Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
Ing 2 COMMUNITY DEVELOPMENT Permit#: ELR2022-00083
Date Issued: 8/31/2022
TIGAiR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1 S126DC00901
Jurisdiction: Tigard
Site address: 9650 SW GREENBURG RD
Project: Terrace Glen Apartments-West Building Subdivision: TERRACE GLEN APARTMENTS Lot: None
Project Description: Security and Access Control systems.
Contractor: ASSET PROTECTION PARTNERSHIP LTD Owner: GETHSEMANE EVANGELICAL
PO BOX 349 LUTHERAN CHURCH
FOREST GROVE, OR 97116 9640 SW GREENBURG RD
PORTLAND, OR 97223
PHONE: 503-359-4344 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/08/2022 $150.00
12%State Surcharge-Electrical 08/08/2022 $18.00
Type of Use: MF
Class of Work: ALT
Total Number of Systems: 2
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 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: 1 Other: 1 Total $168.00
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 requir s 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 01.0090. You y obtain a c y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .ef-e, Permittee Signature:
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'N 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 USE ONLY
City o Ti and r Permit#:
`J f g �C'v Received DateB t i . . IIII♦ -. -�R. iL_rG� A-.g 13125 SW Hall Blvd.,Tigard,OR 44 Plan Review
N . Phone: 503.718.2439 Q 22 Date/13 : j)� t ite- - ,�I
Email: TigardBuildingPertnits@Tigard-ot:.[g�. o L Ready Date/By: ® See Page 2 for
I IGARD Inspection Line: 503.639.4175 Internet: www.tigard-orif Notified/Method: — Supplemental Information
TYPE OF WORK ,'}N� I)IV�� PLAN REVIEW
r i Please check all that apply(submt 2 sets fclans w/ite o pms checked):
�ew construction ❑Addition%alteration replacement r/e.
❑Service or feeder 400 amps or more g o zee s
0 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.
❑ I-and 2-family dwelling ❑Commercial/industrial ElAccessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
'Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
65 ^ 6 N ❑Addition of new motor load of system.
Job#: Job site address: (7 G� 1 W `o�f 100HP or more. ❑"A","E","1-2","1-3",
t 0 Six or more residential units. occupancy.
City/State/ZIP: T, / 223 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project namee'rn,n("q e 0 Hazardous locations. 0 Supply voltage for more than
l ( ' ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description 1 Qit. 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 1
DESCRIPTION OF WORK Limited energy,residential
q� i
(with above sq.ft.) 75.00 2
�.(,..�1 f' //`(—1 6 /[)f '-'7 JY — Limited energy,multi-family
3 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: 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:( ) 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 CJ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
,p A.Fee for branch circuits with
Business name: SEA— + P W.,�--N.�. t� above service or feeder fee, 7.42 2
each branch circuit
ontact name: C2e (rIA J ,11 B.Fee for branch circuits without
Address: \ic(9 I branch
service it feederitfee,first 56.18 2
vv circuit
City/State/ZIP: %.C4 C w_ I Q W/- 11 6 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
I Phone: ) Q'7( —2 G 9" e 7 Each manufactured or modular 67.84 2
r I ���� Ali^' '\ Reconnect
dwelling, nlice and/or feeder
Z Email: Jt/ T{J only 67.84 2
�l`t CONT CTO (,� ,� Pump or irrigation circle 67.84 2
Business name: A654-- fp Pch� .1.5,fZ,�(�1_� 0 Sign or outline lighting 67.84 2
f .�'I tt"""rr __ (I Signal Meru t(s)or limited-energy ''Page 2 2
.. Address: 1'"1 2... I .61 e panel,alteration,or extension. "
1 n^ /( Each additionalp insection over allowable in any of the above
City/State/ZIP: 'ff- "' r'] [tic,. Additional inspection(1 hr min 66.25/hr
Phone:( ) I v, Investigation(1 hr min) 90.00/hr
`VVV r r I Industrial plant(1 hr min) 78.18/hr
Email: � x l ^^^}}},,, Inspections for which no fee is
CCB Lie.: Mist- Electrical Lic.: l • Sup .'Lic.: J specifically listed(t4 hr min) 90.00/hr
�Un ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: •
y Subtotal: /517, "4'
Print name: o i hP� S LL�,�.k Date: D r /j2 Z ❑Plan Review Required(25%of permit fee):
48,,,
` State surcharge(12%of permit fee): �� `�iAuthorized si nature: TOTAL PERMIT FEE: G(6,D..1�/'
1 �l This permit application expires if a permit is not obtained within 180
Print name: ` -0 k� 1�J l Date: �._ r+�J� t� days after it has been accepted as complete.
_I * Number of inspections allowed per permit.
1:'/Builddvg'Permits'.ELC_PermitApp_ELR_ERE.doc Rev I0/262017 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: FEE SCHEDULE
Fee for all residential systems *
Renewable combined: $75.00 Descrip11on I Qty. Ench Total I
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:
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
El Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
ElOther: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Y hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
. Number of inspections allowed per pennit.
(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
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
Vi Other: grrs.kr - Qe.lp -2fa,S/ a�CC�S Cor•r -
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:03uilding'Permits`ELC_PermitApp_ELR_ERE.doc Rev 10/262017