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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' COMMUNITY DEVELOPMENT Permit#: ELR2019-00215 Date Issued: 12/03/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136CD01501 Jurisdiction: Tigard Site address: 7600 SW ATLANTA ST Project: Tigard Self Storage Subdivision: None Lot: None Project Description: Limited energy for fire alarm installation. Contractor: M & E ELECTRIC Owner: TRAILBLAZER DEVELOPMENT LLC 15708 NE 81ST AVE BY CPS ASSET MANAGEMENT LLC VANCOUVER,WA 98662 333 S STATE ST STE V-144 LAKE OSWEGO, OR 97034 PHONE: 360-573-0459 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 12/03/2019 $75.00 12%State Surcharge-Electrical 12/03/2019 $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 Notificatio enter. Those rules are set forth in OAR 952-001-0010 through OAR 2-001- 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503 32. 987 or 1.800.332 344. Issued By: " — 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. • REED �r ElectricalPermit ApplicationDEC 03 2019 1 Project � Washington County,155 N.1' AV,Suite 350,MS 12, .111*6i? J3,' =`tc6 Phone: 4b-34fiQl to tbidg(a ca.wva him to .ar ri "!.DING DIVISION Permit# ^ Inspection Requests:503-846-3699/www.cn.washington.or.usipiro _ A New cons' oo truction 0 Addition/alteration/replacement ID Other: Please check all that apply: 0 service or feeder 400 amps 0 Hazardous locations or more where the available 0 Service or feeder600 ants or more OATEGORY 0#„CONST fault current exceeds CI Building over three stories 0 1-and 2-family dwelling t14 .ommercialtindustrial 0 Acc.essoly building 10,000 amps at 150 volts or0 marinas and boatyards Multi-familyless to ground,or exceeds Fioatim g I 0 Master builder 0 Other: I rbuildin s 14,000 amps for all other 'i RlM&t N �E OCA installations. Commercial-use agricultural buildings 74,DO �W / Job no.; Job address: � C Dire pump0 i7 Emergency system Installation of I50 K VA nr larger � separately derived system City/Statc/ZIP: 1 7,gck.. t(9�-- (�1r� '1_ 0 Addioonofnewrmot CI „A,,, „„I2y,,,. 3„ ., r load of l Q()ll'r r mare occupancy Suite/bldg.lapt.no.: Project name:Tp am, S>✓(oa_ 0 Six or more residential units SuplyvltRecreational vehicle pants © Health-care facilities 0 Supply voltage for more than Cross street/directions to job site: AV 1g4 epso 600 volts nominal Subdivision: 9 Lot no.: E HE 1 Description ) ttT Fee I Intal� Tax maplparcel no,: i #, - or nand- i try .r lt. ¢°_=. bed,r.rage. . !" .�'°". . . . . » 1,000 ft,or less JId) tie`f ao, Ea.add't 500 sq.ft.or portion Limited energy,reside/Mal with above I)— 107.Otr 2 ID pRftfoif 1, TENS ." Limited energy irrupt-tiarraily ,;, rssadenttal(wash above sg.ft) 107.00 2 I Name: Address: 00 i�tni piSil s E r't City/State/ZIP: anips to 600 amps ) Phone: _ Email: 601 t., °vex 1,000 amps or volts 642.00 Owner installation:This iiatallation is being made on residential or>arrn property owned by rma ur a bubbler of my immediate family. This property is nut intended for sal.exchange or rem.TORS 479.540(T 1 and '' 479,5600). Owner signature: Date: ` 200 snips or less `07 t* � 201 amps to 400 amps I 161.002 trt 3 ?401 amps to 599 amps 1214.110 2 Business name: #6 t f/`',°'/,t@ Id, Dix-e- , .`I 1srr a;;ait¢: ..*. *-" . , A.Fee for branch circuits with , Contact name; / t 6,44 telWoo icId.t -0 ; above service or feeder fee, 9.50 n q / each brach circuit 2 Address: h 70 8 ,(Y E if ,Poe B.Fee for branch circuits CitylStatc'ZIP: 1/ COLL IIIv� without service or feeder107,00 /`- ! JAL 9,�fr/z fee,first branch circuit Phone: 3 j r..-A53—©/ !c, Each add t branch circuit 9.0 I -� E-mail: `f. > i 14 14' im ue etc t or �;. 3.5 M Each manufactured or modular 113,50 2 ::.. g. and/or feeder }- Reconnect onl 1o7,00 1 Business name: ',, '7� ,r� ! � y f-� (,r`°I g �z'�tt1„, ri t'ii ew tin/9 , »° Pump or irrigation circle 107.00 2 Address: " y�",,;,�' J'(� �u/.�" '� �`'.$ Sign or outline lighting E07.00 2 CitydStateIZIP: �- / 03 Signal circuits)or limited- "r•' rl .tr Y'r + energy panel,alteration,or Email: I, �# extension.Describe: , 107.00 /�'F>Slit �' c `/ , .. °"yy, +z? I „ ,lVC- , 2 Phone: 3 0. f„,zx� (/7 6CCB tic.no..: % �t �t _ e a311r c .;w F g per inspection 107.00 Electrical lie.no.: of‘W S' <. City or metro I ic.:0 p ,//A _C Investigation fee iseecompliance) Supervising electrician }� Other: k signature required: ✓ .`-' S3�/ k\ I C�� A r Print naraae: � "- ... ... / l�/ it`s > Date: ° ! r° Subtotal 7S ,�7 Authorized /"'' Plan review(25°.rr<of permit fee) signature: ,J.si�' ' I State surcharge(12%of permit fee) 9 .Ge� re: " ,/ ( TOTAL PERMIT FEE ryt Print name: ✓�.. ,r � 'Rate; ,J ,, f� r�J�.t is "✓ / /r l/f/J.% Thin permit application expires If a permit is not obtained v Disclaimer:Sly signing this application,the per t applicant crcknowledIes ar�X agrees within 180 days after it has been accepted as complete that they have obtained any required permission for the proposed work from the pr'per tat *Number of inspections allowed per permit. Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: DescriFee for all residential systems combined: $75.00 Renewable Qty. Each Total R Sr Renewaa ble electrical 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 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 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ 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: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspe foch o fee is 90.00/hr specificallyctions listerdwhi(Y hrn min) etin is str,�t+�h >,: xltt FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): y ' Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation Ej 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 1\Building\Permits\ELCPermitApp_ELR_ERE.doe Rev 10/26/2017