Permit (16) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
rrt, COMMUNITY DEVELOPMENT Permit#: ELR2016-00057
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2016
T[GA�tL1 Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7236 SW DURHAM RD 600
Project: Lake Oswego PD Storage Subdivision: None Lot: None
Project Description: Low voltage for security&cameras
Contractor: SECURITY FIRST ALARM LLC Owner: PACIFIC REALITY ASSOCIATES LP
515 NW SALTZMAN RD#825 ATTN: N PIVEN
PORTLAND, OR 97229 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-296-9100 PHONE:
FAX: 503-672-7751
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/16/2016 $75.00
12%State Surcharge-Electrical 03/16/2016 $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: 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 $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 issuanc- or if work is suspended for more the 180
days. AT ION: Orego law requires you to follow the rules adopted by the Oregon Utility Notification C nt- Those rules are set forth in OAR
952-00 0010 through OAR 952-•0 :.•.. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2•87 0 .800.332.2344.
I sued By: / /109/ 40,
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 Applicalt`jcE i v�'°/ OK h (,FFI( t: I. Sl: OSI.\
III Received �" �y
City of Tigard Date/B � Permit#: ��v�/tp_coo rJ
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie
Phone: 503.718.2439 Fax: 503.5 A i01 6 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: orris: ® See Page 2 for
I I t \I:D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
❑ 1 C, ° p a StPl PLAN REVIEW
New construction dtt /re aC;e t Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
s,`Y OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El ,�1-and 2-family dwelling .�mmercial/industrial ❑ less to round,or exceeds 14.000 0 Commercial-use agricultural
Accessory building g
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
S. 0 Addition moew motor load of system.
Job#: I b site address: �� W C\`\ � ❑"A"."E","I-2","1-3",
100HP or more.
�� (� �j ‘\ :,y / ❑Six or more residential units. occupancy.
City/State/ZIP: v \ `I*%( 5x, ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I/Project name: 10.. ❑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 I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'I 500
sq ft.or portion _3
3.9_ I
DESCRIPTION OF WORK Limited energy,residential 75.00
1^V
(` ���M� 5 (with above sq. lti
h"�V , Cp` `,\ Limited energy,multi-family 75.00 2
residential(with above sq.6.)
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER I ❑ TENANT • Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:
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 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
T PERSON Branch circuits—new,alteration,or extension,per panel
0 APPLICANT 0 CONTA
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7'42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add.'branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: ( ) I Fax: :( ) Each manufactured or modular
67.84 2
Email: dwelling,service and/or feeder
Reconnect only 67.84 2
^�CONTRACTTRR Pump or irrigation circle 67.84
Business name: . l��``\ `�� Sign or outline lighting 67.84 2
`�` \ `� Signal circuit(s)or limited-energy' 2
Address: 1~i� ❑ See Page 2 _
panel,alteration,or extension. 75-. C)
City/State/ZIP: Y 4 Each additional inspection over allowable in any of the above
j���' Additional inspection(I hr min) 66.25/hr
Phon t3 ) t-A!.."..,
...i C� // Fa �� _27 , .1 Investigation(I hr min) 90.00/hr
• ,` �'(\ Industrial plant(I hr min) 78.18/hr
Email: � � �V`� � `t �\
Inspections for which no tee is 90.00/hr
CCB Lic.: ��5�(� `7 Electrical Lic.' Su rv. specifically listed(1 hr min)
`"� I ���p �� ELECTRICAL PERMIT FEES
Suprv. Electrician signature,re ire : --•••••...... .... Subtotal: ?��
Print mine s S�� Dat.. ...j / 0 Plan Review Required(25%of permit fee):
���VVV 7State surcharge(I2%of permit fee): 9.47o
TOTAL PERMIT FEE: 00
Authorized sign y
'> J This permit application expires if a permit is not obtained within 180
Print name: I Date�'�IL (�, days atter it has been accepted as complete.
L� * Number of inspections allowed per permit.
1:Building Permits FLC_Perma App_ELR ERE.doe Rec 06 17 2015 440-4615T(1 105 COM WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RE'1 *OAK ONLY: ;. FEE SCHEDULEy
Description I Qty. I Each I Total r
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 ha 301.04
50.01 to 100 kva 552.26 2
n Garage Door Opener*
>100 kva(fee in accordance 552.26 2
with OAR 915-309-0040)
n 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 any of the above:
n Other: Each additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I Building Permits ELC PermitApp ELR ERE.doc Res 06 17 2015