Permit II 7 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2020-00060
Date Issued: 04/21/2020
T I G A R I 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 350
Project: Grand European Travel Subdivision: None Lot: None
Project Description: Limited Energy for HVAC for TI.
Contractor: HUNTER DAVISSON INC Owner: PORTLAND SW CENTER LLC
1800 SE PERSHING ST BY FELTON PROPERTIES INC
PORTLAND, OR 97202 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/20/2020 $75.00
12%State Surcharge-Electrical 04/20/2020 $9.00
Type of Use:
Class of Work:
Total Number of Systems: 0
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 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 95 1-009 ou may vaina copy he rules or direct questions to OUNC by calling 503.23 .1987 or 1.800.332.2344. p
Issued By: /'✓ Permittee Signature: ! , C e
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 503.639A175 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
Receive � ,
City of Tigard DateBy/Z2 �/ . �j,�z� i .
• 13125 SW Hall Blvd.,Tigard,OR 97223 APR 8 2020 Plan Revi w � 'l ��
` Phone: 503.718.2439 Fax: 503.598.1960 Date/By: !VL f�j
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: mds. 'I�"El See Page for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stones.
❑ Demolition Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El -and 2-family dwelling ElCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agr cultural
amps for all other installations. buildings.
❑ Multi-family 0 Master builder D Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
_ // p / ❑Addition of new motor load of system.
Job#:p^(O(f) 96 Job site address:? ' ' StA/ PiArXctni /S q, I00HP or more. ❑"A `E","I-2 "I-3
City/State/ZIP: "7-j oe '97a O sR cu atic
0 Six or more residential units. occupancy.
❑Health-care facilities. 0Recreational vehicle parks.
\LLl Idg./apt.#: Project name: s 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: 6-��nei -lit T�� Trom p/ FEE SCHEDULE
VV ! / Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
�7 [ (with above sq.ft.) 75.00 2
/�Q,(es ext..-Fla ��nl JJ Q,t'MOS�0.� TO �tGGc�MMo�4/4. �-T, Limited energy,multi-family •
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
® PROPERTY OWNER .-/. -❑ TENANT Services or feeders installation,alteration,and/or relocation
•
Name: CO AA M1 0-c_1 a 1/ Co N/f r r S —1;JC-• 200 amps or less 100.70 2
Address: .S,r'7 3 S /st C rc/e. 201 amps to 400 amps 133.56 2
�, /� t 401 amps to 600 amps 200.34 2
City/State/ZIP: i.'t/4p,f de, WA 9 //� 601 amps to 1,000 amps 301.04 2
Phone:( ) tJ Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
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
APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension,per panelEl
A.Fee for branch circuits with
Business name: /1140-{¢t•.. VJSSO/`t ,2jd G.• above service or feeder fee, 7.42 2
/Ira N �T2�� / ah branch circuit
Contact name: B.Fee for branch circuits without
//•
d`l service or feeder fee,first
Address:
alb O c&� Ar,s-) // cri-ree.± branch circuit 56.18 2
City/State/ZIP:Zr1(4N c1/ p�
et r /07-pa Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(Sa3 ),c4/a-,36*-a:r Fax: :( ) Each manufactured or modular 67.84 2
/
Email: dwelling service and/or feeder
(srf¢e,-/-e /tAfs�es.citt✓/5gcs^J s.Go.N1 Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: /-/ jss.r.. OgviJ.j on/ ING Sign or outline lighting 67.84 2
/� / Signal circuit(s)or limited-energy g
Address: /r' o SE /best iN 1 r'02 " panel,alteration,or extension. See Pa e 2 2
/
at
City/State/ZIP: /bt'1(o✓,GI o `i r,p� Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(S•03)sya-3C c2.5' Fax:( ) Investigation(1 hr min) 90.00/hr
Email: ../.. ..{- / Industrial plant(I hr min) 78.18/hr
(`�oeQ /ea �7t4t✓tCra4✓/SSOt/,GaM Inspections for which no fee is
/ !.� specifically listed(Va hr min) 90.00/hr
CCB Lic.: /�/a Electrical Lic.:�6-ed'd C(e'1 Suprv.Lic.: bop LE
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: -O p 0 Plan Review Required(25%of permit fee):
J;M AV) `i' d,
/J, t State surcharge(12%of permit fee):
Authorized signature: Z /rtli3mo TOTAL PERMIT FEE:
� This permit application expires if a permit is not obtained within 180
Print name: Ryq iv /0 1 1 Ct✓ L u Date: /— U(j-a o days after it has been accepted as complete.
/ r Number of inspections allowed per permit.
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description 1 Qty. 1 Each i Total i "
Fee for all residential systems combined: $75.00 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
Wind generation systems in excess of 25 kva:
tEl Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 55126 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)
Inspections for which no fee is 90D0/hr
specifically listed('Va hr min)
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
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: l
*No licenses are required. Licenses are required for all
other installations
I\Building\Pmnits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015