Permit{
IIICITY OF TIGARD ELECTRICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit#: ELC2020-00536
Date Issued: 8/4/2021
T.I G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AD02200
Jurisdiction: Tigard
Site address: 8900 SW BURNHAM ST F27
Project: Burnham Storage Subdivision: BURNHAM STORAGE PARK Lot: None
Project Description: Reconnect only.
Contractor: Owner: BURNHAM BUSINESS&STORAGE LLC
9500 SW BARBUR BLVD STE 300
PORTLAND, OR 97219
PHONE:
PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 07/09/2021 $67.84
Specifics: 1 ea 12%State Surcharge- 07/09/2021 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
I
Total $75.98
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 throuoh OAR 952-001-0090. You may obtain a coos of the rules or direct questions to OUNC by callina 503.232.1987or 1.800.332.2344.
f Issued By: Holly Vcvn/Dei Wege Permittee Signature: OwAppUcati-oIt
OWNER INSTALLATION ONLY
r
' The installation is being made on property I own which is not intended for sale,lease or rent.
f
OWNER'S SIGNATURE: Date:
t
/, CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC'N Date:
LICENSE NO.
'r. 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.
a
Y
Electrical Permit Applicati ECELVED FOR OFFICE ESE ONLY
City of Tigard Date/Bed
13125 SW Hall Blvd.,Tigard,OR 97223 OCT 2 6 2020 "r' !� A7., �� ,!i _ _ _[
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 C`- OF TIGARD1 Ready Date/By: See Page 2 for
TIGARD D'V I�.Jlo Notified/Method: IiiiMI Supplemental Information
Internet" www tlgard-or gov 1 pP
BUILDING
' P I.Affr
TYPE OF WORK ,W9o,+ , �d�
❑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 ❑Building over three stories.
❑ 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.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 1a,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITEINFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system
Job#: Job site address: Unit F27 8900 SW Burnham St 100HP or more. ❑"A","E °t-z "1-3
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard/OR/97223 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: F27 Project name: ❑Hazardous locations. ❑Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: :Ia. "�
T'ESCIFEATIC,1� ,ii .
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel 4:
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTIONT'OF WORK ^, Limited energy,residential
75.00 2
(with above sq.ft.)
Commertial Storage unit need electricity meter inspection to get power from PGE Limited energ
y,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER. ® TENANT Services or feeders installation,alteration,and/or relocation
Name:Hang Cai 200 amps or less 100.70 2
Address: Unit F27 8900 SW Burnham St 201 amps 10400amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard /OR /97223 601 amps to 1,000 amps 301.04 2
Phone:(206) 778-5184 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:hang.caipdx@gmail.com relocation
f.
Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 I
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
CZ APPLICANT 0,CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:FORESTPORT LLC. above service or feeder fee, 7.42 2
each branch circuit
Contact name:Hang Cal B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:6897 NW 163rd Ave branch circuit
City/State/ZIP:Portland/OR/97229 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
r Phone:(206 )77851 84 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:hang.caipdx@gmail.com Reconnect only 1 67.84 67,`11 2
CONTRACT R
. ,�, � ,'�lr .` Pump orittigationcircle 67.84 2
Business name: Sign or outline lighting 67.84 2
Signal circuits)or limited-energy 0 See Page 2 2
Address: panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lie.: Suprv.Lie.: specifically listed('/z hr min)
ELECTRICAL-PERMIT-FEES °,
Suprv.Electrician signature,required: Subtotal: 6-7 V.,f
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): r t it
Authorized signature: TOTAL PERMIT FEE: 7.�,r�
This permit application expires if a permit is not obtained within 180
Print name: Han Cal Date: 10/12/2020 days after it has been accepted as complete.
g * Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE,doc Rev 06/17/2015 440-4615T(I I/05/COM/WEB
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard ReceivDateived Permit#:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
: S Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Jui is: H See Page 2 for
T I G A R h Internet: www.tigard-or.gov Notified/Method: Supplemental Information
$ TYPE OF WORK PLAN REVIEW
Please check all that apply(submit 2 sets ofplans w/items checked):
❑New construction ❑Addition/alteration/replacement PP y
El or feeder 400 amps or more ElBuilding over three stories.
❑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.
z ❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
&lcO C' ) ❑Addition of new motor load of system.
Job#: Job site address. �.lJ �-�J ut'r'S�r'S q w1 100HP or more. ❑"A","E","1-2","i-3",
t occupancy.
City/State/ZIP: q Six or more residential units.
i r a)1, CA . ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: c El Hazardous locations. ❑Supply voltage for more than
Qvrn�� ❑Service or feeder 600 amps or more. 600 volts nominal.
I 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: Lot#: Includes attached garage.
1,000 sq.ft.or less ' 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential
Commertial Storage unit need electricity meter inspection to get power from PGE (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
0 PROPERTY OWNER ® TENANT Services or feeders installation,alteration,and/or relocation
Name:Hang Cai 200 amps or less 100.70 2
Address: Unit F27 8900 SW Burnham St 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard /OR/97223 601 amps to 1,000 amps 301.04 2
r Phone:(206) 778-5184 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation.alteration,and/or
Email:hang.caipdx@gmail.com 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: 741- Date: 10/01/2020 401 amps to 599 amps 168.54 2
® APPLICANT lI// ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
0 Business name:FORESTPORT LLC. above service or feeder fee, 7.42 2
each branch circuit
0 Contact name:Hang Cai B.Fee for branch circuits without
1 service or feeder fee,first 56.18 2
Address:6897 NW 163rd Ave branch circuit
r Each add'l branch circuit 7.42 2
City/State/ZIP:Portland/OR/97229
Miscellaneous(service or feeder not included)
/} Phone:(206 )7785184 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:hang.caipdx@gmail.com Reconnect only 67.84 2
rCONTRACTOR Pump or irrigation circle 67.84 2
r Business name: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension.
j Each additional inspection over allowable in any of the above
City/State/ZIP:
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
r Email: Inspections for which no fee is 90.00/hr
P CCB Lic.: Electrical Lic.: Suprv.Lie.:
specifically listed('h hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fec):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
7 Print name: Date: days after it has been accepted as complete.
p * Number of inspections allowed per permit.
1 I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev06/17/2015 440-4615T(11/05/COM/WEB
1
i
f+
2
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description I Qty. EEach 'Totaly Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n 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
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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
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
Data Telecommunication Installation
n Fire Alarm Installation
I-I HVAC
I I Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
El Medical
n Nurse Calls
Outdoor Landscape Lighting*
n Protective Signaling
7 Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Tina Escalera
From: Hang Cai <hang.caipdx@gmail.com>
Sent: Thursday, October 1, 2020 3:48 PM
To: #Building Permit Technicians
Subject: Electrical Permit Application
Attachments: ELC_PermitApp.pdf
Categories: Tina
Caution!This message was sent from outside your organization.
Dear Tigard Government Officials,
Frist, I want to thank you for your dedicated service during the pandemic.
I have attached the filled permit application form. I am not sure if it is the right one or if I have filled it correctly. I rented
an commercial storage unit at Burnham storage(just next to the Tigard city building) and I am trying to get electricity, I
call PGE they said that power on that location hasn't been disconnected for more than 6 months so it needs a city
inspection on the electricity meter before they can connect power. Please let me know if I have the right form for the
permit or inspection.
Thank you very much,
Hang Cai
1
Branden Taggart
From: #Building Permit Technicians
Sent: Thursday, October 8, 2020 2:33 PM
To: 'hang.caipdx@gmail.com'
Subject: RE: Electrical Permit Application
Attachments: ELC_PermitApp.pdf
Hello Hang,
An Electrical permit to reconnect power is needed if the power has been disconnected for 6 months or longer. The
attached application is correct, but since you are not the owner,you will need you to remove your name from the owner
installation section, and sign the "Authorized signature" section at the bottom of the form. Please be sure to print your
name and date the application as well. Furthermore, we will need you to include the job site address on the
application. Please let me know if you have additional questions.
Thank you,
Branden Taggart
N City of Tigard
Senior Permit Technician
Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-orgov
From: Hang Cai <hang.caipdx@gmail.com>
Sent:Thursday, October 1, 2020 3:48 PM
To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: Electrical Permit Application
Caution!This message was sent from outside your organization.
Dear Tigard Government Officials,
Frist, I want to thank you for your dedicated service during the pandemic.
I have attached the filled permit application form. I am not sure if it is the right one or if I have filled it correctly. I rented
an commercial storage unit at Burnham storage (just next to the Tigard city building) and I am trying to get electricity, I
call PGE they said that power on that location hasn't been disconnected for more than 6 months so it needs a city
inspection on the electricity meter before they can connect power. Please let me know if I have the right form for the
permit or inspection.
Thank you very much,
Hang Cai
1