Permit ° CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
. ' COMMUNITY DEVELOPMENT 1Permit#: ELR2020-00038
Date Issued: 03/12/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 630
Project: Prodapt Subdivision: METZGER,TOWN OF Lot: 9
Project Description: HVAC system.
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
5035 SE 24TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97202-4765 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-239-4600 PHONE: 503-413-4844
FAX: 503-239-7038
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/11/2020 $75.00
12%State Surcharge-Electrical 03/11/2020 $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: 1 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 S84.00
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. 32 1.800.332.2344.E
Issued By: ee Signature: N�
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 RECEIVE
FOR OFFICE USE ONLY
C1 Of Tigard RECEIVE 11 .eceived y Permit No.:
`J g ! FFFaaarrr�d Date/By: J// .- _ay,3.
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' 0'' Phone: 503.718.2439 Fax: 503.598.1960 MAR 9 204U Date/By: Other Permit J C )d ?(31/
I GA x 1.) Inspection Line: 503.639.4175 Date Ready/By: Jecis: ® See Page 2 for
Internet: www.tigard-or.gov i V OF TiGNR 1 Notified/Method: ' ? Supplemental Information
,TYPE OF WO dhti; ..;. -i,
Please check all that apply(submit 2 sets of plans w/items checked below)
I New contruction El Additionialteration/rePlacement
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
t > itl�r "(( ie -r "-- ali t "lt j: exceeds 10,000 amps at 150 volts or 0 Floating buildings.
TEG{IRYE 'ON s` °I'�' s
- 4�� — --_ ('1 1""� - less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
O Multi family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
g: _ -1 ❑Emergency system. larger separately derived system.
.- y ,� .. :..,. „�,r�,` �� — ,�„r ❑Addition ofnew motor load of ❑"A,> `.E„ `.l-2'"1.3„
1oo11P or more. occupancy.
Job no.: Job site address: 10260 Greenburg Rd
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 0 Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.:630 I Project name:Prodapt @ Lincoln Tower ❑Service or feeder 600 amps or more.
; .w3 i ,
Cross street/directions to job site: Description Qty. Fee. Total •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: _ Limited energy,residential
''`.... °°�4 't% .j- with above s ft.) 75 DO 2
li f A>SGltll'7TO1 OF r4 ( q
�� '� Limited energ
y,multi-family 75.00 2
low voltage wiring and T-stats residential(with above sq.ft)
3learwab101Kft 0 See Page 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
133.56 2
Name: 401 amps to 600 amps 200.34 2
.dress: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Dale: Branch circuits-new,alteration,or extension,per panel
--" - 4 e,a` A.Fee for branch circuits with
® APPLIC 1E® CONTACT PERSON
.- above service or feeder fee,
7.42 2
Business name:American Heating Inc. each branch circuit
B.Fee for branch circuits without
Contact name:Sara Bainard service or feeder fee,fist 56.1E 2
branch circuit
Address:5035 SE 24ra Ave. Each add'1 branch circuit 7.42 2
City/State/ZIP:Portland,OR,97202 Miscellaneous(service or feeder not included)
ty Each manufactured or modular
Phone:(503)2394600 I Fax: :(503)239-7038
dwelling,service and/or feeder 67 84 2
Reconnect only 67.84 2
E-mail:s.bainard@americanheating.net Pump or irrigation circle 67.84 2
_ n{jii-tip ° r Sign or outline lighting 67.84 2
Business name:American Heating Inc. Signal circuit(s)or limited-energy I See I
panel,alteration,or extension. Page 2 2
Address:Sara Bainard Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Portland,OR.,97202 Investigation(1 hr min) 66.25/hr
Phone:(503)239-4600 Fax:(503)239-7038 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 33135 Electrical Lic.: 26993CRE Suprv.Lic.: 2640LEB s.- ificall listed /hrram
t K£ �r : i i,I ir '..,� , .1. . ,.
uprv.Electrician signature,required:13 Subtotal:
Wint name: T Steve Young ate: 3/3/2020 Plan review(25%of permit fee):
111 State surcharge(12%of permit fee):
Authorized signature: 1 3 �� TOTAL PERMIT FEE:
J r This permit application expires if a permit is not obtained within 180
Print name: Sara Bainard I Date: 3/2 020 days after it has been accepted as complete.
' Number of inspections allowed per permit.
❑\Building\Permits\ELQ_PermitApp_EI-R_ERE.doe Rev 05/21/2013 440-4615T(IiIOS/COM/'EB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
,t SIDtt4f L V'012K UNL ':
FEE SCHED:;.I`
Fee for all residential systems combined ... $75.00 Des°ripaon Qty. Fee 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
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
ElBurglar 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 552.26 2
ElHeating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
El Other:
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 90.00!hr
s ci6ca11 listed(%:hr min
COMMERC1AL .o NLY:
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete. •
" Number of inspections allowed per permit.
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other •
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits ELC PemutApp_EIR_ERE.doc Rev 05/21/2013