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Permit CITY OF TIGARD ELECTRICAL PERMIT 14 s ' COMMUNITY DEVELOPMENT Permit#: ELC2023-00607 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2023 Parcel: 1S135AB01003 Jurisdiction: Tigard Site address: 10300 SW GREENBURG RD 180 Project: Heritage Bank Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Install(20)circuits for TI. Contractor: URBAN ELECTRIC COMPANY LLC Owner: LINCOLN CENTER LLC PO BOX 822405 BY SHORENSTEIN PROPERTIES LLC VANCOUVER,WA 98662 235 MONTGOMERY ST, 16TH FLOOR SAN FRANCISCO,CA 94104 PHONE: (360)606-2674 PHONE: FAX: FEES Quantity Description Date Amount 20 crl Branch Circuits wo/Purchase 10/11/2023 $197.16 Specifics: Service or Feeder 1 ea 12%State Surcharge- 10/11/2023 $23.66 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $220.82 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 952-001-009 . You mavCcbtajp�a coov o(the rules or direct Questions to OUNC by callina 503.232.1987 or 1.800.332.2344. ��'��,��'ppp Issued By: r Permittee Signature: Gr l`� 'O !i'7 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 dale. 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 A licatio ECEI V ED FOR OFFICE USE ONLY 11111 City of Tigard Received • 13125 SW Hall Blvd.,Ti ard,OR 97223 OCT 1 1 2023 Date/B : o Pemut":�(��b- (�ObC' g Plan Review a Phone: 503.718.2439 Fax: 503.598.196 Date : Related Permit#: Inspection Line: 503.639.4175 ITY OF TI GAND Ready DateBy: ruris: HI See Page 2 for T I GA 11 D Internet: www.tigard-or.gov 6UILDING DIVISION Notified/Method: (O (( , 3�. Supplemental Information 'TYPE'OF-WORK avi4-01 w01''21OPLAN 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 ❑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 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Multi-familyMaster builderamps for all other installations. buildings. ❑ ❑ 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 10300 SW Greenbur RD ❑Addition of new motor load of system. g 100HP or more. ❑"A" "E" "1-2""1-3" City/State/ZIP: Tigard,OR 97223 ❑Six or more residential units. occupancy. ❑Health-care facilities_ 0 Recreational vehicle parks. Suite/bldg./apt.#: 180 Project name: Heritage Bank TI 0 Hazardous locations. 0 Supply voltage for more than D 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: Lot#: 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 Install 20 New Circuits For New Tenant Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 0 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:( ) 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 0 APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without service or feeder fee,first I 56 18 s61s 2 Address: branch circuit City/State/ZIP: Each add'l branch circuit 19 7.42 140.98 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: • Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Urban Electric Company LLC Sign or outline lighting 67.84 2 Address: PO Box 822405 Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP: Vancouver,WA 98662 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25'hr Phone:( 360 ) 606-2674 Fax:( ) Investigation(I hr min) 90.001 hr Email: igor@urbanelectricalco.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 224562 Electrical Lie.: C1439 Suprv.Lie.: 6349S specifically listed('/i hr min) ?,- .- ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: /d�✓X Subtotal: 197.16 Print name: Igor Tkachuk Date: 10/9/2023 ❑Plan Review Required(25%of permit fee): 49.29 State surcharge(12%of permit fee): 23.66 Authorized signature: TOTAL PERMIT FEE: 270.11 This permit application expires if a permit is not obtained within 180 Print name: Igor Tkachuk Date: 10/9/2023 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-46157 I1/05/COM/4F.B Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: _FEE SCHEDULE Description Qtv. Each Total I " Fee for all residential systems combined: $75.00 Renewable 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 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(I hr min) Inspections for which no fee is 90 00/hr specifically listed(''i hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1). Fee for each commercial system: $75.00 " Number of aspectleas 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 ❑ 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:\Baddig\Permits\ELC PermitApp ELR_ERE.doc Rev 06l17/2015