Permit (20) CITY OF TIGARDIli ELECTRICAL PERMIT
1e . COMMUNITY DEVELOPMENT Permit#: ELC2023-00330
T j(A rt,0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/31/2023
Parcel: 2S102DB09600
Jurisdiction: Tigard
Site address: 8803 SW OMARA ST
Project: Tigard Senior Housing Subdivision: TIGARD SENIOR HOUSING Lot: 1
Project Description: Solar photovoltaic system.
Contractor: IMAGINE ENERGY LLC Owner: TIGARD, CITY OF
5506 SE INTERNATIONAL WAY 13125 SW HALL BLVD
MILWAUKIE,OR 97222 TIGARD,OR 97223
PHONE: 503-477-9585 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea 15.01 to 25 kva 05/31/2023 $200.34
Specifics: 1 ea 12%State Surcharge- 05/31/2023 $36.51
Electrical
Type of Use: 14 ea Each additional kva over 25 05/31/2023 $103.88
Class of Work:
Type of Const:
Occupancy Grp:
Total $340.73
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: Ore n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are t forth in OAR
952-001-0010 throuah OAR�2-001, 1-000090. You m v obtai /aJc000�v of the rules or direct auestions to OUNC by callina 503.z321 or j1. 00.332.2344.
Issued By: )c • < �"v Permittee Signature: CJJ/
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 ouTicE I SF;OyIA
City of Tigard Received
Date/B : S / EI C " r
III • 13125 SW Hall Blvd.,Tigard,OR 97223 F Plan Review
I Phone: 503.718.2439 Fax: 503.59 l i(1 " Date/B : Related Permit#:
Inspection Line: 503.639.4175 t t - .. Ready Date/By: ® See Page 2 for
T I G A P.D Internet: www.tigard-or.gov Notified/Method: NM Supplemental Information
TYPE OF WORM AY I Lu43 PLAN REVIE
pp y I
0 New construction Addition/alteration/re lacement Please check all that a (submit 2 sets oftans w/ e checked):
Building
0 Service or feeder 400 amps or more over three stories.
El Demolition El Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CON&A11.41titil4 L114i°lvi'4 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ and 2-family dwelling 0 Commercial/industrial El Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
Multi-family El Master builder 0 Other: ampsfor all other installations. nstdings.
❑Firee pump. 0 Installation of 150 KVA or
JOB SITE_I 't ' . :BON AND LOCATION- 0 Emergency system. larger separately derived
a _ ❑Addition of new motor load of system
Job#: Job site ads s 5).✓ (1 ma r,,t, JT, 100HP or more. ❑"A","E","1-2",°1-s'°,
City/State/ZIP: f l 1 0 Six or more residential units. occupancy.
tj d 0 ❑Health-care facilities. El Recreational vehicle parks.
-�
6L/
0 Supply voltage for more than
Suite/bldg./apt.#: Project name: r`I � 0Hazardous locations.❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 'l✓eSt 0 4 .. j,,/ I4.1.( I?1../(1, FEE SCHEDULE
Ni 04— Description I Qty. I Each I Total
�✓ h�h C. 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 t
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Q a {� (with above sq.ft.)
kW i���� (Lt �t� Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
PROPERTY OWNER 1] TENANT 2
Services orRenewable Energy feeders installation,alteration,❑ SeePage and/or relocation
Name: 7a,5(.` y.i`(I d 200 amps or less 100.70 2
/ 201 amps to 400 amps 133.56 2
Address: •S i 8 C E wi`l 160,61 S+ 401 amps to 600 amps 200.34 2
City/State/ZIP: i I 1,„ v k'� , ® p, 'V A. 601 amps to 1,000 amps 301.04 2
Phone:(S? )65 i-t'`.. COO? )4-, ((5 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: it it l-1 d✓-'Dig 2 v /t T relocation
Owner installation:This installation is being m on prtapf/rty 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 ;,CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Let,r'eabove service or feeder fee,
( I ��`��� f�� each branch circuit 7.42 2
Contact name: G'TCG, L f ,aor fL S B.Fee for branch circuits without
service or feeder fee,first
Address: S 5 0 1 S f.tCr-IA.0,f,:avul,I W I/ branch circuit 56.18 2
City/State/ZIP: s' 92A, Each add'1 branch circuit 7.42 2
M` U-11 V t 0 Miscellaneous(service or feeder not included)
Phone:(5 i('1 ) 'j( _.t 90 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: iit , G, w, A, tv'C- e n6r ✓1C!
•I\C,tti!'✓t S �;/ l � �, Reconnect only 67.84 2
ONTRACT _ Pump or irrigation circle 67.84 2
Business name: TYwr2, me_ I� L . Sign or outline lighting 67.84 2
Address: tj_Su �� ��,( 9 Signal circuit(s)or limited-energy 0 See Page 2 2
(�,YI4C r____ f t ci ilcA t 1 01- y panel,alteration,or extension.
City/State/ZIP: M tI , n Q9��l \ // Each additional inspection over allowable in any of the above
1'v W�t V(�t(i i �i J� oC h Additional inspection(1 hr min) 66.25/hr
Phone:(5 LH ) C 0 —k j -ij Fax:( ) Investigation(1 hr min) 90.00/hr
Email: iq•l4e0-r, S V „ iw,/lve,in e1/ f! , , e'� Industrial plant(1 hr min) 78.18/hr
! Inspections for which no fee is 90.00/hr
CCB Lic.:()t la J`� 63 Electrical Lic.: 7 Suprv.Lic.:_col 11 specifically listed(1/4hr min)
" ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: I Subtotal: , 3 30ti-11,.
✓Print name: ' 4 Date: S Tyzi 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): y Po•5-1
Authorized signature: ila 7 TOTAL PERMIT FEE: P 14
This permit application expires if a permit is not o tained wttt��'n 180
Print name: IA
e -—'i j' e 1, , Date:..5 3/�3 * days after it has been accepted as complete. ,Q 4/4"),'7 2
V 1 ` Number of inspections allowed per permit. y J V ✓
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty, 1 Each I 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
5.01to15kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva f 200.34 zoo,31 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 exc ss of 25 kva:
System* Each additional kva over 25 i'It 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(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):,4,6—y3"
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000) 3z).
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
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015