Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•111111
COMMUNITY DEVELOPMENT Permit it: ELR2021-00045
Date Issued: 5/10/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 136 DC00300
Jurisdiction: Tigard
Site address: 11600 SW 72ND AVE
Project: Tigard Triangle Subdivision: 72ND&BAYLOR APTS Lot: 19
Project Description: Installation and termination of low voltage wire for HVAC
Contractor: LTT PARTNERS LLC Owner: TIGARD TRIANGLE LIMITED PARTNERSHIP
1455 NW IRVING ST 125 NE ALBERTA ST
SUITE 200 PORTLAND, OR 97211
PORTLAND, OR 97209
PHONE: (503)545-7794 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/10/2021 $75.00
12%State Surcharge-Electrical 05/10/2021 $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: 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: If ally Vrx.vune.WP.ftP Permittee Signature: QvVAppUC.Cttan
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 FOR OFFICE t'SE ONLY
City of Tigard Receiv :eived S Permit#:
Dat13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit if:
Inspection Line: 503.639.4175 Ready DateBy: Zt t N cJ furls: VI See Page 2 for
I I('1{i I) Internet: www.tigard-or.gov Notified/Method: Supplemental Information
"'
131 . . PLAN RE.
New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of s w/items checked):
❑Service or feeder 400 amps or more uilding over three stories.
❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION (':'f :):..f., exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑jog and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agncultural
amps for all other installations. buildings.
Multi-family ❑ Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
❑Emergency system. larger separately derived
O Addition of new motor load of system.
Job#: Job site address: 11600 SW 72nd Ave 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: Portland, OR, 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Tigard Triangle Cl Hazardous locations. ID Supply voltage for more than
g g ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: Liu.. FEE SCHEDULE
motion I Qty. I Each I Total I '
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
• DESCRIPTION OF WORK
Limited energy,residential
(with above sq.ft.) 75.00 2
Installation and termination of low voltage wire for HVAC Limited energy,multi-family 7500 2
controllers and thermostats. residential(with above sq.ft.) _
Renewable Energy ❑ See Page 2
maiiiiiiierOPERTY OWNER ❑ ''`°` '
- Services or feeders installation,alteration,and/or relocation
Name: Tigard Triangle Limited Partnership 200 amps or less 100.70 2
Address: 125 Ne Alberta st 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR, 97211 601 amps to 1,000 amps 301.04 2
Phone:( ) 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
p- ❑ APPLICANT CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: LTT Partners LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Aaron Sinclair B.Fee for branch circuits without
service or
Address: 2175 NW Raleigh st. Suit#110 branch circuider fee,first 56.18 2
City/State/ZIP: Portland, Or, 97210 Eachadd'lbranchcircuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503) 545-7794 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Aaron@Ittpartners.com
Reconnect only 67.84 2
Itit_ CONTRACTOR,,;, ...s '-„'- ,,',, Pump or irrigation circle 67.84 2
Business name: LTT Partners LLC Sign or outline lighting 67.84 2
Address: 2175 NW Raleigh st. Suite#110 panel,al cteatio)orlextension. 0 See Paget 2
panel,alteration,or extension.
City/State/ZIP: Portland, OR, 97209 Each additional inspection aver allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 503/545-7794 Fax:( ) Investigation(I hr min) 90.00/hr
Email: Aaron@Ittpartners.com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.:223554 Electrical ic.C L=608 Suprv.Lie.: 5388LEA specifically listed('/)hr min)
C
Suprv.Electrician signature,required: ✓ l 'l^ (,, ELECTRICAL PERMIT FEESSubtotal.
Print name:Jacob Shepardson Date: 5/4/2021 0 Plan Review Required(25%of permit fee):
/��%,�g� State surcharge(12%of permit fee):
Authorized signature: 'LL/�k TOTAL PERMIT FEE: b.-I.00
This permit application expires if a permit is not obtained within 180
Print name: Aaron Sinclair Date: 5/5/2021 days after it has been accepted as complete.
a Number of inspections allowed per permit.
P\Buildmg'Pernuts\ELC PermitApp ELR ERE.doc Rev 06/17/2015 440.615T(I I/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: .1111111 FEE SCHEDULE ,wor
DFee for all residential systems combined: $75.00 Renewable°° Qty. Each Total
�' 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
❑ Garage Door Opener* 50.01 to 100
kva 552.26 2
>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(I hr min)
Inspections for which no fee is 9p.00/hr
slisted('. hr min)
COMMERCIAL WORK ONLY ELECTRICAL PERMIT FE ' .:
Fee for each commercial system: $75.00 Subtotallowed rpermt.Filter 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
❑ Fire Alarm Installation
�HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical •
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:/Building5Permits'ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015