Permit INCITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'. COMMUNITY DEVELOPMENT Permit#: ELR2021 00047
T I:G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/20/2021
Parcel: 1 S 134AA02100
Jurisdiction: Tigard
Site address: 10340 SW NIMBUS AVE NC
Project: Kaeser Compressor Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Low voltage cabling for data
Contractor: ADVANCED COMMUNICATIONS SERVICES INC Owner: DIETRICH, NANCY BISHOP
PO BOX 231196 ROBINSON, JERRY CHRISTOPHER TRUST
PORTLAND, OR 97281-1196 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-598-7082 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/20/2021 $75.00
12%State Surcharge-Electrical 05/20/2021 $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: 1 Fire Alarm: 0
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 plan 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 requir ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-00 ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: .. Ar (/r7a'
OWNER INSTALLATION ONLY
The installation is beade 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 FOR OFFICE I SI:()NI.)
City of Tigard Received/el ;; Permit#: ELRZQ2 OOO14-7
III • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris: lZ1 See Page 2 for
I It,1l I) 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):
O Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition Ill Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
IDI-and 2-family dwelling ®Commercial/industrial ElAccessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:or8665 Job site address:10340 SW Nimbus Ave I0OHP or more. ❑"A","E",°t-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.#:NC Project name:Kaeser Compressor ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I .Each _I Total I
New residential single-or multi-family dwelling unit.
Subdivision: l,ot#: 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
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:(503 ) 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: 5/20/2021 401 amps to 599 amps 168.54 2
El APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Advanced Communications Services above service or feeder fee, 7.42 2
each branch circuit
Contact name:Joeseph M. Foti B.Fee for branch circuits without
ry Address:8184 SW Durham Road braanch circuit fee,first 56.18 2
City/State/ZIP:Tigard, OR 97223 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:V )503.598.7082 Fax::( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:support@advcomserv.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Advanced Communications Services Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:8184 SW Durham Road panel,alteration,or extension.
City/State/ZIP:Tigard, OR 97223 Each additional inspection over allowable in any of the above
g Additional inspection(1 hr min) 66.25/hr
Phone:( )503.598.7082 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:support@adveomserv.eom •
Inspections for which no fee is 90.00i hr
CCB Lie.:179445 Electrical ic.:CLE139 Suprv.Lie.: specifically listed('z hr min)
4- L' .0 ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: �4/�/G i/!� Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): '/
Authorized signature: TOTAL PERMIT FEE: g id
This permit application expires if a permit is not obtain/ed within 180
Print name:Joseph M. Foti Date:5/20/2021 days after it has been accepted as complete.
• Number of inspections allowed per pennit.
l:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: Renewable
Fee for for all residential systems combined: $75.00 nesewan eaeh "`*Total
ble electrical energy systems:
Check Type of Work Involved: 5 kvaorless 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 552.26 2
with OAR 918-309-0040)
❑ 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 90.00/hr
s,eclficall listed('Ye hr mm)
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4111
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
VI 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:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermeApp_ELR_ERE.doc Rev 06/17/2015