allowable in an of the above: ❑ Other: Each additional inspection is1111 66.25/hr —� char•ed at an hourl (1 hr min) Isnspecectficall tions for fisted(whichhr numinfee is 0.0 ■ 90/hr —� /i ) Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):* Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ pata Telecommunication Installation Ell Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Euilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015