Permit (9) CITY OF TIGARD ELECTRICAL PERMIT
111 ," ' COMMUNITY DEVELOPMENT Permit#: ELC2023-00600
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2023
Parcel: 2S110DB01300
Jurisdiction: Tigard
Site address: 15298 SW ROYALTY PKWY
Project: EyeHealth Northwest Subdivision: 1996-010 PARTITION PLAT Lot: 2
Project Description: (24)branch circuits and low voltage for medical system.
Contractor: TIMBERLINE ELECTRICAL CONTRACTORS Owner: TIGARD INVESTMENT PROPERTIES LLC
PO BOX 918 11086 SE OAK ST
LAKE OSWEGO, OR 97035 MILWAUKIE, OR 97222
PHONE: 503-459-4089 PHONE:
FAX: 503-254-4227
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 10/17/2023 $56.18
Specifics: Service or Feeder
Type of Use: COM 23 crt Branch Circuits w/Purchase 10/17/2023 $170.66
Service or Feeder
Class of Work: ALT 1 ea Limited Energy 10/17/2023 $75.00
Type of Const: 1 ea Plan Review Electricial 10/17/2023
$75.46
Occupancy Grp: 1 ea 12%State Surcharge- 10/17/2023 $36.22
Electrical
Total $413.52
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 is nce, r if wok is suspended for more the
180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification` en r. T e r ales €r set forth in OAR
952-001-0010 through O 952-001-0090. You may obtain of the rules or direct;:::::::::ell0
503.232. 7 r 1. 024.: ��JJ
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—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
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Description I Qty. I Each Total
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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
0 Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 I 7.42 3
O 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 inin)
Inspections for which no fee is 90.00/hr
syecihca1l listed
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Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
O Data Telecommunication Installation
O Fire Alarm Installation
❑ HVAC
0 Instrumentation
❑ Intercom and Paging Systems
O Landscape Irrigation Control*
is Medical
0 Nurse Calls
O 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