Permit (2) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT71
Permit#: ELR2019 00190
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/01/2019
TIGARD Parcel: 1S135BB00501
Jurisdiction: Tigard
Site address: 10575 SW CASCADE AVE 100
Project: Biamp Subdivision: None Lot: None
Project Description: Fire alarm and data telecommunications system.
Contractor: POINT MONITOR CORPORATION Owner: ICON OWNER POOL 3 WEST LLC
5863 LAKEVIEW BLVD STE 100 BY INDCOR PROPERTIES
LAKE OSWEGO, OR 97035 2 NORTH RIVERSIDE PLAZA, STE 235
CHICAGO, IL 60606
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/01/2019 $150.00
12%State Surcharge-Electrical 10/01/2019 $18.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 $168.00
Other Desc: Required Items and Reports(Conditions)
1
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 c r direct questions to OUNC by calling 503.232.1987 or 1.800.34.234 .-4
P fhE _ ,
Issued By: iL�. ��G ' 5'�' Permittee Signatures-__ ��-�,.�_; '
��'' 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 toll OFFICE use()NI
ill,
City of Tigard t '� "" 1 Received
Dateiv : 1,
13125 SW Hall Blvd.,Tigard,OR 97223 �� VERIi
n Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 '.l C i 1 201 J Datc'B : MIMMI
Related Permit#:
Inspection Line: 503.639.4175 • 'g ''CI(.�'I`. -
1I
(:A R D toe _ Ready Date/By: 'Mil H See Page 2 for
Internet: www.tigard or.gov f- rte, Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction Z Addition/alteration/replacement 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.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 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.
0 Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 10575 SW Cascade Ave. 0 Addition of new motor load of system.
]00HP or more. ❑ A" "E""I 2""1-3"
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:BiAmp-Cascade 0 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 1 Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.A.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Fire Alarm AND Phone/Data (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
0 PROPERTY OWNER ® TENANT Renewable Energy ❑ Sec Page 2
Services or feeders installation,alteration,and/or relocation
Name:BiAmp-Cascade 200 amps or less 100.70 2
Address: 10575 SW Cascade Ave. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Email:
Temporary services or feeders installation,alteration,and/or
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
Branch circuits–new,alteration,or extension,per panel
® APPLICANT 0 CONTACT PERSON
A.Fee for branch circuits with
Business name:Point Monitor Corp. above service or feeder fcc,
each branch circuit 7.42 2
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 service or feeder fee,first 56.18 2
branch circuit
2
City/State/ZIP:Lake Oswego,OR 97035 Each add'l branch circuit 7.42
Miscellaneous(service or feeder not included)
Phone:(503)627-0100 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:bwilliams@pointmonitor.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Point Monitor Corp. Sign or outline lighting 67.84 2
Address:5863 Lakeview Blvd.Suite 100 Signal circuit(s)or limited-energy
panel,alteration,or extension. ® Sec Page 2 2 2
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bwilliams@pointmonitor.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 135901 Electrical Lie.: 34508CLE Suprv.Lie.: 4460LEA specifically listed(%hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name: Ben Breit Date: 9/25/19 ❑Plan Review Required(25%of permit fee):
- P-, State surcharge(12%ofpennit fee):
Authorized signature: ( ''�— TOTAL PERMIT FEE: /�j
This permit application expires if a permit Is not obtained 48tbin 180
Print name: Ben Breit Date: 9/25/19 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I.Budding Permits ELC PennitApp_ELR EKE doe Rei,Of 17 2015 440-46157(11 OS('OM WEE
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Renewable
ion Qty. Each I Total 1 .
Reneelectrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 toes kva
200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 2.42 I 13
LI Vacuum Systems* >100 kva-no additional charge 0.0 IJ 3
I:: Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is
specifically listed(1/2hr min) 90.00/hr
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):
(SEE OAR 918-309-0000) • Number of inspections allowed per permit,
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
® Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems: 2
*No licenses are required. Licenses are required for all
other installations
I.Building Permits EL(_PemutApp_ELR_ERE.doc Rev 06 172015