Permit (46) 1114CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
A COMMUNITY DEVELOPMENT Permit#: ELR2016 00191
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/08/2016
Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 140
Project: Perlo Construction Subdivision: None Lot: None
Project Description: Low voltage for fire alarm
Contractor: CAPITOL ELECTRIC CO INC Owner: PACIFIC REALTY ASSOCIATES LP
11401 NE MARX STREET ATTN: N PIVEN
PORTLAND, OR 97220 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics:
Restricted Energy Permit 09/08/2016 $75.00
12%State Surcharge-Electrical 09/08/2016 $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: 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 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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 8-7......04-7,—,Z. 32
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 AAplieat El CEiLP FOR OFFICE USE ONLY
' CReceived
Permit no.:
�:I�T of Tigard Date/By: 9�/ /(p � 16-coO � 7
lig "11 13125 SW Hall Blvd.,Tigard,OR 9741n, 0 2016 Plan Review
L' Other Permit:� �1,__co/30
503,639,4171 Fax: 543.598. Date/By:
I ARS Inspection Line: 503.639.4175 y Date Read /B Juris:
Internet: www.tf d-or. OV Ready/By: I❑ See Page 2 for
g V. 'a ry -` 1 ') Notified/Method: Supplemen al Information
I 1 ,, N
»' rv_ -: ,f ."`.*x.' ,.UI'61' a6 -` -'-w`4 1 r 1i:ill ,= - " =-.' -7-`"":2f. .'-i:" ',"m` -», , -._ W,... ice'
New construction VI Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑ Demolition ❑ Other Service or feeder 400 am B 'Id' th t
4 T ps or more ui mg ove ree s ones
❑ r
LI�y � -_ „ _ where the available fault current ❑ Marinas and boatyards
LI 1 and 2-family dwelling ✓ Commercial/industrial C Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi family ❑ Master Builder El Other less to ground,or exceeds 14,000 Commercial-use agricultural
m- (t' a I:a = 0 , -!:
_ amps for all other installations. ❑ buildings
Job no.: 161464 Job site address: 16101 SW 72nd Avenue CI Fire Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State/ZIP: Tigard,OR 97224 ❑ Addition of new motor load of ❑"A","E","1-2","1-3",
100HP or more. ❑ occupancy
Suite/bldg,/apt.no.: Suite 140 (Project name: Perlo TI ❑ Six or more residential units ❑ Recreational vehicle parks.
❑ Health-care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
Subdivision: I Lot no.: . . - L - '1"1�, #*
Tax map/parcel no: n Fee. Total
Descriptio I Qty,
New residential-single or multi-family dwelling unit.
1),..11" ' 8 ' `p -` `.;,° Includes attached garage.
Install Fire Alarm Circuit in Suite 140 per Submittal Plans. 1000 sq.ft.or less $ 168.54 4
Ea.Add 1500
sq ft or portion $ 33.92 1
( .E; -t 6.- ( - --- I Limited energy residential
Name: (with above sq.ft.) $ 67.84 2
Limited energy,multi-family
Address: residential(with above sq.ft.) $ 67.84 2
Service or feeders installation,alteration,and/or relocation
City/State/ZIP: 200 amps or less $ 100.70 2
201 amps to 400 amps $ 133.56 2
Phone: Fax: 401 amps to 600 amps $ 200.34 2
601 amps to 1000 amps $ 301.04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 552.26 2
intended for sale,lease,rent or exchange,according to ORS 447,449,670,and 701 Temporary services or feeders installation,alteration,and/or
Owner signature: Date: relocation
.
1
_ 2001 amps
to
to amps less 400 amps
2
2$ 125.08
.- = ' AP 5� �� �� 201
Business Name: 401 amps to 599 amps $ 168.54 2
Branch circuits-new,alteration,or extension,per panel
Contact name: A. Fee for branch circuits with
service or feeder fee,each
Address: branch circuit $ 7.42 2
B. Fee for branch circuits
City/State/ZIP: without service or feeder fee,
first branch circuit $ 56.18 2
Phone: Fax: Each additional branch circuit: $ 7.42 2
Miscellaneous(service or feeder not included)
E-mail Each manufactured d l
or mo u modular
µ
#,', ' y_, 0
, -.4 dwelling,service and or feeder 5 67.84 2
Business Name: CAPITOL ELECTRIC CO.,INC. Reconnect only $ 67.84 2
Pump or irrigation circle $ 67.84 2
Contact name: SHANE TERCEK 503.262.0405 DIRECT Sign or outline lighting $ 67.84 2
Signal circuit(s)or limited-
Address: 11401 NE MARX ST. energy panel,alterations,or
extension. Describe: Fire Alarm I Page 2 $ 75.00 2
City/State/ZIP: PORTLAND,OR 97220-1041
Each additional inspection over allowable in any of the above
Phone: 503-255-9488 Fax: 503-257-7121 Per inspection $ 66.25
Investigation per hour(1 hr min) $ 66.25
CCB Lie.: 48748 !Electrical Lie.: 26-496C jSuprv.Lic.: 3132-S Industrial plant per hour $ 78.18
Suprv.Electrician signature,required: / CAVA r
Subtotal $ 75.00
Print Name: DARRELL MCN EL 08/02/16 Plan review(25%of permit fee)
Authorized signature: 1-14412.--)111e...-
�� �� State surcharge( 12% of permit fee) $ 9.00
TOTAL PERMIT FEE $ 84.00
Print Name: DARRELL MCNEEL This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete,
*Nwnber of inspections per permit allowed.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16101 SW 72ND AVE 140, TIGARD, OR, 97224
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00191
Herb Stabenow
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9455 SW WASHINGTON SQUARE RD A15,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00191
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor