Permit (16) ELECTRICAL RESTRICTED ENERGY PERMIT
74CITY OF TIGARD
2 ''' COMMUNITY DEVELOPMENT Permit#: ELR2016-00218
Date Issued: 08/31/2016
T E4 ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16290 SW UPPER BOONES FERRY RD
Project: Oregon State Treasury Subdivision: None Lot: None
Project Description: Low voltage for audio/stereo wiring
Contractor: COMPVIEW Owner: PACIFIC REALTY ASSOCIATES LP
10035 SW ARCTIC DRIVE ATTN: N PIVEN
BEAVERTON, OR 97009 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 800-448-8439 PHONE:
FAX: 503-601-5575
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/31/2016 $75.00
12%State Surcharge-Electrical 08/31/2016 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 1 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 permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all •4-r applic-•le 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 ice••rk is su ':ended for more the 180
days. ATTEk o .egon law requires you to follow the rules adopted by the Oregon Utility Notification Cente Those r -s are set forth in OAR
952-001-0%10 through OA' 95 •• -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 =7•r 1.800.3 .2344.
Issue', By: /1 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 Application FOR OFFICE USE ONLY
City of Tigard r it•' :' ,,fit i A,, Received f'� Permit#:E� /�_��a1 Q
a 13125 SW Hall Blvd.,Tigard OR 97223 Date B c�
1114
= Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/B Related Permit#:
Inspection Line: 503.639.4175 .1111 t.rv,
AUG1 I h ReadyDate/By: Juris:
TIGARD wV� 3 y SeePage2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF Oik .,, 1 ': ) PLAN REVIEw
New r '1N,
❑ ®Add1t10n/�t>�II3t�0����1��P�11�i�I 9 Please check all that apply(submit 2 sets of plans w/items checked):
0 New constructionri
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Other: where the available fault current
❑Marinas and boatyards.
CATEGORY OF ,CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#:PD5824 Job site address: 16290 SW Upper Boones Ferry Rd El Addon of new motor load of system.
or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Boardroom AV ❑Hazardous locations. 0 Supply voltage for more than
❑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: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Audio visual installation (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER ®TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: afe oittL" �/`�eQ5�r 200 amps or less 100.70 2
Address: 16 I 5 4/ C v II� /��4'�C'` ,Qj/ 201 amps to 600 amps 133.56 2
17 V19.4/0( po� {i 9 7,a F,�/�/� �"� 401 amps to 1,600 amps 200.34 2
Phonetate/ZIP: < 601 amps to 1,000 amps 301.04 2
Phone:(s0? 3 -5 5.--‘Z Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary
T-1-141• 5'et,I/e/ a Si. 5,4,11 0g • v S Temporary services or feeders installation,alteration,and/or
Trelocation
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
APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,Per panel
A.Fee for branch circuits with
Business name:Oregon State Treasury above service or feeder fee,
each branch circuit 7.42 2
Contact name:Tim Sayre B.Fee for branch circuits without
Address: 16290 SW Upper Boones Ferry Rd service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Tigard OR 97224 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)378.3563 Fax: :( ) Each manufactured or modular
Email:Tim.Sayre@ost.state.or.us
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:CompView Sign or outline lighting 67.84 2
Address: 10035 SW Arctic Dr Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 1 2
City/State/ZIP:Beaverton,OR 97005 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)8288487 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:tmiano@compview.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 134110 Electrical Lic.• -514CL .- Suprv.Lic.: 4071LEB specifically listed(9z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
!�/
Subtotal: --A,--,00
Print name: Chris Rogers Date: 8/25/16 0 Plan Review Required(25%of permit fee):
/4 State surcharge(12%of permit fee): �'.' '
Authorized signature: 11,--r,4 TOTAL PERMIT FEE: sq O0
l 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLYFEE SCHEDULE
I *
Fee for all residential systems combined: $75.00 ne: ewacripti" I Qty• I Earn I Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
El Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
El Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
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(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
® Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015