Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'ipfi COMMUNITY DEVELOPMENT Permit#: ELR2020-00061
Date Issued: 05/15/2020
T I ;A iz t} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1050
Project: Sentry Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Low voltage wiring and T-stats.
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: 503-412-4844
FAX: 503-239-7038
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/15/2020 $75.00
12%State Surcharge-Electrical 05/15/2020 $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 $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 -quires 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-' 0090. Y u may of in a copy of the lea or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r� _ s
Issued By: GeV - --6 / SPermittee Signature: (/C�-!
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 503.539.4175 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
City of Tigard APR 1 5 2020 DateBy `1 7-g1za 4O Permit N lg.4 €2 219 -D®06/
13125 SW Hall Blvd.,Tigard,OR 97223 1�/ lan Review
0 Phone: 503.718.2439 Fax: 503.598.19 0 f I T OF T'C%tr1 co-J Date/By: Other Permit:
.1'IUARD Inspection Line: 503.639.4175 BUILDING i n h.(G D VIS1OI?teReady/By: mds RI See Page 2 for
Internet: www.tigard-or.gov V 'l�otified/Method: Supplemental Information
(,P ra t z� (T:
❑New construction Ej Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
ElService or feeder 400 amps or more 0 Building over three stories.
0 Demolition El Other:
where the available fault current ❑Marinas and boatyards.
r, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
El 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
.. . ; ❑Emergency system, larger separately derived system.
t ,P N �^. T SE ' r 1 q _ L ❑Addition of new motor load of ❑"A" "E" "1 2" "1 3>,
1oo1IP 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.:1050 I Project name:Sentry Ste TI 0 Service or feeder 600 amps or more
t=f' - 11;FEE SCHEDULE >:
Cross street/directions to job site: Description I Q13. I 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'!500 sq.ft.or portion 33.92 1
Tax map/parcel no.: _ Limited energy,residential
- .,a DESCRIPTION OF WO i _ + � i4(1.. (with above sq.ft.) 75.00 2
e._ -- � 1✓{ai Limited energy,multi-family
low voltage wiring and T-stats residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2'i
Services or feeders installation,alteration,and/or relocation
a`a , '•1 - $ 200 amps or less 100.70 .2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 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:( ) I 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: _Date: Branch circuits—new,alteration,or extension,per panel
® CONTACT PERSON A.Fee for branch circuits with
- - - - -^�' t�' • above service or feeder fee,
Business name:American Heating Inc.
each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name:Amanda Bostic service or feeder fee,first 56 18 2
branch circuit
Address:5035 SE 24th Ave. Each add'l branch circuit 7 42 2
City/State/ZIP:Portland,OR.,97202 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(971)678-2094 I Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:a.bostic@americanheating.net Pump or irrigation circle 67.84 2
kx .. a. h. . :- ' 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:Amanda Bostic Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR.,97202
Investigation(I hr min) 66.25/hr
Phone:(971)678-2094 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 33135 Electrical Lic.: 6993CRE Suprv.Lic.: 2640LEB s. cifcally listed(Az hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,require J 7S ell
Print name: I Steve Young Date: �1 Plan review(25%of permit fee):
4 t �� State surcharge(12%of permit fee): 91 elf)
Authorized signature: CioArvoyvvict...€0t^�iVA_ TOTAL PERMIT FEE: % f�
� d�This permit application expires if a permit is not obtained within 180
Print name: Amanda Bostic I Date:
U days after it has peen accepted as complete
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COMAVEa
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
r)1-AL''WORK(A IX: r° r
FEE SCHEDULE
Fee for all residential systems combined $75.00 Q,y I Ere I i.lai I
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 zs 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 1001rva 552.26 2
>100 kva(fee in accordance with 552.26 2
OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning
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
❑ 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)
Inspections for which no fee is 90.00/hr
�, s.-cifically listed(V.hr min)
sc _i, IAL WORK ONLY: Via' .. ."° ELECTRICAL PERVIrr FEES
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
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
�IVAC
❑ 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
IAEuilding\Permits\ELC_PermitApp_ELR_FRF.doe Rev 05/21/2013