Permit CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit#: ELC2023-00518
TI GA R.L7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/29/2023
Parcel: 2S102BC00701
Jurisdiction: Tigard
Site address: 10135 SW WALNUT ST
Project: Ramos Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 5
Project Description: Reconnect only.
Contractor: Owner: HPA II BORROWER 2020-1 LLC
120 S RIVERSIDE PLAZA STE 2000
CHICAGO, IL 60606
PHONE:
PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 08/29/2023 $67.84
Specifics:
1 ea 12%State Surcharge- 08/29/2023 $8.14
Electrical
Type of Use: SF
Class of Work: OTR
Type of Const:
Occupancy Grp:
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 approvedplans. Thispermit will expire if work is not started within 180 days of issuance, or if work is suspended for more the
PP P Y P
180 days. ATTENTION: law requires yo to follow the rules adopted by the Oregon Utility Notification nter. Those rules are set forth in OAR
952-001-0010 throua R 001-0090,-you in a coov of the rules or direct auestions to OUNC by calling 503.232. 7 or 1.800.332.2344.
Issued By: l/2'+-;—' Permittee Signature: _ ------Si;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 ApplicaRECEIVED I(At OFFICE USE ONE y
. City of Tigard Received
JG 2 9 2023 DateB t� loll�: Q.
loll • n Perm t# Lfi
E C 2 [s0SI8"
11111 ° 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 G Related Permit#
Date/By:
FX ,:,ORI7 Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: lnris. ® See Page 2 for
. Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
•
New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition OtheC: ❑Service or feeder 400 amps or more 0 Building over three stories.Lia
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
®Multi-family0 Master bllildeC amps for all other installations. buildings.
❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: 10 3 S u/ t r t_ ❑Addition of new motor load of system.
W Q l M c 1 100FIP or more. (]..A» •`E., "1 2„`•l_J,>
City/State/ZIP: I-1) Vd 0 7^ El..2-
or more residential units. occupancy.
.Z 3 ❑Health-care facilities. parks.
Suile/bld /a t.#: 0 Supply voltage for more than
g• 1> Project name: ❑Hazardous locations.
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description j Qtr. 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'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
R[GDN Pat C / /qer 'tr (with above sq.ft.) 75.00 2
J 1 Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
II PROPERTY OWNER 0 TENANT
Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
p
Name: l t.%4 v( (,A/ le.p,MA 0 200 amps or less 100.70 2
Address: 0,135 $N1 vapk, l W t/;' S.1,' 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 1-C elli aca 0g cl 7�a,..3 601 amps to 1,000 amps 301.04 2
Phone:I T I ) 3, ', AGl Lib Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: "ANAh6 W p re w►1 te Y " w a r k 3 . vv..a' relocation
Owner installation: •S installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease, or exchan ing to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: `ti/2• /9.3 401 amps o 599 amps 168.54 2
`a APPLI ANT ®'CONTACT• PERSON Branch circuits-new,alteration,or extension,per panel
Business name: - A.Fee for branch circuits with
pee v 6rks aboveserviceorfeederfee,
each branch circuit 7.42
Contact name: A.n d B.Fee for branch circuits without
•
Address: io/5��t5 C�W vJ�fti•v f' S branch service ucuedder fee,first 56.18
City/State/ZIP: 'r•11it/G' tig 7 n 2 Each add'I branch circuit 7.42 2
!! �r ^1 ` I� , Miscellaneous(service or feeder not included)
Phone:(ij Ti) 3 3 l< • p m (� p FIDC ;( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
CONTRACTOR Reconnect only ' 67.84 2
%1 1- , Pump or irrigation circle 67.84 2 •
Business name: Pre tom^rti/ ry (f Y4j Sign or outline lighting 67.84 2
e Signal circuit(s)or limited-energy See Page 2 2
Address: -jy-' /l�^o/ ,/e f/� 1 tvA ,t Ll panel,alteration,or extension. 0 g
City/State/ZIP: Vay.,e�vet W4 r/ 4!1�/'`ti r Each additional inspection over allowable in any of the above
IV Y - Additional inspection(1 hr rein) 66.25/hr
Phone:(Sp3) 7 S(/ 'j o 3 Fax:( ) Investigation(l hr min) 90.00/hr
Email: drew f vim✓ - Industrial plant(I lir min) 78.18/hr
i1 �j I ,I� Inspections for which no fee is
CCB tic.: 'a,��(/j/ Electrical Lie.: // IV Suprv.Lic.: specifically listed('/,hr min) 90.00/hr
ELECTRICAL PERMIT FEES
S�prv.Electrician signature,required: Subtotal:
"'rint name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signatur • TOTAL PERMIT FEE:
Print name: it,1 n `" l Ye• /r
Z ((/ This permit application expires if a permit is not obtained within 180
ovah/ D I z 3 rm days after it has been accepted as complete.
* Number of inspections allowed per permit.
I'.\Budding\Permits'ELC_PernetApp ELR_ERF,.doc Rev 06/17/2015 440-4615T(l1/05/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
Description [ Qty. I Each I Total I "
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
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._6 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90 00/hr
specifically listed(%a 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
❑ Fire Alarm Installation
El HVAC
El Instrumentation
❑ Intercom and Paging Systems
Cl 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
I'.�Building\Permits iELC PermitApp_ELR_ERE.doc Rev 06/17/2015